The spinal med device market appears to be stabilizing with growth in 3 key areas, according to a letter to investors published this week from Leerink Partner’s Richard Newitter, who attended the North American Spine Society’s annual meeting in Chicago last week.
Newitter said the meeting was “neutral-to-positive” for firms in the spinal market, and said that feedback from the event suggested “stable trends” for U.S. trade volumes.
“Most of our checks with surgeons were suggestive of generally stable U.S. volume trends. Several docs called out an incremental impact from ACA (positive) but also some impact (negative) from shifts to higher deductible plans and greater out-of-pocket expenses,” Newitter wrote. “As for our company conversations, commentary around 3Q was limited given proximity to earnings reports. Still, in all, we came away from most of our company discussions with a sense of “status quo,” which we view as a positive sign.”
In the letter, Newitter highlighted 3 individual fields that received increased attention at the event, including 3D printing, image-guidance, navigation and robotics and new implant surfaces and materials being used in spinal implants.
3D Printing, which Newitter said is still in its early days, garnered increased attention at the event as 3D-printed solutions begin to debut and the field received it’s own specialty track.
The device is ‘grown’ using titanium powder and a high-energy laser beam, which allows the interbody system to incoporate porosity and surface roughness associated with bone growth, K2M said.
The Cascadia system has recevied 510(k) clearance from the FDA and CE Mark approval in the European Union.
“With 3D printed Lamellar Titanium Technology, an innovative alternative to many traditionally manufactured PEEK and titanium designs now exists in the interbody space. I’m excited about the Cascadia platform because it provides a balance of roughness and porosity that may allow the bone to grow into the implant,” Dr. Tom Morrison of Atlanta, Ga.’s Polaris Spine & Neurosurgery Center said in a press release.
Image guidance, navigation and robotics were marked a growing sector in the spinal market, Newitter said. He reported that “Docs in general seem more receptive to image guidance/navigation/robotics solutions than in years past.”
Mazor Robotics (NSDQ:MZOR), Globus Medical (NYSE:GMED) and Medtech SA were referenced by Newitter as key companies in the robotics field, with Stryker, Johnson & Johnson (NYSE:JNJ) and Medtronic (NYSE:MDT) leading the navigation field.
Newitter wrote that Mazor has sold 96 of its Renaissance robotic pedicle screw placement platforms and is expanding its sales team for the coming year. Medtech SA reported it sold 51 units of its Rosa robotic spinal platform, and expects FDA clearance for spinal indications by the end of the year.
Newitter noted that Medtronic, for the 3rd year in a row, had no presence at the NASS meeting, but that docs at the meeting viewed its Stealth system as “a key navigation technology.”
On the front of new implant surfaces and materials, Newitter noted that docs at the conference “increasingly continue to highlight interest in alternative materials to PEEK,” which is still the majority of cages. The interest stems from the goal of finding a material that can aid with bone ingrowth and implant stability and potentially reduce the need for large amounts of bone graft material, which is required for PEEK implants.
Titan Medical‘s (CVE:TMD) titanium surface technology was on display at the event, Newitter said, as the rough surface of the implant drew attention for its ability to generate bone ingrowth versus PEEK material implants.
Newitter said the company was making “the biggest inroads with this technology as its surface allows for a nanometer level surface structure on an all-titanium implant. The rough surface is an improvement upon titanium sprays on PEEK material, which can potentially carry delamination risks, and other titanium implants without nano-level surface area.