Spine Implant Market Size and Share
Market Definition
Hardware to treat degenerative disc disease, herniated discs, scoliosis and vertebral fractures.
April 2025
Mike Evers, Senior Market Analyst
Welcome to our spine implant market report, a companion to the spine chapter in THE ORTHOPAEDIC INDUSTRY ANNUAL REPORT®. The competitive landscape has shifted dramatically in recent quarters, and we anticipate more changes.
The Market at a Glance
Spine has highly favorable patient demographics, but the segment’s competitive dynamics are undergoing significant change.
As the rate of innovation slows around highly commoditized implants, large companies are turning to digital technology ecosystems to improve spine surgery outcomes and defend highly valuable market share. Spine accounts for over 17% of global orthopedic sales with $10.8 billion in revenue.
Market Forecast
According to our estimates, the spine segment generated $10.8 billion in sales in 2024 and will grow to $12.3 billion in worldwide sales by 2028. Favorable demographics, short-term headwinds and improved technology informed our forecast.
Exhibit 1: Worldwide Spine Sales by Year ($millions)
Get More Orthopedic Market Data. Download the Orthopedic Companies Sales Matrix for our most complete and granular numbers. It contains worldwide orthopedic sales for 75 public and private companies by segment from 2016 through 2024.
Here are some of the spine market dynamics we considered in our forecasts:
Accelerating Demand for Care. Spine’s surgical volumes will increase as the global population grows and ages. The number of people aged 60 or older will double between 2020 and 2050, from one billion to 2.1 billion. Back pain affects one in 10 people globally and is the primary cause of disability in the U.S., costing the government $560 billion annually due to treatment expenses and productivity loss. Spine companies seek ways to improve the efficiency and accuracy of treatment without ballooning the costs of care.
Spine’s Slow Inroads into the ASC. Open surgery accounts for about 80% of spine procedures, not an ideal fit for outpatient settings. While higher acuity surgeries will remain at hospitals, certain lumbar and cervical procedures are becoming more common in the ASC. Improving technology and adoption of MIS techniques will accelerate the shift to ASC settings in the coming years, adding more pressure for efficient and cost-effective care. This trend currently favors smaller spine companies with portfolios that target specific procedures and offer efficient implant and instrument systems. However, the market’s largest players are eyeing the ASC market and will likely win a percentage share in the future.
Short-term Headwinds, Long-term Acceleration. The rapidly shifting competitive landscape of the spine market, economic uncertainty in the United States., VBP in China and supply challenges will remain headwinds through 2025. However, demographic trends and better surgical outcomes stemming from innovative technologies will likely push the market’s growth comfortably into the 3% to 4% range.
Sales by Region
Short-term headwinds like VBP and macroeconomic disruption impacted the growth rate of sales in Asia-Pacific countries. Many of those headwinds will remain in play for 2025. But, overall, markets outside the United States represent a compelling opportunity for many spine companies as consolidation changes the competitive landscape.
Globus Medical is in the beginning stages of ramping up its combined international Globus/NuVasive offering and saw strength in Western Europe and Japan in 2024. The company called its international growth “virtually untapped.” Likewise, ATEC’s targeted approach outside the United States saw success in Australia and New Zealand. The company is also very bullish on its prospects in Japan for 2025 and beyond.
Exhibit 2: Spine Sales by Region ($millions)
| Region | FY24 | FY23 | $ Chg | % Chg |
|---|---|---|---|---|
| US | $7,637.1 | $7,361.7 | $275.4 | 3.7% |
| OUS | $3,149.8 | $3,050.9 | $98.9 | 3.2% |
| EMEA | $1,790.6 | $1,707.7 | $83.0 | 4.9% |
| APAC | $1,057.1 | $1,051.7 | $5.4 | 0.5% |
| ROW | $302.0 | $291.6 | $10.5 | 3.6% |
| Total | $10,786.9 | $10,412.6 | $374.3 | 3.6% |
Exhibit 3: Spine Market Share by Region ($millions)
Top Companies
Medtronic and Globus Medical are the only two spine companies with double-digit market share. Combined they account for 42% of global spine sales.
The top five players generate 62% of all spine sales. Stryker divested its spinal implant business to VB Spine in early 2025, meaning two of the top six largest spine companies are now privately held.
Exhibit 4: Top 10 Spine Players and All Others ($millions)
| Company | FY24 | FY23 | $ Chg | % Chg |
|---|---|---|---|---|
| Medtronic | $2,400.6 | $2,297.3 | $103.3 | 4.5% |
| Globus Medical | $2,126.7 | $2,032.2 | $94.5 | 4.6% |
| J&J MedTech | $934.1 | $944.0 | ($9.9) | (1%) |
| Stryker | $707.0 | $713.0 | ($6.0) | (0.8%) |
| ATEC | $492.9 | $377.6 | $115.3 | 30.5% |
| Highridge Medical | $343.5 | $323.8 | $19.8 | 6.1% |
| Orthofix | $285.9 | $266.3 | $19.6 | 7.4% |
| SI-BONE | $167.2 | $138.9 | $28.3 | 20.4% |
| ulrich medical | $156.5 | $148.2 | $8.3 | 5.6% |
| Aesculap | $153.9 | $159.5 | ($5.6) | (3.5%) |
| All Others | $3,018.4 | $3,011.6 | $6.7 | 0.2% |
| Total | $10,786.9 | $10,412.6 | $374.3 | 3.6% |
Exhibit 5: Spine Market Share by Company ($millions)
Spine is a two-horse race between Medtronic and Globus Medical. It is no coincidence that those two companies field the segment’s most fully fledged robotics and technology ecosystems. Whatever else may be true of technology in orthopedics, it is having a profound effect on the competitive dynamics at the top of the spine market.
In the spine’s mid-tier, Johnson & Johnson MedTech’s business hasn’t grown much in years. VB Spine, freshly invested with over $700 million of Stryker implant sales, could shake things up moving forward. However, both companies must contend with the ongoing, rapid ascent of ATEC, which should eclipse the $730 million mark this year and hit $1 billion in sales by 2027. ATEC’s spine-focused approach and growing technology portfolio make it a strong contender to move into the segments’s top tier.
Companies like SI-BONE and Centinel Spine, which focus on the sacroiliac joint and total disc replacement, respectively, have been rewarded for their specialization. We believe smaller companies will find higher growth potential by focusing on niche indications.
Important Developments in the Spine Market
Longtail Disruption. While overall M&A activity has slowed significantly, spine still provided some of the most consequential deals in the orthopedic industry’s recent history. Globus Medical and Orthofix shook up the market with their mergers (NuVasive and SeaSpine, respectively), privately held Highridge Medical emerged out of ZimVie’s spine assets and VB Spine purchased Stryker’s implant business. Impacts from those moves will play out over several years. But, judging from executive commentary, the disruption isn’t a one-way street. Several companies sounded bullish on competitive employee recruiting within the upended spine market.
Technology Shifting Competitive Dynamics. Scale alone is no longer enough to compete at the top levels of spine. Enabling technology’s role is expanding across orthopedics and has become a strategic necessity for spine’s biggest players. Mid-tier companies like Orthofix and ATEC recognize the value of technology in spine surgery, while AR-based navigation technology from companies like Augmedics and OnPoint Surgical continues to draw investor dollars despite the tough funding environment. One of the biggest takeaways from Stryker’s divestment, which does not include the newly FDA 510(k) cleared Mako Robot, is that companies can’t focus on only one differentiating solution to compete at the top of the spine market. They need a strong, cohesive ecosystem of technology, implants and supporting products.
Smaller Players Developing Breakthrough Devices. Nearly 29% of all orthopedic investments made since 2016 went to spine companies. The next highest category is enabling technology, a segment with significant spine overlap, at 19%. Despite a challenging funding environment, spine is on pace for its second-highest funding volume in nearly a decade. Companies like Bioretec, Canary Medical, MiRus, ORTHOSON and Renovos received FDA Breakthrough Device Designations in 2024, joining Carlsmed and Premia Spine as recent designees. Time will tell if the market will reward companies innovating with materials, sensors and personalized approaches to spinal repair.
Further Reading
Thanks for visiting! Need more insight on the spine market? Questions and comments are always welcome. You can reach me by email. Until then, I’ve selected a few posts that give insight into our thinking on the spine market.
March 28, 2025
,
Carolyn LaWell
January 13, 2025
,
Carolyn LaWell
Our overview of the $10.8 billion spine implant market includes up-to-date information on forecasted growth, the top companies and industry-driving trends.
Market Definition
Hardware to treat degenerative disc disease, herniated discs, scoliosis and vertebral fractures.
April 2025
Mike Evers, Senior Market Analyst
Welcome to our spine implant market report, a companion to the spine chapter in THE ORTHOPAEDIC INDUSTRY ANNUAL REPORT®. The competitive landscape has shifted dramatically in recent quarters, and we anticipate more changes.
The Market at a Glance
Spine has highly favorable patient demographics, but the segment’s competitive dynamics are undergoing significant change.
As the rate of innovation slows around highly commoditized implants, large companies are turning to digital technology ecosystems to improve spine surgery outcomes and defend highly valuable market share. Spine accounts for over 17% of global orthopedic sales with $10.8 billion in revenue.
Market Forecast
According to our estimates, the spine segment generated $10.8 billion in sales in 2024 and will grow to $12.3 billion in worldwide sales by 2028. Favorable demographics, short-term headwinds and improved technology informed our forecast.
Exhibit 1: Worldwide Spine Sales by Year ($millions)
Get More Orthopedic Market Data. Download the Orthopedic Companies Sales Matrix for our most complete and granular numbers. It contains worldwide orthopedic sales for 75 public and private companies by segment from 2016 through 2024.
Here are some of the spine market dynamics we considered in our forecasts:
Accelerating Demand for Care. Spine’s surgical volumes will increase as the global population grows and ages. The number of people aged 60 or older will double between 2020 and 2050, from one billion to 2.1 billion. Back pain affects one in 10 people globally and is the primary cause of disability in the U.S., costing the government $560 billion annually due to treatment expenses and productivity loss. Spine companies seek ways to improve the efficiency and accuracy of treatment without ballooning the costs of care.
Spine’s Slow Inroads into the ASC. Open surgery accounts for about 80% of spine procedures, not an ideal fit for outpatient settings. While higher acuity surgeries will remain at hospitals, certain lumbar and cervical procedures are becoming more common in the ASC. Improving technology and adoption of MIS techniques will accelerate the shift to ASC settings in the coming years, adding more pressure for efficient and cost-effective care. This trend currently favors smaller spine companies with portfolios that target specific procedures and offer efficient implant and instrument systems. However, the market’s largest players are eyeing the ASC market and will likely win a percentage share in the future.
Short-term Headwinds, Long-term Acceleration. The rapidly shifting competitive landscape of the spine market, economic uncertainty in the United States., VBP in China and supply challenges will remain headwinds through 2025. However, demographic trends and better surgical outcomes stemming from innovative technologies will likely push the market’s growth comfortably into the 3% to 4% range.
Sales by Region
Short-term headwinds like VBP and macroeconomic disruption impacted the growth rate of sales in Asia-Pacific countries. Many of those headwinds will remain in play for 2025. But, overall, markets outside the United States represent a compelling opportunity for many spine companies as consolidation changes the competitive landscape.
Globus Medical is in the beginning stages of ramping up its combined international Globus/NuVasive offering and saw strength in Western Europe and Japan in 2024. The company called its international growth “virtually untapped.” Likewise, ATEC’s targeted approach outside the United States saw success in Australia and New Zealand. The company is also very bullish on its prospects in Japan for 2025 and beyond.
Exhibit 2: Spine Sales by Region ($millions)
| Region | FY24 | FY23 | $ Chg | % Chg |
|---|---|---|---|---|
| US | $7,637.1 | $7,361.7 | $275.4 | 3.7% |
| OUS | $3,149.8 | $3,050.9 | $98.9 | 3.2% |
| EMEA | $1,790.6 | $1,707.7 | $83.0 | 4.9% |
| APAC | $1,057.1 | $1,051.7 | $5.4 | 0.5% |
| ROW | $302.0 | $291.6 | $10.5 | 3.6% |
| Total | $10,786.9 | $10,412.6 | $374.3 | 3.6% |
Exhibit 3: Spine Market Share by Region ($millions)
Top Companies
Medtronic and Globus Medical are the only two spine companies with double-digit market share. Combined they account for 42% of global spine sales.
The top five players generate 62% of all spine sales. Stryker divested its spinal implant business to VB Spine in early 2025, meaning two of the top six largest spine companies are now privately held.
Exhibit 4: Top 10 Spine Players and All Others ($millions)
| Company | FY24 | FY23 | $ Chg | % Chg |
|---|---|---|---|---|
| Medtronic | $2,400.6 | $2,297.3 | $103.3 | 4.5% |
| Globus Medical | $2,126.7 | $2,032.2 | $94.5 | 4.6% |
| J&J MedTech | $934.1 | $944.0 | ($9.9) | (1%) |
| Stryker | $707.0 | $713.0 | ($6.0) | (0.8%) |
| ATEC | $492.9 | $377.6 | $115.3 | 30.5% |
| Highridge Medical | $343.5 | $323.8 | $19.8 | 6.1% |
| Orthofix | $285.9 | $266.3 | $19.6 | 7.4% |
| SI-BONE | $167.2 | $138.9 | $28.3 | 20.4% |
| ulrich medical | $156.5 | $148.2 | $8.3 | 5.6% |
| Aesculap | $153.9 | $159.5 | ($5.6) | (3.5%) |
| All Others | $3,018.4 | $3,011.6 | $6.7 | 0.2% |
| Total | $10,786.9 | $10,412.6 | $374.3 | 3.6% |
Exhibit 5: Spine Market Share by Company ($millions)
Spine is a two-horse race between Medtronic and Globus Medical. It is no coincidence that those two companies field the segment’s most fully fledged robotics and technology ecosystems. Whatever else may be true of technology in orthopedics, it is having a profound effect on the competitive dynamics at the top of the spine market.
In the spine’s mid-tier, Johnson & Johnson MedTech’s business hasn’t grown much in years. VB Spine, freshly invested with over $700 million of Stryker implant sales, could shake things up moving forward. However, both companies must contend with the ongoing, rapid ascent of ATEC, which should eclipse the $730 million mark this year and hit $1 billion in sales by 2027. ATEC’s spine-focused approach and growing technology portfolio make it a strong contender to move into the segments’s top tier.
Companies like SI-BONE and Centinel Spine, which focus on the sacroiliac joint and total disc replacement, respectively, have been rewarded for their specialization. We believe smaller companies will find higher growth potential by focusing on niche indications.
Important Developments in the Spine Market
Longtail Disruption. While overall M&A activity has slowed significantly, spine still provided some of the most consequential deals in the orthopedic industry’s recent history. Globus Medical and Orthofix shook up the market with their mergers (NuVasive and SeaSpine, respectively), privately held Highridge Medical emerged out of ZimVie’s spine assets and VB Spine purchased Stryker’s implant business. Impacts from those moves will play out over several years. But, judging from executive commentary, the disruption isn’t a one-way street. Several companies sounded bullish on competitive employee recruiting within the upended spine market.
Technology Shifting Competitive Dynamics. Scale alone is no longer enough to compete at the top levels of spine. Enabling technology’s role is expanding across orthopedics and has become a strategic necessity for spine’s biggest players. Mid-tier companies like Orthofix and ATEC recognize the value of technology in spine surgery, while AR-based navigation technology from companies like Augmedics and OnPoint Surgical continues to draw investor dollars despite the tough funding environment. One of the biggest takeaways from Stryker’s divestment, which does not include the newly FDA 510(k) cleared Mako Robot, is that companies can’t focus on only one differentiating solution to compete at the top of the spine market. They need a strong, cohesive ecosystem of technology, implants and supporting products.
Smaller Players Developing Breakthrough Devices. Nearly 29% of all orthopedic investments made since 2016 went to spine companies. The next highest category is enabling technology, a segment with significant spine overlap, at 19%. Despite a challenging funding environment, spine is on pace for its second-highest funding volume in nearly a decade. Companies like Bioretec, Canary Medical, MiRus, ORTHOSON and Renovos received FDA Breakthrough Device Designations in 2024, joining Carlsmed and Premia Spine as recent designees. Time will tell if the market will reward companies innovating with materials, sensors and personalized approaches to spinal repair.
Further Reading
Thanks for visiting! Need more insight on the spine market? Questions and comments are always welcome. You can reach me by email. Until then, I’ve selected a few posts that give insight into our thinking on the spine market.
March 28, 2025
,
Carolyn LaWell
January 13, 2025
,
Carolyn LaWell
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