Highridge Medical is betting on this spine tech

Highridge Medical has returned to the spine tech developer’s roots and is betting big on some key technologies, CEO Rebecca Whitney says in an exclusive interview.

We spoke with Whitney ahead of Highridge’s announcement that it sold its EBI bone healing business to focus on spine tech as a pure-play company. (You can read more about the deal at MassDevice.)

HIghridge Medical has now doubled its investment in spine tech R&D and is expanding its portfolio, with an eye toward enabling tech partnerships and external expertise, Whitney said.

“Historically, we really focused on our two most differentiated brands, which are the Mobi-C Cervical Disc and the Tether for pediatric scoliosis,” Whitney said. “We lead the market in both segments. We’ve got a No. 1 share position, which a lot of people don’t fully recognize or understand. But we’re not stopping there.”

Highridge Medical is “essentially standing up three verticals in parallel,” she said: complex spine, motion preservation and minimally invasive surgeries (MIS).

Tether leads complex spine, with Highridge Medical building out its pedicle screw system and posterior cervical system to support the segment.

“We’re not just doing it for product innovation. We’re Triple Diamond sponsors of the Scoliosis Research Society (SRS). It’s only us and Medtronic,” she said, “and Medtronic is obviously about eight times the size we are, so we’re making a big push into that surgical community.”

Previously: The Tether helps kids with scoliosis — if they can get it in time

Cervical disc leads Highridge’s motion segment, and the company is also considering adding a lumbar disc for more relevance and differentiation, Whitney said.

Minimally invasive investment at Highridge

But Highridge’s biggest R&D investment is in MIS for new and next-generation procedures and enabling technology, she said.

“We fully appreciate and understand that to be a major player in the spine market, we’ve got to have our own enabling tech solution [and] we’re looking for the right partnerships and external experts to help us get there,” she said. “… We’re looking at AI, we’re looking at predictive analytics, preoperative planning, navigation, augmented reality. The nice thing about our position is we’re the largest implant company without a unique, proprietary enabling tech solution, so a lot of these other companies out there are highly motivated to work with a company of our size and scale for distribution.”

“That’s not something that we would invent internally,” she continued. “It would take us far too long, and it’s not our skill set. We’re in a nice, privileged position of being able to look at all these different options and pick and choose, and we don’t have to go with just one. That’s in the process of being assessed, and probably by Q3 of this year we’ll be ready to make some formal decisions and announcements.”

Whitney compares MIS in spine to building a ship in a bottle.

“You’re trying to do this very precise, intricate surgical procedure blind, essentially. Unlike open, long construct deformity solutions where you open up the back and can see everything, it’s very challenging to correct the spine when you’re working blind through a keyhole,” she said. “You need image support, whether it’s navigation or whatever, to help fill in those blind spots.”

“But even more importantly, spine outcomes — especially in the lumbar spine — are still only mid 60% when you look at patient-reported outcomes,” she continued. “Most of the time, patients are not incredibly pleased with their procedure, and it’s because the spine is 26 joints. There’s too much arts and crafts that goes into this, and with AI and predictive analytics and this machine learning that’s really starting to take hold — not just clinically when it comes to spine, but in life in general — there’s a tremendous opportunity to harness AI to better inform patient selection and treatment plans that should have a very positive impact on clinical outcomes. … The implants and the instruments are fantastic, and those need to continue to be innovative. But the real leapfrog forward for us as an industry is going to be around better predicting treatment pathways and then being able to tie that to a predictive result.”

Those predictive results would be based on patient size, patient history, and massive amounts of data to compare any one patient to hundreds of thousands of similar cases to forecast outcomes based on different treatments, she said.

What’s special about spine

Whitney’s been in medtech for more than 25 years and in spine for the past 11, most recently as CEO of Highridge and as leader of the spine business before its 2024 sale by ZimVie, which itself spun off from Zimmer Biomet in 2022.

Zimmer and Biomet merged in 2015, with Biomet buying spine-tech developer Lanx before the deal and Zimmer Biomet later buying another spine company, LDR.

“Our roots are actually in LDR and Lanx. … Both were pure-play spine companies, growing very rapidly, very innovation-driven, surgeon-focused,” Whitney said. “And then as these acquisitions continue to happen, we got swallowed up inside of Zimmer. So I watched these companies get absorbed into a big conglomerate and then slowly spin back out, and now we’re kind of back to where we started, which is fantastic.”

What’s special about the spine tech market are uniquely close partnerships with hands-on surgeons.

“I was told when I first got into spine that spine is a high touch sport, and I think that’s absolutely true,” she said. “It’s very relationship-driven, but not just for the sake of the relationships. It’s that customer intimacy to be able to lock arms, where our engineers and our product marketing team can sit across the table from thought-leading surgeons around the world and innovate together. It’s very different from other sectors of medtech, and it takes a unique perspective and passion for this business to really embrace it and understand some of the quirks.”

And it’s not always an efficient business, with the cost of surgeon engagement, sales force compensation and the inventory needed to support surgeries.

“It doesn’t behave like any other sector, and it doesn’t even behave like hips and knees,” she said. “I spent a couple years on the Zimmer Biomet hip and knee team. It’s very different.”

The biggest challenge facing Highridge

Highridge Medical is owned by private equity firm H.I.G. Capital, and private equity firms traditionally like to exit their investments within three to five years. But that clock is ticking slower for Highridge Medical, Whitney said.

“H.I.G. Capital has multiple funds, and where we sit they actually hold these companies for quite a bit longer,” she said. “That was critically important to me, because I have a lot invested in this company and it was important to me that we had enough runway to really build this thing and create some value. I anticipate that Highridge will be private-equity-backed for quite some time, which is really good, especially for a company that’s gone through so much transition over the last 10 years. It’s been a stabilizing effect. I think you’ll see us owned by H.I.G. Capital as Highridge for the foreseeable future.”

Instead, when asked about the biggest challenge facing Highridge Medical as if refocuses on spine, Whitney identified herself as “a fairly impatient person.”

“Our biggest challenge is I want to do it all yesterday,” she said. “There’s so much we’re taking on and [I want to] get there as fast as we possibly can. We’ve got this unique window of opportunity where we’ve established ourselves as a nimble, relatively small, fast-growing, innovative company, and that is starting to take hold. Now it’s just making sure we don’t miss this opportunity to deliver.”