European Markets for Spinal Implants 2010

This publication has been discontinued on July 20, 2011.

Below is the updated product.

Introduction

Abstract

The European market for spinal implants will continue to grow steadily through 2014, driven by expanding procedure volumes due to the aging population of the region and the consequently increasing incidence of age-related spinal pathologies, particularly degenerative disc disease. Over the forecast period, the spinal nonfusion technology segment will exhibit the strongest growth of the overall spinal implant market. These motion-preserving solutions will continue to appeal to patients who suffer from chronic back or leg pain and are unwilling to undergo a fusion procedure that may limit their range of motion. Although reimbursement for these newer devices varies across Europe, continued positive reimbursement decisions are anticipated as more supportive clinical data regarding these devices are released over the forecast period. Despite the growing popularity of nonfusion treatments, spinal fusions will remain the procedure favored by the majority of surgeons across Europe through 2014. Spinal fusion treatments are supported by strong clinical data and surgeon comfort in performing the procedures. In the face of growing procedure volumes, however, cost-containment efforts by governments and hospitals across Europe will continue to exert downward pressure on pricing, thereby limiting revenue growth. Nonetheless, with a growing aging population supporting strong procedural growth, the spinal implant market in Europe will grow robustly from 2009 to 2014.

METHODOLOGY

RESEARCH METHODOLOGY

This report uses a number of methodologies to gather and present data and analysis. At the outset, a large survey of secondary sources is conducted. These sources act as the basis for the primary research stage, which builds and enhances the quantitative and qualitative attributes of the early research.

Secondary sources include

• Government sources:
  • Securities and Exchange Commission filings
  • Food and Drug Administration and patent filings
  • National Institute for Health and Clinical Excellence
  • Agence Technique de l' Information sur l' Hospitalisation (Technical Hospitalization Information Agency)
• Spinal implant companies:
  • Annual reports, product brochures, corporate profiles, etc.
• Internal databases and reports:
  • Previous reports on similar/related sources
• General Internet searches, medical literature, and newspaper/magazine searches:
  • Identifying various centers of specialization and articles that might provide leads for primary research

The secondary research stage builds the foundation for the primary research.

The primary research methodology has four steps:

Step 1: The first step involves an impartial scan of all the information gathered during the secondary research stage to determine its utility based on the specific requirements of this report. Each piece of information is either discarded or marked as high- or low-priority and then organized appropriately as determined by the structure and sectioning of the report.

Step 2: At this stage, early assumptions are formed as to the implications of the information for the various spinal implant market segments. These assumptions are then used to determine hypotheses using both inductive and deductive approaches. On the quantitative front, these hypotheses result in full historical and projected market data sets (market sizes - unit sales, average selling prices [ASPs], and revenues - as well as market shares).

Step 3: At this stage, the research is in position for its most important primary phase - expert interviews. Throughout the secondary research phase, industry and medical experts are identified. These experts are then contacted by telephone and asked to participate in interviews on recent trends and developments in the industry. Interviews are either conducted at the time of the initial call or scheduled at the convenience of the expert. Interview questions are tailored to the expertise of each particular interviewee, although in most cases, the most important questions are asked of all experts. The questions are largely based on the assumptions and hypotheses developed in Step 2, which are then augmented, discarded, or adjusted based on the views and positions put forth. Attempts are made, whenever possible, to cross-check the views of various experts against each other and to reach positions of consensus on issues and market numbers.

Step 4: The final stage of primary research involves individual and group analysis by Millennium Research Group. All research results are assessed and cross-checked thoroughly to determine their validity, relevance, and weight. From this process, qualitative conclusions are reached and data points finalized.

FORECAST METHODOLOGY

In addition to Steps 1 through 4 as outlined above, the following “bottom-up” methodology is used to develop forecast assumptions for the report.

A comprehensive breakdown of various spinal implant procedures/sales is prepared using data from several sources, including professional associations, government statistics, and private research/media sources. Industry experts and practitioners are consulted to ensure accuracy and verify observed trends. As a cross-check, total industry revenues available through annual reports and other sources are compared against modeled industry revenues.

Using the best estimates of industry experts, practitioners, private research/media sources, and inhouse experts, year-by-year growth rates and ASPs are applied individually to each subcategory to derive forecasts. These estimates are cross-checked by industry experts (marketing managers, product managers, CEOs, etc.) and further refined.

Overall findings are compared against market and procedure forecasts published by other sources to ensure reasonable estimates.

Table of Contents

TABLE OF CONTENTS

LIST OF FIGURES AND TABLES

EXECUTIVE SUMMARY

METHODOLOGY

1.0 INTRODUCTION

• 1.1 Anatomy of the Human Spine
  • 1.1.1 Degenerative Spinal Disorders
  • 1.1.2 Deformity Spinal Disorders
  • 1.1.3 Tumor/Trauma Spinal Disorders
  • 1.1.4 Treatment Options
• 1.2 Thoracolumbar Fusion Devices
  • 1.2.1 Implant Design
  • 1.2.2 Thoracolumbar Pathology
• 1.3 Cervical Fusion Devices
• 1.4 Interbody Fusion Devices
  • 1.4.1 Implant Design
  • 1.4.2 Implant Material
  • 1.4.3 Surgical Approach
• 1.5 Spinal Nonfusion
  • 1.5.1 Dynamic Stabilization
  • 1.5.2 Artificial Discs
  • 1.5.3 Nuclear Disc Prostheses
  • 1.5.4 Annulus Repair

2.0 EUROPEAN SPINAL IMPLANT MARKET

• 2.1 Market Overview
• 2.2 Market Analysis
  • 2.2.1 Key Report Updates
  • 2.2.2 Procedures by Country
  • 2.2.3 Procedures by Segment
    • 2.2.3.1 Spinal Fusions
    • 2.2.3.2 Spinal Nonfusions
  • 2.2.4 Market Forecast
  • 2.2.5 Market Drivers and Limiters
    • 2.2.5.1 Market Drivers
    • 2.2.5.2 Market Limiters
• 2.3 Competitive Analysis
  • 2.3.1 Market Shares
  • 2.3.2 Competitor Discussions (in Alphabetical Order)
    • Aesculap Implant Systems
    • DePuy Spine
    • Medtronic Spinal & Biologics
    • Scient' x (acquired by Alphatec Spine in December 2009)
    • Stryker Spine
    • Synthes Spine
    • Zimmer Spine
    • Other

3.0 FRENCH SPINAL IMPLANT MARKET

• 3.1 Market Overview
• 3.2 Market Analysis
  • 3.2.1 Procedures
    • 3.2.1.1 Traditional Thoracolumbar Fusions
      • Degenerative Traditional Thoracolumbar Fusions
      • Deformity Traditional Thoracolumbar Fusions
      • Tumor/Trauma Traditional Thoracolumbar Fusions
    • 3.2.1.2 Traditional Cervical Fusions
      • Anterior Traditional Cervical Fusions
      • Posterior Traditional Cervical Fusions
    • 3.2.1.3 Interbody Device Fusions
      • Anterior Lumbar Interbody Fusions
      • Posterior Lumbar Interbody Fusions
      • Transforaminal Lumbar Interbody Fusions
      • Lateral Lumbar Interbody Fusions
      • Cervical Interbody Device Fusions
    • 3.2.1.4 Spinal Nonfusions
      • Interspinous Process Decompression Device Procedures
      • Pedicle Screw-Based Dynamic Stabilization Procedures
      • Facet Arthroplasties
      • Cervical Total Disc Replacements
      • Lumbar Total Disc Replacements
      • Nuclear Disc Prosthesis Procedures
      • Annulus Repair Device Procedures
  • 3.2.2 Market Forecast
    • 3.2.2.1 Traditional Thoracolumbar Implant Market (Degenerative, Deformity, and Tumor/Trauma)
    • 3.2.2.2 Traditional Cervical Implant Market (Anterior and Posterior)
    • 3.2.2.3 Interbody Device Market (Anterior, Posterior, Transforaminal, Lateral, and Cervical Interbody Fusion Devices)
    • 3.2.2.4 Spinal Nonfusion Technology Market (Interspinous Process Decompression Devices, Pedicle Screw-Based Dynamic Stabilization Systems, Facet Arthroplasty Devices, Cervical Artificial Discs, Lumbar Artificial Discs, Nuclear Disc Prostheses, and Annulus Repair Devices)
  • 3.2.3 Market Drivers and Limiters
    • 3.2.3.1 Market Drivers
    • 3.2.3.2 Market Limiters
• 3.3 Competitive Analysis
  • 3.3.1 Competitive Landscape
  • 3.3.2 Market Shares

4.0 GERMAN SPINAL IMPLANT MARKET

• 4.1 Market Overview
• 4.2 Market Analysis
  • 4.2.1 Procedures
    • 4.2.1.1 Traditional Thoracolumbar Fusions
      • Degenerative Traditional Thoracolumbar Fusions
      • Deformity Traditional Thoracolumbar Fusions
      • Tumor/Trauma Traditional Thoracolumbar Fusions
    • 4.2.1.2 Traditional Cervical Fusions
      • Anterior Traditional Cervical Fusions
      • Posterior Traditional Cervical Fusions
    • 4.2.1.3 Interbody Device Fusions
      • Anterior Lumbar Interbody Fusions
      • Posterior Lumbar Interbody Fusions
      • Transforaminal Lumbar Interbody Fusions
      • Lateral Lumbar Interbody Fusions
      • Cervical Interbody Device Fusions
    • 4.2.1.4 Spinal Nonfusions
      • Interspinous Process Decompression Device Procedures
      • Pedicle Screw-Based Dynamic Stabilization Procedures
      • Facet Arthroplasties
      • Cervical Total Disc Replacements
      • Lumbar Total Disc Replacements
      • Nuclear Disc Prosthesis Procedures
      • Annulus Repair Device Procedures
  • 4.2.2 Market Forecast
    • 4.2.2.1 Traditional Thoracolumbar Implant Market (Degenerative, Deformity, and Tumor/Trauma)
    • 4.2.2.2 Traditional Cervical Implant Market (Anterior and Posterior)
    • 4.2.2.3 Interbody Device Market (Anterior, Posterior, Transforaminal, Lateral, and Cervical Interbody Fusion Devices)
    • 4.2.2.4 Spinal Nonfusion Technology Market (Interspinous Process Decompression Devices, Pedicle Screw-Based Dynamic Stabilization Systems, Facet Arthroplasty Devices, Cervical Artificial Discs, Lumbar Artificial Discs, Nuclear Disc Prostheses, and Annulus Repair Devices)
  • 4.2.3 Market Drivers and Limiters
    • 4.2.3.1 Market Drivers
    • 4.2.3.2 Market Limiters
• 4.3 Competitive Analysis
  • 4.3.1 Competitive Landscape
  • 4.3.2 Market Shares

5.0 ITALIAN SPINAL IMPLANT MARKET

• 5.1 Market Overview
• 5.2 Market Analysis
  • 5.2.1 Procedures
    • 5.2.1.1 Traditional Thoracolumbar Fusions
      • Degenerative Traditional Thoracolumbar Fusions
      • Deformity Traditional Thoracolumbar Fusions
      • Tumor/Trauma Traditional Thoracolumbar Fusions
    • 5.2.1.2 Traditional Cervical Fusions
      • Anterior Traditional Cervical Fusions
      • Posterior Traditional Cervical Fusions
    • 5.2.1.3 Interbody Device Fusions
      • Anterior Lumbar Interbody Fusions
      • Posterior Lumbar Interbody Fusions
      • Transforaminal Lumbar Interbody Fusions
      • Lateral Lumbar Interbody Fusions
      • Cervical Interbody Device Fusions
    • 5.2.1.4 Spinal Nonfusions
      • Interspinous Process Decompression Device Procedures
      • Pedicle Screw-Based Dynamic Stabilization Procedures
      • Facet Arthroplasties
      • Cervical Total Disc Replacements
      • Lumbar Total Disc Replacements
      • Nuclear Disc Prosthesis Procedures
      • Annulus Repair Device Procedures
  • 5.2.2 Market Forecast
    • 5.2.2.1 Traditional Thoracolumbar Implant Market (Degenerative, Deformity, and Tumor/Trauma)
    • 5.2.2.2 Traditional Cervical Implant Market (Anterior and Posterior)
    • 5.2.2.3 Interbody Device Market (Anterior, Posterior, Transforaminal, Lateral, and Cervical Interbody Fusion Devices)
    • 5.2.2.4 Spinal Nonfusion Technology Market (Interspinous Process Decompression Devices, Pedicle Screw-Based Dynamic Stabilization Systems, Facet Arthroplasty Devices, Cervical Artificial Discs, Lumbar Artificial Discs, Nuclear Disc Prostheses, and Annulus Repair Devices)
  • 5.2.3 Market Drivers and Limiters
    • 5.2.3.1 Market Drivers
    • 5.2.3.2 Market Limiters
• 5.3 Competitive Analysis
  • 5.3.1 Competitive Landscape
  • 5.3.2 Market Shares

6.0 SPANISH SPINAL IMPLANT MARKET

• 6.1 Market Overview
• 6.2 Market Analysis
  • 6.2.1 Procedures
    • 6.2.1.1 Traditional Thoracolumbar Fusions
      • Degenerative Traditional Thoracolumbar Fusions
      • Deformity Traditional Thoracolumbar Fusions
      • Tumor/Trauma Traditional Thoracolumbar Fusions
    • 6.2.1.2 Traditional Cervical Fusions
      • Anterior Traditional Cervical Fusions
      • Posterior Traditional Cervical Fusions
    • 6.2.1.3 Interbody Device Fusions
      • Anterior Lumbar Interbody Fusions
      • Posterior Lumbar Interbody Fusions
      • Transforaminal Lumbar Interbody Fusions
      • Lateral Lumbar Interbody Fusions
      • Cervical Interbody Device Fusions
    • 6.2.1.4 Spinal Nonfusions
      • Interspinous Process Decompression Device Procedures
      • Pedicle Screw-Based Dynamic Stabilization Procedures
      • Facet Arthroplasties
      • Cervical Total Disc Replacements
      • Lumbar Total Disc Replacements
      • Nuclear Disc Prosthesis Procedures
      • Annulus Repair Device Procedures
  • 6.2.2 Market Forecast
    • 6.2.2.1 Traditional Thoracolumbar Implant Market (Degenerative, Deformity, and Tumor/Trauma)
    • 6.2.2.2 Traditional Cervical Implant Market (Anterior and Posterior)
    • 6.2.2.3 Interbody Device Market (Anterior, Posterior, Transforaminal, Lateral, and Cervical Interbody Fusion Devices)
    • 6.2.2.4 Spinal Nonfusion Technology Market (Interspinous Process Decompression Devices, Pedicle Screw-Based Dynamic Stabilization Systems, Facet Arthroplasty Devices, Cervical Artificial Discs, Lumbar Artificial Discs, Nuclear Disc Prostheses, and Annulus Repair Devices)
  • 6.2.3 Market Drivers and Limiters
    • 6.2.3.1 Market Drivers
    • 6.2.3.2 Market Limiters
• 6.3 Competitive Analysis
  • 6.3.1 Competitive Landscape
  • 6.3.2 Market Shares

7.0 UK SPINAL IMPLANT MARKET

• 7.1 Market Overview
• 7.2 Market Analysis
  • 7.2.1 Procedures
    • 7.2.1.1 Traditional Thoracolumbar Fusions
      • Degenerative Traditional Thoracolumbar Fusions
      • Deformity Traditional Thoracolumbar Fusions
      • Tumor/Trauma Traditional Thoracolumbar Fusions
    • 7.2.1.2 Traditional Cervical Fusions
      • Anterior Traditional Cervical Fusions
      • Posterior Traditional Cervical Fusions
    • 7.2.1.3 Interbody Device Fusions
      • Anterior Lumbar Interbody Fusions
      • Posterior Lumbar Interbody Fusions
      • Transforaminal Lumbar Interbody Fusions
      • Lateral Lumbar Interbody Fusions
      • Cervical Interbody Device Fusions
    • 7.2.1.4 Spinal Nonfusions
      • Interspinous Process Decompression Device Procedures
      • Pedicle Screw-Based Dynamic Stabilization Procedures
      • Facet Arthroplasties
      • Cervical Total Disc Replacements
      • Lumbar Total Disc Replacements
      • Nuclear Disc Prosthesis Procedures
      • Annulus Repair Device Procedures
  • 7.2.2 Market Forecast
    • 7.2.2.1 Traditional Thoracolumbar Implant Market (Degenerative, Deformity, and Tumor/Trauma)
    • 7.2.2.2 Traditional Cervical Implant Market (Anterior and Cervical)
    • 7.2.2.3 Interbody Device Market (Anterior, Posterior, Transforaminal, Lateral, and Cervical Interbody Fusion Devices)
    • 7.2.2.4 Spinal Nonfusion Technology Market (Interspinous Process Decompression Devices, Pedicle Screw-Based Dynamic Stabilization Systems, Facet Arthroplasty Devices, Cervical Artificial Discs, Lumbar Artificial Discs, Nuclear Disc Prostheses, and Annulus Repair Devices)
  • 7.2.3 Market Drivers and Limiters
    • 7.2.3.1 Market Drivers
    • 7.2.3.2 Market Limiters
• 7.3 Competitive Analysis
  • 7.3.1 Competitive Landscape
  • 7.3.2 Market Shares

APPENDIX A: MRG ACRONYMS AND INITIALISMS

APPENDIX B: SUPPLEMENTAL FIGURES

LIST OF FIGURES AND TABLES

TABLE OF CONTENTS

LIST OF FIGURES AND TABLES

EXECUTIVE SUMMARY

• Figure 1: Spinal Implant Market, by Country, Europe (US$), 2008 - 2014
• Figure 2: Spinal Implant Market, by Segment, as a % of Total, France, 2009 and 2014
• Figure 3: Spinal Implant Market, by Segment, Germany (US$), 2008 - 2014
• Figure 4: Spinal Implant Market, by Segment, Italy (US$), 2008 - 2014
• Figure 5: Spinal Implant Market, by Segment, Spain (US$), 2008 - 2014
• Figure 6: Spinal Implant Market, by Segment, as a % of Total, UK, 2008 - 2014
• Table 1: Companies Mentioned in This Report

METHODOLOGY

• Table 2: Average Currency Exchange Rates, 2009

1.0 INTRODUCTION

• Table 3: Roles of the Spinal Column
• Table 4: Instrumented Spinal Fusion Procedure Classification
• Table 5: Thoracolumbar Fusion Device Classification
• Table 6: Select Thoracolumbar Pedicle Screw Systems, by Company, Europe, 2009
• Table 7: Select Thoracolumbar Anterior Plating Systems, by Company, Europe, 2009
• Table 8: Cervical Fusion Device Classification
• Table 9: Select Anterior Cervical Fixation Systems, by Company and Design, Europe, 2009
• Table 10: Select Posterior Cervical Fixation Systems, by Company and Design, Europe, 2009
• Table 11: IBD Classification
• Table 12: Select Nonbone IBDs, by Company and Surgical Approach, Europe, 2009

2.0 EUROPEAN SPINAL IMPLANT MARKET

• Figure 7: Spinal Implant Market, Europe (US$), 2008 - 2014
• Table 13: Key Report Updates, 2010
• Table 14: Spinal Implant Procedures, by Country, Europe, 2008 - 2014
• Table 15: Instrumented Spinal Fusions, by Country, Europe, 2008 - 2014
• Table 16: Instrumented Spinal Fusions, by Region of the Spine, Europe, 2008 - 2014
• Table 17: Instrumented Spinal Fusions, by Region of the Spine and Country, Europe, 2008 - 2014
• Table 18: Thoracolumbar Fusions, by Levels Fused and Pathology, as a % of Total, 2008 - 2014
• Table 19: Cervical Fusions, by Levels Fused and Approach, as a % of Total, 2008 - 2014
• Table 20: IBD Fusions, by Levels Fused and Approach, as a % of Total, 2008 - 2014
• Table 21: Spinal Nonfusions, by Country, Europe, 2008 - 2014
• Table 22: Spinal Nonfusions, by Segment, Europe, 2008 - 2014
• Table 23: Spinal Implant Market, by Country, Europe (US$ and € ), 2008 - 2014
• Table 24: Spinal Implant Market and Other Spine Markets, by Segment, Europe (US$), 2008 - 2014
• Table 25: Spinal Implant Market and Other Spine Markets, by Segment, Europe (€ ), 2008 - 2014
• Table 26: Spinal Fusion Implant Market, by Country, Europe (US$ and € ), 2008 - 2014
• Table 27: Spinal Fusion Implant Market, by Segment, Europe (US$ and € ), 2008 - 2014
• Table 28: Spinal Fusion Implant Market, by Segment and Country, Europe (US$), 2008 - 2014
• Table 29: Spinal Fusion Implant Market, by Segment and Country, Europe (€ ), 2008 - 2014
• Table 30: Spinal Nonfusion Technology Market, by Country, Europe (US$), 2008 - 2014
• Table 31: Spinal Nonfusion Technology Market, by Country, Europe (€ ), 2008 - 2014
• Table 32: Spinal Nonfusion Technology Market, by Segment, Europe (US$), 2008 - 2014
• Table 33: Spinal Nonfusion Technology Market, by Segment, Europe (€ ), 2008 - 2014
• Table 34: Drivers and Limiters of the Spinal Implant Market, Europe
• Figure 8: Leading Competitors in the Spinal Implant Market, as a % of Total, Europe, 2009
• Table 35: Leading Competitors in the Spinal Implant Market, by Segment, as a % of Total, Europe, 2009
• Table 36: Leading Competitors in the Spinal Implant Market, by Country, as a % of Total, Europe, 2009

3.0 FRENCH SPINAL IMPLANT MARKET

• Figure 9: Spinal Implant Market, by Segment, France (US$), 2008 - 2014
• Table 37: Spinal Implant Procedures, by Segment, France, 2008 - 2014
• Table 38: Thoracolumbar Spinal Implant Procedures, by Segment, France, 2008 - 2014
• Table 39: Cervical Spinal Implant Procedures, by Segment, France, 2008 - 2014
• Table 40: Thoracolumbar Fusions, by Instrumentation, France, 2008 - 2014
• Table 41: Posterior Minimally Invasive Thoracolumbar Spinal Fusions, by Procedure Type, France, 2008 - 2014
• Table 42: Traditional Thoracolumbar Fusions, by Pathology, France, 2008 - 2014
• Table 43: Cervical Fusions, by Instrumentation, France, 2008 - 2014
• Table 44: Traditional Cervical Fusions, by Approach, France, 2008 - 2014
• Table 45: IBD Fusions, by Region of the Spine, France, 2008 - 2014
• Table 46: Lumbar IBD Fusions, by Approach, France, 2008 - 2014
• Table 47: Spinal Nonfusions, by Segment, France, 2008 - 2014
• Table 48: Dynamic Stabilization Procedures and Units, by Segment, France, 2008 - 2014
• Table 49: Dynamic Stabilization Procedure and Unit Growth, by Segment, France, 2009 - 2014
• Table 50: Artificial Disc Procedures and Units, by Segment, France, 2008 - 2014
• Table 51: Artificial Disc Procedure and Unit Growth, by Segment, France, 2009 - 2014
• Table 52: Spinal Implant Market, by Segment, France (US$ and € ), 2008 - 2014
• Table 53: Traditional Thoracolumbar Implant Market, by Pathology, France, (US$), 2008 - 2014
• Table 54: Traditional Thoracolumbar Implant Market, by Pathology, France (€ ), 2008 - 2014
• Table 55: Traditional Thoracolumbar Implant Market Growth, by Pathology, France, 2009 - 2014
• Table 56: Traditional Cervical Implant Market, by Approach, France (US$), 2008 - 2014
• Table 57: Traditional Cervical Implant Market, by Approach, France (€ ), 2008 - 2014
• Table 58: Traditional Cervical Implant Market Growth, by Approach, France, 2009 - 2014
• Table 59: IBD Market, by Approach, France (US$), 2008 - 2014
• Table 60: IBD Market, by Approach, France (€ ), 2008 - 2014
• Table 61: IBD Market Growth, by Approach, France, 2009 - 2014
• Table 62: Spinal Nonfusion Technology Market, by Segment, France (US$), 2008 - 2014
• Table 63: Spinal Nonfusion Technology Market, by Segment, France (€ ), 2008 - 2014
• Table 64: Dynamic Stabilization Device Market, by Segment, France (US$), 2008 - 2014
• Table 65: Dynamic Stabilization Device Market, by Segment, France (€ ), 2008 - 2014
• Table 66: Dynamic Stabilization Device Market Growth, by Segment, France, 2009 - 2014
• Table 67: Dynamic Stabilization Device Market, by Segment, as a % of Total, France, 2008 - 2014
• Table 68: Artificial Disc Market, by Segment, France (US$), 2008 - 2014
• Table 69: Artificial Disc Market, by Segment, France (€ ), 2008 - 2014
• Table 70: Artificial Disc Market Growth, by Segment, France, 2009 - 2014
• Table 71: Artificial Disc Market, by Segment, as a % of Total, France, 2008 - 2014
• Table 72: Nuclear Disc Prosthesis Market, France (US$ and € ), 2008 - 2014
• Table 73: Annulus Repair Device Market, France (US$ and € ), 2008 - 2014
• Table 74: Drivers and Limiters of the Spinal Implant Market, France
• Table 75: Leading Competitors in the Spinal Implant Market, by Segment, as a % of Total, France, 2009

4.0 GERMAN SPINAL IMPLANT MARKET

• Figure 10: Spinal Implant Market, by Segment, Germany (US$), 2008 - 2014
• Table 76: Spinal Implant Procedures, by Segment, Germany, 2008 - 2014
• Table 77: Thoracolumbar Spinal Implant Procedures, by Segment, Germany, 2008 - 2014
• Table 78: Cervical Spinal Implant Procedures, by Segment, Germany, 2008 - 2014
• Table 79: Thoracolumbar Fusions, by Instrumentation, Germany, 2008 - 2014
• Table 80: Posterior Minimally Invasive Thoracolumbar Spinal Fusions, by Procedure Type, Germany, 2008 - 2014
• Table 81: Traditional Thoracolumbar Fusions, by Pathology, Germany, 2008 - 2014
• Table 82: Cervical Fusions, by Instrumentation, Germany, 2008 - 2014
• Table 83: Traditional Cervical Fusions, by Approach, Germany, 2008 - 2014
• Table 84: IBD Fusions, by Region of the Spine, Germany, 2008 - 2014
• Table 85: Lumbar IBD Fusions, by Approach, Germany, 2008 - 2014
• Table 86: Spinal Nonfusions, by Segment, Germany, 2008 - 2014
• Table 87: Dynamic Stabilization Procedures and Units, by Segment, Germany, 2008 - 2014
• Table 88: Dynamic Stabilization Procedure and Unit Growth, by Segment, Germany, 2009 - 2014
• Table 89: Artificial Disc Procedures and Units, by Segment, Germany, 2008 - 2014
• Table 90: Artificial Disc Procedure and Unit Growth, by Segment, Germany, 2009 - 2014
• Table 91: Spinal Implant Market, by Segment, Germany, (US$ and € ), 2008 - 2014
• Table 92: Traditional Thoracolumbar Implant Market, by Pathology, Germany (US$), 2008 - 2014
• Table 93: Traditional Thoracolumbar Implant Market, by Pathology, Germany (€ ), 2008 - 2014
• Table 94: Traditional Thoracolumbar Implant Market Growth, by Pathology, Germany, 2009 - 2014
• Table 95: Traditional Cervical Implant Market, by Approach, Germany (US$), 2008 - 2014
• Table 96: Traditional Cervical Implant Market, by Approach, Germany (€ ), 2008 - 2014
• Table 97: Traditional Cervical Implant Market Growth, by Approach, Germany, 2009 - 2014
• Table 98: IBD Market, by Approach, Germany (US$), 2008 - 2014
• Table 99: IBD Market, by Approach, Germany (€ ), 2008 - 2014
• Table 100: IBD Market Growth, by Approach, Germany, 2009 - 2014
• Table 101: Spinal Nonfusion Technology Market, by Segment, Germany (US$), 2008 - 2014
• Table 102: Spinal Nonfusion Technology Market, by Segment, Germany (€ ), 2008 - 2014
• Table 103: Dynamic Stabilization Device Market, by Segment, Germany (US$), 2008 - 2014
• Table 104: Dynamic Stabilization Device Market, by Segment, Germany (€ ), 2008 - 2014
• Table 105: Dynamic Stabilization Device Market Growth, by Segment, Germany, 2009 - 2014
• Table 106: Dynamic Stabilization Device Market, by Segment, as a % Total, Germany, 2008 - 2014
• Table 107: Artificial Disc Market, by Segment, Germany (US$), 2008 - 2014
• Table 108: Artificial Disc Market, by Segment, Germany (€ ), 2008 - 2014
• Table 109: Artificial Disc Market Growth, by Segment, Germany, 2009 - 2014
• Table 110: Artificial Disc Market, by Segment, as a % of Total, Germany, 2008 - 2014
• Table 111: Nuclear Disc Prosthesis Market, Germany (US$ and € ), 2008 - 2014
• Table 112: Annulus Repair Device Market, Germany (US$ and € ), 2008 - 2014
• Table 113: Drivers and Limiters of the Spinal Implant Market, Germany
• Table 114: Leading Competitors in the Spinal Implant Market, by Segment, as a % of Total, Germany, 2009

5.0 ITALIAN SPINAL IMPLANT MARKET

• Figure 11: Spinal Implant Market, by Segment, Italy (US$), 2008 - 2014
• Table 115: Spinal Implant Procedures, by Segment, Italy, 2008 - 2014
• Table 116: Thoracolumbar Spinal Implant Procedures, by Segment, Italy, 2008 - 2014
• Table 117: Cervical Spinal Implant Procedures, by Segment, Italy, 2008 - 2014
• Table 118: Thoracolumbar Fusions, by Instrumentation, Italy, 2008 - 2014
• Table 119: Posterior Minimally Invasive Thoracolumbar Spinal Fusions, by Procedure Type, Italy, 2008 - 2014
• Table 120: Traditional Thoracolumbar Fusions, by Pathology, Italy, 2008 - 2014
• Table 121: Cervical Fusions, by Instrumentation, Italy, 2008 - 2014
• Table 122: Traditional Cervical Fusions, by Approach, Italy, 2008 - 2014
• Table 123: IBD Fusions, by Region of the Spine, Italy, 2008-2014
• Table 124: Lumbar IBD Fusions, by Approach, Italy, 2008-2014
• Table 125: Spinal Nonfusions, by Segment, Italy, 2008 - 2014
• Table 126: Dynamic Stabilization Procedures and Units, Italy, 2008 - 2014
• Table 127: Dynamic Stabilization Procedure and Unit Growth, Italy, 2009 - 2014
• Table 128: Artificial Disc Procedures and Units, by Segment, Italy, 2008 - 2014
• Table 129: Artificial Disc Procedure and Unit Growth, Italy, 2009 - 2014
• Table 130: Spinal Implant Market, by Segment, Italy (US$ and € ), 2008-2014
• Table 131: Traditional Thoracolumbar Implant Market, by Pathology, Italy (US$), 2008 - 2014
• Table 132: Traditional Thoracolumbar Implant Market, by Pathology, Italy (€ ), 2008 - 2014
• Table 133: Traditional Thoracolumbar Implant Market Growth, by Pathology, Italy, 2009 - 2014
• Table 134: Traditional Cervical Implant Market, by Approach, Italy (US$), 2008 - 2014
• Table 135: Traditional Cervical Implant Market, by Approach, Italy (€ ), 2008 - 2014
• Table 136: Traditional Cervical Implant Market Growth, by Approach, Italy, 2009 - 2014
• Table 137: IBD Market, by Approach, Italy (US$), 2008-2014
• Table 138: IBD Market, by Approach, Italy (€ ), 2008-2014
• Table 139: IBD Market Growth, by Approach, Italy, 2009-2014
• Table 140: Spinal Nonfusion Technology Market, by Segment, Italy (US$), 2008 - 2014
• Table 141: Spinal Nonfusion Technology Market, by Segment, Italy (€ ), 2008 - 2014
• Table 142: Dynamic Stabilization Device Market, by Segment, Italy (US$), 2008 - 2014
• Table 143: Dynamic Stabilization Device Market, by Segment, Italy (€ ), 2008 - 2014
• Table 144: Dynamic Stabilization Device Market Growth, by Segment, Italy, 2009 - 2014
• Table 145: Dynamic Stabilization Device Market, by Segment, as a % of Total, Italy, 2008 - 2014
• Table 146: Artificial Disc Market, by Segment, Italy (US$), 2008 - 2014
• Table 147: Artificial Disc Market, by Segment, Italy (€ ), 2008 - 2014
• Table 148: Artificial Disc Market Growth, by Segment, Italy, 2009 - 2014
• Table 149: Artificial Disc Market, by Segment, as a % of Total, Italy, 2008 - 2014
• Table 150: Nuclear Disc Prosthesis Market, Italy (US$ and € ), 2008 - 2014
• Table 151: Annulus Repair Device Market, Italy (US$ and € ), 2008 - 2014
• Table 152: Drivers and Limiters of the Spinal Implant Market, Italy
• Table 153: Leading Competitors in the Spinal Implant Market, by Segment, as a % of Total, Italy, 2009

6.0 SPANISH SPINAL IMPLANT MARKET

• Figure 12: Spinal Implant Market, by Segment, Spain (US$), 2008 - 2014
• Table 154: Spinal Implant Procedures, by Segment, Spain, 2008 - 2014
• Table 155: Thoracolumbar Spinal Implant Procedures, by Segment, Spain, 2008 - 2014
• Table 156: Cervical Spinal Implant Procedures, by Segment, Spain, 2008 - 2014
• Table 157: Thoracolumbar Fusions, by Instrumentation, Spain, 2008 - 2014
• Table 158: Posterior Minimally Invasive Thoracolumbar Spinal Fusions, by Procedure Type, Spain, 2008 - 2014
• Table 159: Traditional Thoracolumbar Fusions, by Pathology, Spain, 2008 - 2014
• Table 160: Cervical Fusions, by Instrumentation, Spain, 2008 - 2014
• Table 161: Traditional Cervical Fusions, by Approach, Spain, 2008 - 2014
• Table 162: IBD Fusions, by Region of the Spine, Spain, 2008 - 2014
• Table 163: Lumbar IBD Fusions, by Approach, Spain, 2008 - 2014
• Table 164: Spinal Nonfusions, by Segment, Spain, 2008 - 2014
• Table 165: Dynamic Stabilization Procedures and Units, by Segment, Spain, 2008 - 2014
• Table 166: Dynamic Stabilization Procedure and Unit Growth, by Segment, Spain, 2009 - 2014
• Table 167: Artificial Disc Procedures and Units, by Segment, Spain, 2008 - 2014
• Table 168: Artificial Disc Procedure and Unit Growth, by Segment, Spain, 2009 - 2014
• Table 169: Spinal Implant Market, by Segment, Spain (US$ and € ), 2008 - 2014
• Table 170: Traditional Thoracolumbar Implant Market, by Pathology, Spain (US$), 2008 - 2014
• Table 171: Traditional Thoracolumbar Implant Market, by Pathology, Spain (€ ), 2008 - 2014
• Table 172: Traditional Thoracolumbar Implant Market Growth, by Pathology, Spain, 2009 - 2014
• Table 173: Traditional Cervical Implant Market, by Approach, Spain (US$), 2008 - 2014
• Table 174: Traditional Cervical Implant Market, by Approach, Spain (€ ), 2008 - 2014
• Table 175: Traditional Cervical Implant Market Growth, by Approach, Spain, 2009 - 2014
• Table 176: IBD Market, by Approach, Spain (US$), 2008 - 2014
• Table 177: IBD Market, by Approach, Spain (€ ), 2008 - 2014
• Table 178: IBD Market Growth, by Approach, Spain, 2009 - 2014
• Table 179: Spinal Nonfusion Technology Market, by Segment, Spain (US$), 2008 - 2014
• Table 180: Spinal Nonfusion Technology Market, by Segment, Spain (€ ), 2008 - 2014
• Table 181: Dynamic Stabilization Device Market, by Segment, Spain (US$), 2008 - 2014
• Table 182: Dynamic Stabilization Device Market, by Segment, Spain (€ ), 2008 - 2014
• Table 183: Dynamic Stabilization Device Market Growth, by Segment, Spain, 2009 - 2014
• Table 184: Dynamic Stabilization Device Market, by Segment, as a % of Total, Spain, 2008 - 2014
• Table 185: Artificial Disc Market, by Segment, Spain (US$), 2008 - 2014
• Table 186: Artificial Disc Market, by Segment, Spain (€ ), 2008 - 2014
• Table 187: Artificial Disc Market Growth, by Segment, Spain, 2009 - 2014
• Table 188: Artificial Disc Market, by Segment, as a % of Total, Spain, 2008 - 2014
• Table 189: Nuclear Disc Prosthesis Market, Spain (US$ and € ), 2008 - 2014
• Table 190: Annulus Repair Device Market, Spain (US$ and € ), 2008 - 2014
• Table 191: Drivers and Limiters of the Spinal Implant Market, Spain
• Table 192: Leading Competitors in the Spinal Implant Market, by Segment, as a % of Total, Spain, 2009

7.0 UK SPINAL IMPLANT MARKET

• Figure 13: Spinal Implant Market, by Segment, UK (US$), 2008 - 2014
• Table 193: Spinal Implant Procedures, by Segment, UK, 2008 - 2014
• Table 194: Thoracolumbar Spinal Implant Procedures, by Segment, UK, 2008 - 2014
• Table 195: Cervical Spinal Implant Procedures, by Segment, UK, 2008 - 2014
• Table 196: Thoracolumbar Fusions, by Instrumentation, UK, 2008 - 2014
• Table 197: Posterior Minimally Invasive Thoracolumbar Spinal Fusions, by Procedure Type, UK, 2008 - 2014
• Table 198: Traditional Thoracolumbar Fusions, by Pathology, UK, 2008 - 2014
• Table 199: Cervical Fusions, by Instrumentation, UK, 2008 - 2014
• Table 200: Traditional Cervical Fusions, by Approach, UK, 2008 - 2014
• Table 201: IBD Fusions, by Region of the Spine, UK, 2008 - 2014
• Table 202: Lumbar IBD Fusions, by Approach, UK, 2008 - 2014
• Table 203: Spinal Nonfusions, by Segment, UK, 2008 - 2014
• Table 204: Dynamic Stabilization Procedures and Units, by Segment, UK, 2008 - 2014
• Table 205: Dynamic Stabilization Procedure and Unit Growth, by Segment, UK, 2009 - 2014
• Table 206: Artificial Disc Procedures and Units, by Segment, UK, 2008 - 2014
• Table 207: Artificial Disc Procedure and Unit Growth, by Segment, UK, 2009 - 2014
• Table 208: Spinal Implant Market, by Segment, UK (US$, € , and £), 2008 - 2014
• Table 209: Traditional Thoracolumbar Implant Market, by Pathology, UK (US$), 2008 - 2014
• Table 210: Traditional Thoracolumbar Implant Market, by Pathology, UK (€ ), 2008 - 2014
• Table 211: Traditional Thoracolumbar Implant Market, by Pathology, UK (£), 2008 - 2014
• Table 212: Traditional Thoracolumbar Implant Market Growth, by Pathology, UK, 2009 - 2014
• Table 213: Traditional Cervical Implant Market, by Approach, UK (US$), 2008 - 2014
• Table 214: Traditional Cervical Implant Market, by Approach, UK (€ ), 2008 - 2014
• Table 215: Traditional Cervical Implant Market, by Approach, UK (£), 2008 - 2014
• Table 216: Traditional Cervical Implant Market Growth, by Approach, UK, 2009 - 2014
• Table 217: IBD Market, by Approach, UK (US$), 2008 - 2014
• Table 218: IBD Market, by Approach, UK (€ ), 2008 - 2014
• Table 219: IBD Market, by Approach, UK (£), 2008 - 2014
• Table 220: IBD Market Growth, by Approach, UK, 2009 - 2014
• Table 221: Spinal Nonfusion Technology Market, by Segment, UK (US$), 2008 - 2014
• Table 222: Spinal Nonfusion Technology Market, by Segment, UK (€ ), 2008 - 2014
• Table 223: Spinal Nonfusion Technology Market, by Segment, UK (£), 2008 - 2014
• Table 224: Dynamic Stabilization Device Market, by Segment, UK (US$), 2008 - 2014
• Table 225: Dynamic Stabilization Device Market, by Segment, UK (€ ), 2008 - 2014
• Table 226: Dynamic Stabilization Device Market, by Segment, UK (£), 2008 - 2014
• Table 227: Dynamic Stabilization Device Market Growth, by Segment, UK, 2009 - 2014
• Table 228: Dynamic Stabilization Device Market, by Segment, as a % of Total, UK, 2008 - 2014
• Table 229: Artificial Disc Market, by Segment, UK (US$), 2008 - 2014
• Table 230: Artificial Disc Market, by Segment, UK (€ ), 2008 - 2014
• Table 231: Artificial Disc Market, by Segment, UK (£), 2008 - 2014
• Table 232: Artificial Disc Market Growth, by Segment, UK, 2009 - 2014
• Table 233: Artificial Disc Market, by Segment, as a % of Total, UK, 2008 - 2014
• Table 234: Nuclear Disc Prosthesis Market, UK (US$, € , and £), 2008 - 2014
• Table 235: Annulus Repair Device Market, UK (US$, € , and £), 2008 - 2014
• Table 236: Drivers and Limiters of the Spinal Implant Market, UK
• Table 237: Leading Competitors in the Spinal Implant Market, by Segment, as a % of Total, UK, 2009

APPENDIX A: MRG ACRONYMS AND INITIALISMS

MRG Acronyms and Initialisms

APPENDIX B: SUPPLEMENTAL FIGURES

• Figure 14: Spinal Implant Market, by Country, Europe (US$), 2008 - 2014 (Detailed Format)
• Figure 15: Spinal Implant Market, by Segment, as a % of Total, France, 2009 and 2014 (Detailed Format)
• Figure 16: Spinal Implant Market, by Segment, Germany (US$), 2008 - 2014 (Detailed Format)
• Figure 17: Spinal Implant Market, by Segment, Italy (US$), 2008 - 2014 (Detailed Format)
• Figure 18: Spinal Implant Market, by Segment, Spain (US$), 2008 - 2014 (Detailed Format)
• Figure 19: Spinal Implant Market, by Segment, as a % of Total, UK, 2008 - 2014 (Detailed Format)

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EUROPEAN INTERSPINOUS PROCESS DECOMPRESSION DEVICE MARKET WILL GROW NOMINALLY AT 1.2% OVER THE NEXT FIVE YEARS

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