Researcher estimates that the spinal fusion market in 2013 was valued at $4,775m across the 10 regions covered in this report, which include the United States (US), France, Germany, Italy, Spain, the United Kingdom (UK), Japan, Brazil, India and China. By the end of the forecast period in 2020, sales will have grown to $6,982m, with a Compound Annual Growth Rate (CAGR) of 5.58%.

Researcher forecasts that the United States will continue to occupy the majority of the global spinal fusion market through 2020. The country’s global market share will decline over the forecast from 71% in 2013 to 63% in 2020. It will also experience one of the lowest CAGRs over the forecast given how mature the market is in the country and newly enacted reimbursement hurdles from public health payers.

Companies mention in this report: Aesculap, Alphatec Spine, Amedica Corporation, Medtronic Spinal and Biologics, DePuy Spine, Globus Medical, K2M, Biomet, Stryker, Zimmer, Nuvasive, Orthofix, Integra LifeSciences.

Like other medical device markets, emerging economies will be a source of large growth rates over the forecast period. For example, China will experience double digit growth rates through 2020 and this will increase its global market share from 5% in 2013 to 10% in 2020. Additionally, select established economies in the European Union will experience large growth rates over the forecast period including the United Kingdom and Italy. The primary reason for their growth is the increasing procedure volumes for spinal fusion surgeries owing to favorable reimbursement levels and patient’s willingness to undergo surgery with minimally invasive techniques.

While the spinal fusion market is expected to see growth over the forecast period, there are several barriers that are dampening the intervention’s potential adoption levels. Most notably in the US, public payers are beginning to implement strict measures on reimbursement documentation in an effort to eliminate medically unnecessary procedures. For example, Medicare will now require spine surgeons to document prolonged periods of conservative treatment to alleviate the patient’s symptoms prior to undergoing surgery. Another market barrier is the emergence of a new class of medical device technologies that seek to capitalize on one of the persistent weaknesses of spinal fusions. Non-fusion technologies are designed to retain motion at the operated level and reduce stresses experienced by adjacent segments. This is meant to eliminate the progression of symptomatic adjacent segment disease, which still troubles spinal fusion’s effectiveness to this day.

However, despite these barriers the spinal fusion market will experience growth over the forecast. One of primary drivers is the well-known phenomenon of nearly every global economy having a larger proportion of a country’s age demographics shift toward the later years in life. This means that the potential patient population that could develop the conditions the procedure treats will increase. Another market driver is that minimally invasive techniques are being utilized during spinal fusion surgery to reduce the damage done to the patient while maintaining or improving surgeon visualization. Studies have found that these techniques result in faster return to work/play, better long-term patient function, and a decreased hospital stay. Minimally invasive techniques have appealed to spinal surgery candidates and have increased the patient population to include people that would have declined the operation given its invasiveness and risks.

Key Questions Answered

• The reimbursement landscape for spinal fusion procedures in the US is dramatically changing by requiring spine surgeons to provide proof of medical necessity. (Q).How will this payer pressure affect the increasing number of spinal fusion procedures in the US?
• One of the drivers for the spinal fusion market is the vast number of indications in which the surgery can be used. (Q).Which indications for spinal fusion have seen the highest adoption rates in the past five years? (Q).Which indications will have high adoption rates in the next five years?
• Non-fusion medical devices were developed to eliminate the progression of symptomatic adjacent segment disease, a major problem still associated with spinal fusion surgeries. (Q).Which non-fusion technologies pose the largest threat to spinal fusion procedures?
• The research and development (R&D) efforts amongst orthopedic medical device manufacturers are intense. (Q).What is the trends in the pipeline products for spinal fusion procedures that will have the most impact on the competitive landscape? (Q).Which companies are expected to become key players?
• Similar to other medical device markets, emerging economies will be a source of immense growth for the spinal fusion market. However, certain established economies will have large Compound Annual Growth Rates (CAGRs) as well. (Q).Which emerging economies will experience the largest CAGRs over the forecast period? (Q).Which established economies will experience the largest CAGRs over the forecast period?