Spine is dead!

I am officially announcing that Spine has reached its saturation point.


There are the natural technology cycles in orthopedics. Once one area becomes saturated with too many players and too many product options, a new technology area opens up and creates new opportunities and expansion. It looks something like this over time.

AI > Imaging/Nav > Extremities > Robotics > Biologics > Spine > Joints > Trauma

In order to ride the technology curve over the next 5 years, a new company should find a way to work in the AI or Imaging or the Nav space today for max growth potential. The other areas have had their disruptive decade and have run their course until everyone copies each other. There are just too many competitors and too much price pressure with the exception of Extremities nearing the end of its golden years probably by 2028.


More on the death of the spine cycle.

Back in 1997, the acquisition of SpineTech for $600M sparked a frenzy in the spine industry, leading to the “spine bubble.” Companies eagerly jumped into the spine sector, attracted by the high valuations. This trend continued into the 2000s, with firms like Alphatec Manufacturing pivoting their focus and rebranding to Alphatec Spine.

Fast forward to 2024, and it’s clear that the spine market has exhausted this momentum. We now have an oversaturated market with 250 companies and 10,000 products, all competing for the attention of the same group of spine surgeons in the US. The growth in procedures isn’t keeping pace with the plethora of product options available.

In this highly competitive environment, many spine companies are finding it challenging to increase their sales, even with new products.

However, there are some standout exceptions. Companies like Alphatec are managing to carve out larger market shares at the expense of others (ZimVie and Medtronic). Niche players such as SpineGuard are also experiencing growth, and there’s a wave of emerging startups introducing innovative treatments. Despite these bright spots, the overall trend suggests a market that has reached its zenith and is now in a state of decline.

Additionally, a percentage of potential spine patients will be shedding pounds due to the advent of GLP-1s. Read more – The largest transformational change in orthopedics is coming. Buckle up!.


Three Exceptions

1/ Spine motion is a big exception. 2024 will be the breakout year for motion. Every spine surgeon will consider “fusion versus motion” for the first time in history.

2/ Endoscopic spine is another growing trend. Decompression has always been the main objective in spine surgery and we will start to see procedures carried out through full endoscopy. This will become a viable option in several situations. Look for inroads into endoscopic decompression in 2024.

3/ Interventional pain treatments. A new wave of growth in spine going upstream in the treatment continuum with non-surgical technologies for treating back pain. Watch the interventional pain space in 2024.


Agree or disagree?

tiger@tigerbuford.com


Rebuttal article from the SPINEMarketGroup

Is the Spine Industry Dead? A Closer Look at Contrasting Views

In recent days, I encountered an article boldly titled “Spine is Dead.” With all due respect to its author and content, I wish to express my disagreement with its assertions. The article confidently posits that the spine market has succumbed to inertia, depicting an industry in the throes of decline. Its central argument suggests that the market stands at a crossroads of oversaturation, with 250 companies and an overwhelming array of 10,000 products all vying for the attention of a select group of spine surgeons in the United States. The article also contends that the proliferation of product options far exceeds the growth in medical procedures, painting a rather bleak picture of the current state of the spine industry.This perspective portrays a grim tableau of the spine industry, insinuating that it has reached a juncture of stagnation and oversaturation.

However, an alternative viewpoint challenges this narrative with a more optimistic outlook. Contrary to the notion of an industry in decline, we argue that the spine market continues to flourish. The aging demographic contributes to an escalating prevalence of spinal pathologies, ensuring an unwavering demand for innovative spinal treatments. Notably, the global spinal implant market was estimated to be worth $11.2 billion in 2023, with a projected compound annual growth rate (CAGR) of 5.0% from 2023 to 2028. A market growing at a 5% rate is far from moribund.

Acknowledging the rapid growth witnessed by the industry with limited competition a few years ago, experts view this as a natural ebb and flow within markets. The spine industry has evolved beyond its initial phase of rapid expansion and entered a phase of consolidation. Far from being on life support, the spine industry is more dynamic than ever. Annual product launches, such as those in 2023, and the emergence of innovative companies contribute to an ever-evolving sector. The multitude of products seeking FDA approval adds further credence to the dynamic nature of the industry. Companies are not only vying for attention but are also incorporating cutting-edge technology, such as robotics and imaging equipment, to maintain a competitive edge. The rising prevalence of spinal disorders serves as a catalyst, propelling the demand for groundbreaking solutions.

From this perspective, the industry is not facing its demise but is undergoing a transformative phase. While it may no longer be experiencing rapid growth, it is far from a stagnant or consolidated market. Instead, the spine industry is adapting to the changing landscape, showcasing resilience through continuous innovation and responding to the evolving needs of both medical professionals and patients alike. As the spine industry navigates this phase of consolidation, it remains a vital and dynamic field within the broader healthcare landscape.

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