Copy to clipboard 
The spine market is healthy and expected to continue to be for some time as procedure volumes increase and new technology enters the market. That was the response we heard from spine companies at the North American Spine Society (NASS) Annual Meeting.
We estimated that worldwide spine sales grew 5.5% to $10.4 billion in 2023 and would grow about 4% in 2024. Executives from top-tier companies echoed those numbers, saying that procedure volumes and supply chains have become more predictable and sales will maintain in the mid-single digits for the next few years.
“The pent-up procedure demand post-Covid has normalized,” said Skip Kiil, President of Cranial and Spinal Technologies at Medtronic. “The technology adoption curve has flattened out the opportunity for surgical candidates. We’re going to see a durable market, which is exciting because spine was a low-growth, no-growth space for years. We need to bring data and technology into the workplace and in partnership and collaboration with surgeons who are delivering quality care.”
Mr. Kiil said companies must drive innovation in enabling technologies and implants — it’s not an either/or situation — and products must provide value for surgeons and patients. As the largest player in spine, Medtronic has touted its expansive portfolio for years. It was evident at NASS that medium and small companies believe they too need enabling technology to compete in today’s spine market.
Implanet Forms Partnerships to Build Tech Portfolio
Implanet is a French company known for its Jazz Platform. The company achieved revenue of $8.1 million in 2023 and is making a significant push to grow its presence in the U.S. At NASS, the company announced a U.S. distribution agreement that allows elliquence to sell Implanet’s Olea, an ultrasonic bone scalpel for endoscopic spine surgery, as well as a co-marketing agreement with 8i Robotics, a pre-market startup with a next-generation two-arm robotic system.
“Implanet was a niche company in the past,” said Max Painter, Vice President and General Manager of Implanet America. “Moving forward, we’re going to be a cutting-edge company that’s got the best in robotics through our partnership with 8i, and our ultrasonic scalpel is taking market share. We’re also launching a full spine line to go hand-in-hand with our technology.”
Mr. Painter said the company’s future is in the U.S. and Canada. Implanet is setting up a distribution center in Memphis and will begin a year-plus product launch initiative starting in the fourth quarter of 2024. As a small company, enabling technology will play a vital role in growing its presence, he said.
“Surgeons don’t want to waste time,” Mr. Painter said. “They’re tired of me-too products, want to make smaller incisions and use top-notch navigation or robotic systems.”
Orthofix Leverages 7D Navigation System
Orthofix welcomed new leadership this year, including company President and CEO Massimo Calafiore and President of Global Spine Max Reinhardt. They said that spine companies must have highly differentiated enabling technology to drive sales, and Orthofix has that in its 7D Flash Navigation System. Orthofix ended 2023 with $266.3 million in spine revenue and enabling technology is behind its strong growth in 2024.
“Our 7D Navigation System is at the center of our innovation agenda,” Mr. Reinhardt said. “Its unique functionality gives us an opportunity to play in the deformity space, which is the most complex spinal segment. Adult deformity patients face a 30% reoperation rate. We’re facing the toughest challenges by coupling our enabling technology with our comprehensive portfolio. Fusion is important for patients with comorbidities, so we also bring strength with our biologics and bone growth therapies.”
Mr. Calafiore said spine surgeons indicate that they want to use enabling technology. To gain adoption, technology must create value in the operating room through decreased radiation, quick registration and increased procedural proficiency. He noted that enabling technology will play an important role in problem-solving for ways to improve patient outcomes.
“I’m excited about the innovation opportunities in enabling technologies,” Mr. Reinhardt said. “Tying that innovation together with meaningful progress and implant instrumentation to make an ecosystem is important. We’re thinking about how we combine these technologies to enable bone healing.”
Medtronic Expands AiBLE Ecosystem
Medtronic’s AiBLE platform is an ecosystem of navigation, robotics, data and AI, imaging, software and implants. The company launched AiBLE to integrate technology in a way that provides more predictable outcomes. Medtronic leadership said their focus on enabling technology is changing the competitive landscape in spine. The company finished fiscal year 2024 with $2.4 billion in spine sales.
At NASS, Medtronic announced a global partnership to comarket the Siemens Healthineers Multitom Rax imaging system. The system allows for standing, weight-bearing imaging, cone-beam CT and supine X-ray capabilities and provides an additional preoperative component to AiBLE.
“We’re looking at the continuum of care for patients — where does it begin and where does it end,” said Michael Carter, Vice President and General Manager of Medtronic Spine and Biologics. “There was a gap with preoperative scanning. We’re continually thinking about where else we can go with the AiBLE system.”
Mr. Carter said the aim with AiBLE is that the data will provide insight to assist surgeon decision making and ultimately decrease the variability in patient outcomes.
“A third of our industry is small companies focused on the metal side of the business,” Mr. Kiil said. “Our perspective is that there’s not a lot of utility in that. It’s an ‘and’ conversation. You need enabling technology and it can’t just be navigation or robotics. It’s a combination of AI, big data and machine learning with the utility of a robot, navigation and an imaging device.”
These are just three examples of companies touting the need for enabling technology. We spoke with Johnson & Johnson MedTech about VELYS Spine, Stryker about Spine Guidance 5 Software featuring Copilot and Highridge Medical about future additions to their enabling technology portfolio. Further, the NASS exhibit hall featured numerous companies focused on open navigation and robotic platforms.
While the enabling technology market is small, just $1.3 billion in 2023 for all of orthopedics, spine companies of all sizes are betting it will give them the leverage they need to grow their business.
The spine market is healthy and expected to continue to be for some time as procedure volumes increase and new technology enters the market. That was the response we heard from spine companies at the North American Spine Society (NASS) Annual Meeting.
We estimated that worldwide spine sales grew 5.5% to $10.4 billion in 2023 and would...
The spine market is healthy and expected to continue to be for some time as procedure volumes increase and new technology enters the market. That was the response we heard from spine companies at the North American Spine Society (NASS) Annual Meeting.
We estimated that worldwide spine sales grew 5.5% to $10.4 billion in 2023 and would grow about 4% in 2024. Executives from top-tier companies echoed those numbers, saying that procedure volumes and supply chains have become more predictable and sales will maintain in the mid-single digits for the next few years.
“The pent-up procedure demand post-Covid has normalized,” said Skip Kiil, President of Cranial and Spinal Technologies at Medtronic. “The technology adoption curve has flattened out the opportunity for surgical candidates. We’re going to see a durable market, which is exciting because spine was a low-growth, no-growth space for years. We need to bring data and technology into the workplace and in partnership and collaboration with surgeons who are delivering quality care.”
Mr. Kiil said companies must drive innovation in enabling technologies and implants — it’s not an either/or situation — and products must provide value for surgeons and patients. As the largest player in spine, Medtronic has touted its expansive portfolio for years. It was evident at NASS that medium and small companies believe they too need enabling technology to compete in today’s spine market.
Implanet Forms Partnerships to Build Tech Portfolio
Implanet is a French company known for its Jazz Platform. The company achieved revenue of $8.1 million in 2023 and is making a significant push to grow its presence in the U.S. At NASS, the company announced a U.S. distribution agreement that allows elliquence to sell Implanet’s Olea, an ultrasonic bone scalpel for endoscopic spine surgery, as well as a co-marketing agreement with 8i Robotics, a pre-market startup with a next-generation two-arm robotic system.
“Implanet was a niche company in the past,” said Max Painter, Vice President and General Manager of Implanet America. “Moving forward, we’re going to be a cutting-edge company that’s got the best in robotics through our partnership with 8i, and our ultrasonic scalpel is taking market share. We’re also launching a full spine line to go hand-in-hand with our technology.”
Mr. Painter said the company’s future is in the U.S. and Canada. Implanet is setting up a distribution center in Memphis and will begin a year-plus product launch initiative starting in the fourth quarter of 2024. As a small company, enabling technology will play a vital role in growing its presence, he said.
“Surgeons don’t want to waste time,” Mr. Painter said. “They’re tired of me-too products, want to make smaller incisions and use top-notch navigation or robotic systems.”
Orthofix Leverages 7D Navigation System
Orthofix welcomed new leadership this year, including company President and CEO Massimo Calafiore and President of Global Spine Max Reinhardt. They said that spine companies must have highly differentiated enabling technology to drive sales, and Orthofix has that in its 7D Flash Navigation System. Orthofix ended 2023 with $266.3 million in spine revenue and enabling technology is behind its strong growth in 2024.
“Our 7D Navigation System is at the center of our innovation agenda,” Mr. Reinhardt said. “Its unique functionality gives us an opportunity to play in the deformity space, which is the most complex spinal segment. Adult deformity patients face a 30% reoperation rate. We’re facing the toughest challenges by coupling our enabling technology with our comprehensive portfolio. Fusion is important for patients with comorbidities, so we also bring strength with our biologics and bone growth therapies.”
Mr. Calafiore said spine surgeons indicate that they want to use enabling technology. To gain adoption, technology must create value in the operating room through decreased radiation, quick registration and increased procedural proficiency. He noted that enabling technology will play an important role in problem-solving for ways to improve patient outcomes.
“I’m excited about the innovation opportunities in enabling technologies,” Mr. Reinhardt said. “Tying that innovation together with meaningful progress and implant instrumentation to make an ecosystem is important. We’re thinking about how we combine these technologies to enable bone healing.”
Medtronic Expands AiBLE Ecosystem
Medtronic’s AiBLE platform is an ecosystem of navigation, robotics, data and AI, imaging, software and implants. The company launched AiBLE to integrate technology in a way that provides more predictable outcomes. Medtronic leadership said their focus on enabling technology is changing the competitive landscape in spine. The company finished fiscal year 2024 with $2.4 billion in spine sales.
At NASS, Medtronic announced a global partnership to comarket the Siemens Healthineers Multitom Rax imaging system. The system allows for standing, weight-bearing imaging, cone-beam CT and supine X-ray capabilities and provides an additional preoperative component to AiBLE.
“We’re looking at the continuum of care for patients — where does it begin and where does it end,” said Michael Carter, Vice President and General Manager of Medtronic Spine and Biologics. “There was a gap with preoperative scanning. We’re continually thinking about where else we can go with the AiBLE system.”
Mr. Carter said the aim with AiBLE is that the data will provide insight to assist surgeon decision making and ultimately decrease the variability in patient outcomes.
“A third of our industry is small companies focused on the metal side of the business,” Mr. Kiil said. “Our perspective is that there’s not a lot of utility in that. It’s an ‘and’ conversation. You need enabling technology and it can’t just be navigation or robotics. It’s a combination of AI, big data and machine learning with the utility of a robot, navigation and an imaging device.”
These are just three examples of companies touting the need for enabling technology. We spoke with Johnson & Johnson MedTech about VELYS Spine, Stryker about Spine Guidance 5 Software featuring Copilot and Highridge Medical about future additions to their enabling technology portfolio. Further, the NASS exhibit hall featured numerous companies focused on open navigation and robotic platforms.
While the enabling technology market is small, just $1.3 billion in 2023 for all of orthopedics, spine companies of all sizes are betting it will give them the leverage they need to grow their business.
You’ve reached your limit.
We’re glad you’re finding value in our content — and we’d love for you to keep going.
Subscribe now for unlimited access to orthopedic business intelligence.
CL
Carolyn LaWell is ORTHOWORLD's Chief Content Officer. She joined ORTHOWORLD in 2012 to oversee its editorial and industry education. She previously served in editor roles at B2B magazines and newspapers.
