According to Millennium Research Group (MRG), the global authority on medical technology market intelligence, spinal nonfusion volumes will grow rapidly over the forecast period due to an accumulation of positive clinical evidence and the emergence of new segments (including annulus repair, facet arthroplasty and nuclear disc prostheses) within this market.

The rise of the spinal nonfusion technology market will, however, put some pressure on spinal fusion procedures, which, unlike nonfusion technology, do not preserve motion.

Nevertheless, spinal fusions are well-established procedures, supported by extensive clinical evidence, and they remain the gold-standard treatment. Therefore, spinal fusions will continue to account for the bulk of spinal implant procedures performed and generate the vast majority of revenues in the spinal implant market in the United States.

The US spinal fusion implant market is very mature, featuring many large, established competitors and highly commoditized products. The high potential of the spinal nonfusion technology market has, however, attracted more competitors launching innovative devices. Notably, in the fast-growing cervical artificial disc segment, three devices have recently been approved: NuVasive's PCM, Globus Medical's Secure-C and LDR Spine's Mobi-C. The Mobi-C represents the first product to be granted conditional approved for two-level applications, which will boost the use of cervical artificial discs at the expense of anterior cervical fusions.

Both the fusion and nonfusion markets will be influenced by the trend toward minimally invasive surgeries. New products that enable this technique will encourage patients who were previously unable or reluctant to undergo open surgery to seek spinal implant treatment.

This trend has also allowed a growing number of spinal implant procedures to be performed in ambulatory surgical centers, which have the potential to be lower cost and are more convenient for patients.

"Although new spinal implant products are being launched in the US, it isn't all smooth sailing for manufacturers," said MRG Analyst Rene Azeez. "Innovation in this market will face challenges due to limited reimbursement and the medical device excise tax. The innovation that is now emerging is very strategic in that companies must focus on segments with high growth potential." Overall, the US spinal implant market will expand modestly through 2021.

Millennium Research Group's US Markets for Spinal Implants 2013 report includes procedure, unit, average selling price and revenue information, along with market drivers and limiters and a competitive landscape for thoracolumbar implants, traditional cervical implants, interbody devices and spinal nonfusion technologies in the United States.