“Change” has come to the spine market, and we see a significant impact to the
surgeon, the hospital, the implant manufacturer, and the patient.
• The major product trends that were obvious came with the increased offering of
lateral access fusion approaches and an improved outlook for cervical discs.
• We obtained additional clarity from surgeons on the payer pushback that is making
it more arduous to prove medical necessity for spinal procedures.
• Pricing continues to be bad, and we would not expect an improvement any time
soon as surgeons’ conversations are becoming more financially weighted.
• The treatment of vertebral compression fractures (VCFs) through vertebroplasty
and kyphoplasty still remains on the brink, and we believe a blanket CMS noncoverage
decision is possible.
• Physician-owned distributorships (PODs) are another trend proliferating in a
market where some surgeons are looking to supplement declining incomes.
Canaccord Adams...
