Spine Surgical Robots: Market Shares, Strategies, and Forecasts, Worldwide, 2016 to 2022

Table of Contents

Spine Surgical Robot Executive Summary 23
Spine Surgical Robot Mapping 23
Spine Surgery Robotics Market Driving Forces 27
Spine Surgery Robot Market Shares 28
Surgical Robot for Spine Market Forecasts 30

1. Spinal Surgery Robots Market Description and Market Dynamics 31
1.1 Key Elements Of Spinal Robot System 31
1.2 Industry Overview - Spine 33
1.2.1 Robot Assisted Surgery 35
1.2.2 Spine Robotic Surgical Market Strategy 36
1.2.3 Focus on Key Institutions 37
1.2.4 Focus on Leading Surgeons to Drive Rapid and Broad Adoption 37
1.2.5 Maintain Market Leadership 38
1.3 Spine Surgery 38

2. Spine Surgical Robot Market Shares and Forecasts 41
2.1 Spine Surgical Robot Mapping 41
2.1.1 Spine Surgery Robotics Market Driving Forces 45
2.2 Spine Surgery Robot Market Shares 47
2.2.1 Mazor 51
2.2.2 Surgical Robots for the Spine: Mazor Robotics 51
2.2.3 Mazor Renaissance System 55
2.2.4 Mazor Robotics Guidance System Maximizes Precision And Safety 56
2.3 Surgical Robot for Spine Market Forecasts 57
2.3.1 Surgical Robot Systems vs. Disposable Instruments Forecasts 69
2.3.2 Shenzhen Advanced Institute Spinal Surgical Robot 74
2.3.3 U.S. Minimally Invasive Spinal Implant Market To Outpace Growth In Traditional Spine Market 74
2.4 Medical Robotic Surgery Challenges 75
2.5 Key Players In The Global Medical Robots 78
2.5.1 Key Players In The Global Spinal Implant Market 81
2.5.2 Medtronic 84
2.5.3 NuVasive 84
2.5.4 SI-BONE 85
2.5.5 Minimally Invasive Surgical Instruments 85
2.5.6 Spinal Restorative Therapy Target Markets 87
2.6 Spine Surgery Robot Prices 87
2.7 Spine Surgery Robot Regional Market Segments 91
2.7.1 US 93
2.7.2 U.S.-Europe Product Introduction Swap 94
2.7.3 Asia-Pacific 95
2.7.4 China 95
2.7.5 Underdeveloped Regions 96
2.7.6 Brazil 96
2.7.7 Spinal Patients in Taiwan Receive Fast Care with Unique Reimbursement Structure; Market Led by DePuy Synthes, Medtronic 97

3. Surgical Robots Product Description 98
3.1 Mazor Robotics 98
3.1.1 Mazor Renaissance In the Operating Room 101
3.1.2 Mazor Robotics Ease of Use and Reduced Length of Stay 101
3.1.3 Mazor Products: Components of the Renaissance System 102
3.1.4 Mazor Mounting Platforms, Disposables, and Accessories 104
3.1.5 Surgical Workflow Using Mazor Renaissance 104
3.1.6 Mazor Three-Dimensional (3D) Synchronization 106
3.1.7 Mazor Spine Surgical Execution 107
3.1.8 Mazor Spine Robot Surgery Applications: 109
3.1.9 Mazor Spine Robot Surgery Applications: Spinal Fusion 110
3.1.10 Mazor Spine Robot Surgery Applications: Scoliosis Surgery 110
3.1.11 Mazor Renaissance System For Robotic Guidance 111
3.1.12 Mazor Renaissance Spine Procedures 113
3.1.13 Mazor Robotics Spine Procedures 117
3.1.14 Mazor Robotics Clinical Study 118
3.1.15 Mazor Robotics Reduced Exposure to Radiation 119
3.2 Medtronic 119
3.2.1 Medtronic Spinal Fusion 121
3.2.2 Medtronic Cervical Artificial Disc Products 122
3.2.3 Medtronic Biologics Products 124
3.2.4 Medtronic Minimally Invasive Spinal Surgery 124
3.2.5 Medtronic Posterior OCT Reconstruction 127
3.3 Stryker Spine Surgery 128
3.3.1 Stryker Spine Navigation Software 128
3.3.2 Stryker's VertaPlex HV First PMMA to Receive Clearance for Treating Sacral Insufficiency Fractures 129
3.4 Exactech 131
3.5 Zimmer / Biomet Spine 132
3.6 Medacta 133
3.7 DJO 135
3.8 Johnson & Johnson / DePuy 138
3.8.1 Johnson & Johnson / Ethicon 138
3.9 NuVasive 139
3.9.1 Nuvasive Spinal Surgical Solutions 140

4. Medical Robot Technology and Disease Statistics 142
4.1.1 Healthcare Robotics Enabling Technology 142
4.1.2 Robotic-Assisted Minimally Invasive Surgery Market Driving Forces 143
4.2 Mazor Renaissance Surgical Spine Robot FDA Marketing Clearance 510(k)146
4.3 Robotic Surgical Clinical Applications 146
4.4 Mesenchymal Stem Cells (MSC) Role In Regenerative Medicine 148
4.5 Types of Spine Surgeries 148
4.6 Minimally Invasive Spine Fusion: 150
4.6.1 Scoliosis Correction Surgery: 151
4.6.2 Vertebroplasty: 152
4.6.3 Spine Biopsies: 153
4.7 Spine Surgery Device Market 154
4.8 Mazor Renaissance Guidance System Technology 155
4.9 Government Regulation 156
4.9.1 California Regulation 159
4.9.2 International Regulation 159
4.9.3 Third Party Reimbursement 160

5. Spinal Surgical Robots Company Description 163
5.1 Accel Spine 163
5.2 Alliance Spine 163
5.2.1 Alliance Spine has Surgical Advisory Boards 164
5.2.2 Alliance Spine Bone Marrow Concentrate System 165
5.3 Alphatec 168
5.3.1 Alphatec Spine 168
5.4 Apollo Spine 170
5.5 Ascendx Spine 170
5.6 Back 2 Basics Spine 171
5.7 Boston Scientific 172
5.7.1 Boston Scientific Precision™ Plus Spinal Cord Stimulator System 172
5.7.2 Boston Scientific Pain Medicine 173
5.8 Brainlab AG 174
5.8.1 Brainlab AG Revenue 175
5.8.2 Brainlab 177
5.9 Captiva Spine 178
5.10 Centinel Spine 179
5.11 Elekta 180
5.11.1 Elekta Gamma Radio Surgery System 181
5.11.2 Elekta - Interim Report May – October 2015/16 182
5.11.3 Elekta Transformation Program On Track 184
5.12 Globus Medical 186
5.10.1 Globus Purchased Excelsius Surgical 188
5.13 K2M 188
5.14 Life Spine 190
5.15 Mazor Robotics 190
5.15.1 Mazor Robotics Creates Robotic Guidance Systems 192
5.15.2 Mazor Robotics Strategy 192
5.15.3 Research Agreement with Cleveland Clinic Foundation (CCF) 196
5.15.4 Mazor Surgical Workflow Using Renaissance for Spine Procedures 197
5.15.5 Mazor Robotic Pre-Operative Planning 198
5.16 Medacta 201
5.16.1 Medacta Business 202
5.17 Medtronic 202
5.17.1 Medtronic Revenue 203
5.17.2 Medtronic Operating Segments 206
5.17.3 Medtronic Sacroiliac Joint Fusion Device Spinal Implant Market 212
5.17.4 Medtronic Spine 213
5.17.5 Medtronic in the U.S. Spinal Implant Market 214
5.17.6 Medtronic Acquisition of Covidian 215
5.17.7 Medtronic Acquisition of RF Surgical Systems 215
5.17.8 Medtronic Acquisition of Medina Medical 215
5.17.9 Medtronic Pelvic Mesh Litigation 216
5.17.10 Medtronic Restorative Therapies Group 216
5.18 MicroPort Scientific Corporation 218
5.18.1 MicroPort Orthopedic Devices 219
5.18.2 MicroPort Acquires OrthoRecon Business from Wright Medical Technologies 219
5.18.3 Microport Hip Systems 220
5.19 NLT Spine 220
5.20 NuVasive 221
5.20.1 NuVasive Full-Year 2015 Revenue 221
5.21 Precision Spine 223
5.22 Shenzhen Advanced Institute Spinal Surgical Robot 225
5.23 Si-Bone 225
5.23.1 SI-BONE iFuse Implant System 227
5.24 SIGNUS Medical 228
5.25 Spinal Elements 230
5.26 Spineart 230
5.27 SpineGuard 231
5.28 Spine Frontier 231
5.29 Spineology 232
5.30 Spine Smith Partners 232
5.31 Spine Surgical Innovations 233
5.31.1 Spine Surgical Innovations MIMS Approach, Minimum Incision, Maximum Sight 233
5.32 Spine View 234
5.33 Spine Wave 235
5.34 St. Jude Medical 235
5.35 Stryker 236
5.35.1 Stryker / MAKO Surgical 237
5.35.2 Stryker Revenue 237
5.35.3 Stryker Results Of Operations 239
5.35.4 Stryker Segment Orthopaedics 240
5.35.5 Stryker Business Segment Operations 241
5.35.6 Stryker Revenue 242
5.35.7 Stryker Hip Recall: $1.4 Billion Settlement 243
5.35.8 Stryker Regional Revenue Segment 244
5.35.9 Stryker Robots 245
5.35.10 Stryker / MAKO Surgical 252
5.35.11 Stryker / Mako 253
5.35.12 MAKO Surgical RIO Robotic Arm 263
5.35.13 Stryker Endoscopy 264
5.35.14 Mako Surgical Business 265
5.35.15 Mako Products 266
5.35.16 Mako Surgical Strategy 269
5.35.17 Mako Surgical Revenue 272
5.35.18 Mako Surgical Business 274
5.35.19 Mako Products 275
5.35.20 Mako Surgical Strategy 278
5.35.21 Mako Surgical Revenue 281
5.36 Wenzel Spine 281
5.37 Wright Medical Technology 282
5.37.1 Wright Revenue 282
5.37.2 Wright Medical Group NV Revenue 283
5.37.3 Wright Medical Group N.V. Revenue for 2015 Third Quarter 284
5.37.4 Wright / Tornier 289
5.38 X-spine 289
5.39 Zyga Technology 291
5.40 Zimmer Biomet 293
5.40.1 Zimmer Biomet Sales by Product Category 296
5.40.2 Zimmer Biomet 297
5.40.3 Zimmer Metal-on-Metal Hip Recall 299
5.41 Spine Surgical Companies 301
5.41.1 Spine Surgical Imaging 307

List of Tables and Figures

Table ES-1 25
Robot-Guided Spine Surgery Benefits 25
Table ES-2 25
Spine Surgery Robot-Guidance Features 25
Table ES-3 26
Robot-Guide For Spine Surgery Components 26
Table ES-4 27
Robot Spine Surgery Market Driving Forces 27
Figure ES-5 29
Spine Surgical Robot Market Shares, Shipments, Dollars, Worldwide 2015 29
Figure ES-6 30
Spinal Surgical Robots Market Forecasts, Dollars, Worldwide, 2016-2022 30
Table 1-1 32
Key Elements Of A Spinal Robot System 32
Table 1-2 33
Spine Disorder Market Driving Forces 33
Table 1-3 36
Spine Surgical Robot Focus on Key Procedures 36
Table 1-4 39
Spinal Surgery Scientific Advances 39
Table 1-5 39
Robot-Guided Spinal Surgery Advantages: 39
Table 2-1 43
Robot-Guided Spine Surgery Benefits 43
Table 2-2 43
Spine Surgery Robot-Guidance Features 43
Table 2-3 44
Robot-Guide For Spine Surgery Components 44
Table 2-4 45
Robot Spine Surgery Market Driving Forces 45
Figure 2-5 48
Spine Surgical Robot Market Shares, Shipments, Dollars, Worldwide 2015 48
Table 2-6 49
Spine Surgical Robot Market Shares, Dollars, Worldwide, 2015 49
Table 2-7 50
Principal Competitive Factors in the Robotic Spine Surgery Market 50
Table 2-8 51
Mazor Revenue, 2010-2015 51
Figure 2-9 54
Mazor Leading Spine Surgery Innovation 54
Figure 2-10 57
Spinal Surgical Robots Market Forecasts, Dollars, Worldwide, 2016-2022 57
Table 2-11 58
Spinal Surgical Robot Market Forecasts, Dollars, Worldwide, 2016-2022 58
Table 2-12 59
Spinal Surgical Robot Revenue by Segment, Robots and Disposables, Worldwide,
2016-2022 59
Table 2-13 60
Robot Spine Procedures, Number, Worldwide, 2015 60
Table 2-14 61
Spinal Surgical Robot Units Shipped Forecasts, Surgical Robotic Procedures, and
Number Procedures per Installed Unit, Worldwide, 2016-2022 61
Table 2-15 62
Spinal Surgical Robot Installed Base, Percent Spinal Procedure Penetration, and #
Spinal Procedures, US and Worldwide, 2016-2022 62
Table 2-16 63
Spinal Surgical Patients with Chronic Back Pain and % Penetration Procedures
Worldwide, 2016-2022 63
Table 2-17 64
Robot Spine Surgery Market Factors: 64
Table 2-18 65
Robotics Market Aspects 65
Table 2-19 66
Spinal Surgery Hospital Trends 66
Table 2-20 67
Robotic Cost Savings with Spinal Surgical Units 67
Figure 2-21 69
Surgical Robot Systems vs. Instruments Forecasts, Dollars, Worldwide, 2016-
2022 69
Table 2-22 71
Benefits of Robotic Surgery For The Surgeon 71
Table 2-23 72
Benefits of Robotic Surgery For The Patient 72
Table 2-24 73
Benefits of Robotic Surgery For The Hospital 73
Table 2-25 76
Challenges of Open Surgery and Minimally Invasive Surgery 76
Table 2-26 77
Challenges of Developing Medical Robotic Surgery Systems 77
Table 2-27 78
Surgical Robotic Product Development Challenges 78
Table 2-28 79
Key Players In The Global Medical Robots Market 79
Table 2-29 83
Key Players In The Global Spinal Implant Market 83
Table 2-30 86
Advantages of Minimally Invasive Surgeries 86
Table 2-31 86
Challenges of Minimally Invasive Surgeries 86
Figure 2-32 91
Spine Surgical Robot Regional Market Segments, Dollars, Worldwide, 2015 91
Table 2-33 92
Spine Surgical Robot Regional Market Segments, 2015 92
Figure 3-1 99
Mazor 3D Visualization of Surgical Planning 99
Figure 3-2 100
Mazor Planning Software / 3D visualization 100
Table 3-3 102
Mazor Components of the Renaissance System 102
Table 3-4 103
Mazor Renaissance System Component Tasks 103
Table 3-5 105
MAZOR RBT Device Surgical Workflow Using Renaissance for Spine Procedures105
Figure 3-6 107
Mazor Renaissance RBT Device Accuracy of the 3D Synchronization 3D Marker; Carm
in 2 Positions Taking Registration Images for 3D Synchronization Process 107
Figure 3-7 108
Mazor RBT Device (with an arm connected to it) on Clamp Mount Ready To Guide
The Surgeon 108
Figure 3-8 109
Mazor Spine Robot Surgery Applications: 109
Figure 3-9 112
Mazor Robotics’ Renaissance System For Guidance 112
Figure 3-10 113
Mazor Renaissance Spine Procedures 113
Figure 3-11 117
Mazor Robotics Spine Procedures Variety 117
Table 3-12 120
Medtronic Spinal Conditions Treated 120
Table 3-13 123
Medtronic Infuse Bone Graft/LT-Cage Lumbar Tapered Fusion Device Risks 123
Table 3-14 126
Medtronic Minimally Invasive Spine Platform Enables A Variety Of Cervical,
Thoracic, And Lumbar Procedures 126
Figure 3-15 127
Medtronic Posterior OCT Reconstruction 127
Table 3-16 129
Stryker Spine Navigation Software Key Advantages 129
Table 3-17 132
Zimmer / Biomet Spine Surgical Solutions 132
Figure 3-18 133
Biomet Sequoia Thoracolumbar Pedicle Screws with TM Ardis™ Interbody
System133
Figure 3-19 135
DJO Cement Solutions 135
Table 3-20 135
DJO Spine Devices 135
Table 3-21 140
Nuvasive Surgical Solutions Procedures 140
Table 3-22 141
Nuvasive Surgical Solutions NVM5 Nerve Monitoring System 141
Table 4-1 142
Healthcare Robotics Enabling Technologies 142
Table 4-2 143
Robotic-Assisted Minimally Invasive Surgery Market Driving Forces 143
Table 4-2 (Continued) 144
Robotic-Assisted Minimally Invasive Surgery Market Driving Forces 144
Table 4-3 145
Types Of Procedures Performed Using Robotic Surgical Systems 145
Table 4-4 148
Types of Spinal Pathology and Disorders 148
Table 4-5 149
Types of Spinal Deformities 149
Table 4-6 150
Types of Spinal Disorder Treatments 150
Figure 5-1 166
Alliance Spine Nakoma SL Anterior Cervical Plating System 166
Figure 5-2 167
Alliance Spine Alamo C 167
Figure 5-3 173
Boston Scientific SCS System: 32 Contacts and 32 Dedicated Power Sources 173
Figure 5-4 174
Brainlab Collaborative Workspace 174
Figure 5-5 175
Brainlab AG Worldwide Presence, Headquarters in Germany 175
Figure 5-6 179
Captiva Spine Pedicle Screw System 179
Figure 5-7 181
Elekta Gamma Radio Surgery System 181
Figure 5-8 187
Globus Medical Spine Surgery Products 187
Table 5-9 191
Mazor Revenue, 2010-2015 191
Table 5-10 193
Mazor Robotics Strategy Key Elements 193
Table 5-11 193
Mazor Robotics Commercialization of Renaissance System
Strategy Key Elements 193
Table 5-12 194
Mazor Robotics Utilization Of Installed Base Strategy Key Elements 194
Table 5-13 195
Mazor Robotics Clinical And Financial Value Strategy Key Elements 195
Table 5-14 196
Mazor Robotics Research And Development Strategy Key Elements 196
Table 5-15 197
Basic Steps for Surgical Workflow Using Mazor Renaissance Robot 197
Figure 5-16 199
Mazor Surgical Planning Software Provides A Slice-By-Slice Image Display 199
Figure 5-17 200
Mazor Surgical Robot: 3D Marker; C-arm in 2 positions taking registration images
for 3D Synchronization process 200
Figure 5-18 201
Mazor RBT Device (with an arm connected to it) on Clamp Mount ready to guide
the surgeon 201
Figure 5-19 205
Medtronic / Covidian Integration 205
Table 5-20 213
Medtronic Principal Products Offered by Spine Division: 213
Table 5-21 217
Medtronic Spine Division Principal Products 217
Table 5-22 218
MicroPort Advanced Technology Product Segments Addressed 218
Table 5-23 220
Microport Hip Systems 220
Figure 5-24 224
Precision Spine Cervical Spine Devices 224
Figure 5-25 229
SIGNUS Medical Sacroiliac Joint Medical Device 229
Figure 5-26 246
Stryker Joint Implants 246
Figure 5-27 248
Stryker Patient Specific Pre-Operative Planning 248
Figure 5-28 249
Stryker Patient Specific Pre-Operative Planning 249
Table 5-29 250
Stryker Better Fit Orthopedics 250
Table 5-30 251
Stryker Osteoarthritis Affects Compartments Of The Knee 251
Figure 5-31 252
Stryker / MAKO Surgical RIO Robotic Arm Interactive System 252
Figure 5-32 260
MAKO Surgical Restoris 260
Figure 5-33 262
Mako Robotic Arm Technology Assists in Total Hip Replacement 262
Figure 5-34 263
MAKO Surgical 263
Figure 5-35 264
MAKO Surgical Implants 264
Table 5-36 269
MAKO Robotic Surgery Benefits 269
Figure 5-37 273
Mako Robotic Arm Technology Assists in Total Hip Replacement 273
Table 5-38 278
MAKO Robotic Surgery Benefits 278
Figure 5-39 292
Zyga Technology SImmetry System 292
Table 5-40 298
Zimmer Biomet Musculoskeletal Healthcare Offerings 298
Table 5-41 300
Zimmer Metal On Metal Hip Replacement Difficulties and Side Effects. 300

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