About | Tiger Buford

An Illinois startup is revolutionizing cast design

Illinois Start-Up Revolutionizing Cast Design (ODTMag)
website Cast21
Polymer-based design allows for breathability and gives patients and physicians easy access to the affected area.
It is estimated that in the United States about six million emergency room visits involve broken bones. Ask anyone who’s been there—breaking a bone is no fun. Of course there is the pain of the initial injury and not being fully functional for a few months.
For those patients who will ultimately need a cast, there are also extenuating affects like not being able to get to an itch, the smell of the cast, and extra effort needed to cover it when taking a shower. About 40 percent of those patients experience some sort of skin or soft tissue damage throughout their experience as well.
A University of Illinois startup, Cast21, is helping take part of the sting out of the recovery with a revolutionary cast design. Made of various polymers, its netted structure allows for breathability and gives patients and physicians easy access to the affected area for treatment and comfort. And it is completely waterproof, meaning no need to cover your arm or leg with a garbage bag in the shower. It also doesn’t trap water against the skin like some of the current models on the market.
To read the full feature, see it at ODTmag – Illinois Start-Up Revolutionizing Cast Design

Bones from hip replacement transplants give new life

PHOTO: Hip bones are cleaned and ground down into ‘Crunch’ after surgery. (ABC: Ginny Stein)

MAP: Sydney 2000

Bones from hip replacement transplants give new life (ABC Australia)

In the business of bone donation, old hips are giving new life to people needing reconstructive surgery.
More than 33,000 hip replacements are performed each year in Australia.
VIDEO: Bones from hip replacement transplants give new life(Lateline)
If the patient ticks the bone donation box, part of the hip is taken away to be processed and turned into bone grafts.
When a hip is replaced, the ball at the top of the hip joint, the femoral head, is removed and a plastic socket put in its place.
In New South Wales, just 600 out of 6,000 hip replacement patients last year agreed to become living donors.
While the number remains low, it represents a steady increase.
Sharon Bryce from the Australian Tissue Donation Network said the majority of people are not aware of bone donation.
“You see bone from people in their 60s and 70s and 80s being used for example to transplant into children who are having spinal surgery,” Ms Bryce said. “So children as young as two or three years of age are actually recycling or re-using bone from older people.”
Old hips give new life
PHOTO: Bernard Lamerton became a living bone donor when he had hip replacement surgery. (ABC: Ginny Stein)
Bernard Lamerton said the decision to become a living bone donor took no time at all to make.
“I just thought it was a given, I will certainly do it. I was happy to do it, I never gave it a second thought. I was always going to do it,” he said.
On the day he was told he needed a hip replacement, his surgeon, Professor Warwick Bruce, presented him with two other options.
“I told him he could help two to four other people by donating his femoral head, which would otherwise be thrown out,” Professor Bruce said.
Professor Warwick Bruce uses donated bone and tissue in a range of reconstructive procedures, from knee reconstructions through to children having spinal surgery to repair scoliosis or curvature of the spine.
He has been at the forefront of promoting bone donation for decades.
“I actually had the first bone bank in Sydney in 1984,” he said. “A patient died in the hospital and I asked permission and I harvested all their bones. It kept me in bone for about three or four years.”
With bone and tissue grafts the second most performed procedure after a blood transfusion, there is now a push to raise awareness about what it means to become a donor.
Crunch: Milled up bone fills gaps
PHOTO: Crunch – the product created after bone has been ground down. (ABC: Ginny Stein)
Lateline was given a rare glimpse into a world few outsiders have ever seen.
Simon Berry is the CEO of Australian Biotechnologies, a laboratory in northern Sydney where donated bone is recycled for use in surgery.
At the lab, a team of specialist technicians carry out what is a very niche trade.
Donated bone from living and deceased donors is shaped into blocks or plugs for ready use in surgery.
“The surgeons prefer this tissue because it replicates the natural healing properties of the patient’s own bone, and effectively it remodels into the patients’ own bone over a six to 12-month period,” said Mr Berry.
It is also ground down into a product aptly named Crunch, to fill in the gaps and help healing after surgery. “Crunch is effectively milled up bone to a certain granulated size.
“We use a special process to clean and then sterilize that bone, and that can be used in surgery such as orthopaedic and spinal surgery.”
In the past decade 25,000 Australians have benefited from bone grafts manufactured in the Australian Biotechnologies lab.
‘It’s worked amazingly’
PHOTO: Natalia Lisowski received donated bone to repair her scoliosis. (ABC: Ginny Stein)
Natalia Lisowski is 15 years old and dreams of becoming a professional footballer.
Earlier this year, she began to doubt she was capable of pursuing her dream when she started to struggle to breathe.
“I was really scared just because I thought there was something that could go wrong and prevent me from doing things that I love like playing soccer. I was terrified,” she said.
She underwent surgery with donated bone used to repair her scoliosis.
Three months after her surgery, she has now been given the all clear to start playing again.
“It has worked so well. I don’t have much pain anymore.
“I’m back to doing almost everything I used to do, it’s worked amazingly.”

OFFER: Free career advice for engineers in orthopedics

I would like to give back.
The orthopedic industry has been very good to me over the last 30 years. I started my journey as an engineering intern at Smith and Nephew and ended up leading the R&D efforts in my last three startups. I understand how the orthopedic industry works and I can coach engineers to accelerate their careers in this amazing industry.
I am happy to give you free advice – no strings attached. But you MUST have at least 2 years industry experience in a musculoskeletal company somewhere (otherwise, you really don’t know yourself yet).
If you are interested, just send me an email at [email protected] or send me a LinkedIN invite at and mention “career advice” and we will find a time to talk.
Best,

Paper: a review of corrosion in spine implants

Clinical and retrieval evidence for corrosion of spine implants
Vasiliki Panagiotopoulou demonstrates the importance of understanding the mechanisms in the multifactorial cause for failure in spinal implants
All prosthetic implants are subject to some degree of wear and corrosion in the body. Wear is a mechanical process resulting from changes in load distribution and micro-motion, while corrosion is an electrochemical process of metal degradation. Certain types of corrosion, such as fretting, occur when chemical and mechanical factors, including crevice and abrasive wear, act on the implant.
Both wear and corrosion result in debris release from the implants into the surrounding tissues and subsequently into the human circulation, and can manifest with local and systemic reactions which, over time, may demand revision of components. Although numerous studies have focused on the clinical significance of corrosion and wear of hip and knee replacements, research involving spine instrumentation is not well documented.
Recently, we received spine instrumentation, with cobalt–chrome (CoCr) rods with titanium (Ti) fixtures, of a 36-year-old female patient (Figure 1). She was diagnosed with adult idiopathic scoliosis (Figure 1A); however, soon after surgical implantation (Figure 1B) she experienced persistent pain and muscle fasciculation. Surgeons recommended removal of metalwork after two years of implantation, where intra-operatively they discovered metal staining of the tissue. We analysed the retrieved components in our facilities, and this case will serve here as a running example.
Figure 1: (A) Pre-operative radiograph of the patient showing progressive scoliosis. (B) Post-primary radiograph of the patient showing the metalwork from T3 to T11, including two rods, 11 screws and two connectors. (C) Post-revision radiograph showing progression of of scoliosis.

This article aims to demonstrate the importance of retrieval analysis of corroded spinal components (Figure 2) in combination with clinical examination findings, medical imaging, blood and tissue analysis in understanding the mechanisms in the multifactorial cause for failure in spinal surgery.

Figure 2: highly corroded junctions on spine retrievals, with signs of: (A) corrosive debris (blue arrow) compared with unworn areas (green arrow); (B) corrosive deposits (blue arrow) in higher magnification; and (C) fretting (yellow arrow) and pitting (red arrow).

Emphasis is placed on the following:

incidence of corrosion and wear-related reactions in spine surgery patients;
the mechanisms behind wear and corrosion;
methods to investigate corrosion and wear of spine implants;
findings from retrieval analysis of spinal explants; and
implant, patient and surgeon factors that contribute to increased corrosion and wear of spine implants.

Evidence for corrosion and wear of spine implants in current clinical practice
Several case reports have been published on revision of spine components where the reason for revisions were strongly linked with corrosion and wear of the implants [1–7]. Medical complications included unexplained pain, neurological effects, implant loosening, implant failure, swelling and metal staining of the skin.
In 2005, Tezer and co-workers reported the revision of stainless steel (SS) spine instrumentation due to intraspinal metallosis leading to paraparesis during the third post-operative year [2]. Retrieval analysis of the components revealed crevice and fretting at the junctions between rod and fixtures. Imaging, histological and tissue analysis, combined with intra-operative assessment, revealed a granulomatous mass made of metal debris, macrophages and giant cells pressing the spinal cord, leading to lower limb paralysis. Symptoms ceased soon after the implant was removed. There are two earlier case reports on patients with neurologic symptoms that resolve soon after the removal of the instrumentation [1]; in both cases, soft tissue samples were composed of metal debris and macrophages.
In a further case, a paediatric patient with scoliosis was revised twice for persistent pain six and 12 months post-operatively, respectively [6]. The first revision was after radiological diagnosis of implant failure, while the second revision was performed to remove soft tissue mass. Histological analysis of tissue taken during revision revealed metal debris and presence of macrophages. In this case, pain was associated with unstable fusion and implant loosening. Gaine and others [3] reported six cases of later operative pain associated with debris release from SS implants.
Recently, a review of spine metallosis included a case report of spinal metalloma in a patient with titanium spine implants. The reason for revision was severe lower back pain and lumbar radiculopathy. Intra–operative findings included scar tissue and a granulomatous mass, both removed for analysis, while histological analysis concluded that this was a case of spinal metallosis [4].
These case reports conclude that corrosion and wear are independent of materials used in spine instrumentation. Reactions to metal debris can vary from late operative pain to neurological complications, while spine metalloma seems to be the common denominator.
In comparison with the spine instrumentation of our case example, the patient was revised for persistent pain and muscle spasms. During revision surgery, metal staining of the periprosthetic tissue was observed. Tissue samples were taken and sent for histological analysis (Figure 3). Upon removal of the metalwork, the patient went pain free, although the pain spasms still occur.

Figure 3: Histological analysis at different magnifications showing presence of macrophages and giant cells with ingested wear particles, consistent with adverse reaction due to wear and corrosion of spine implants.
How to assess the effects of wear and corrosion of spine implants
Here we will address (i) the mechanisms that link corrosion and wear of implants with local and systemic effects, as well as (ii) how corrosion and wear manifest and can be identified in current clinical practice.
Metal debris can either stay locally or circulate in the bloodstream. In the case of local reactions, macrophages form giant cells that ingest the metal debris – this is probably an immune mechanism for managing the effects of metal presence in the body. In addition, wear debris is also suspected to be responsible for bony loss (osteolysis), affecting the interface between implant and bone and hence resulting in implant loosening and pain. In the case of circulation in the bloodstream, metal ions bound with proteins or in the form of salt solutions travel to remote organs, setting in motion systemic reactions, such as metal hypersensitivity, carcinogenesis and toxicity.
Generally, different particles and ions stimulate different reactions. For example, cobalt is suspected to lead to cellular apoptosis and necrosis [8,9], and aluminium is associated with seizures and epilepsy [10] and is strongly linked with Alzheimer’s disease [11], while titanium inhibits osteoclastic activity, accelerates osteoclastic differentiation and causes osteolysis [12].
In clinical practice, evaluation of imaging and blood test results can serve as indications of corrosion and wear in spine implants, although they are not established as part of the routine monitoring of patients. In most case reports with corroded and worn spine instrumentation, computed tomography (CT) myelography showed the presence of soft tissue mass, which was later identified as metalloma. In studies involving total disc replacements, ion levels in blood were found comparable with the values measured in patients with total joint arthroplasties, suggesting a similar wear rate.
Single photon emission computed tomography (SPECT) combined with CT scanning is used to detect changes by identifying the reasons behind early or late increased uptakes on the scans. Early increased uptake is a sign of possible infection, whereas late uptake serves as an indication of implant loosening or increased bone activity. Increased uptake could be an indication of increased vascularity due to inflammatory reaction to metal debris. Future work, combining retrieval analysis with assessment of advanced imaging, is needed.
Laboratory tests for metal ions in blood are not part of the routine clinical practice in spine surgery – compared with hip reconstructive surgery for patients with metal-on-metal implants. A study measuring metal concentrations in the serum and hair of patients with Ti spine implants was inconclusive: only one-third of the patients had abnormal metal concentration in serum, compared with one-fifth of the patients with abnormal results in hair. When patients with failed instrumentation and abnormal blood test results were compared with patients with well-functioning implants and abnormal test results, there was no significant difference, suggesting that blood tests could not be used as an accurate diagnostic tool for implant failure [13]. However, even the presence of metal ions in the blood indicates that debris from spine instrumentation can enter the bloodstream, so more work is needed to correlate blood metal ions with corrosion and surface degradation.
In our case example, no blood was taken during the implantation period for counting the metal ion concentrations in order to determine whether metal ions are released due to wear of the components. Only a year after removal of the metalwork, blood tests revealed 14nmol/L for whole blood Cr and 3nmol/L for whole blood Co, while Ti levels were undetectable (<10nmol/L). Imaging during implantation revealed good level of fusion (Figure 1B), which suggested the removal of components without fear of recurrence of scoliosis. CT and MRI scans during the implantation did not show any signs of failure of the metalwork, such as implant loosening or fracture of any component. A year after the revision surgery, MRI scan did not reveal any soft tissue mass consistent with the presence of pseudotumour, as a reaction to metal debris release.
Retrieval analysis of corrosion and wear of spine implants
Most papers on retrieval analysis focus on total disc replacements, although there are a few studies investigating spinal rods from scoliosis patients. In this section we will review retrieval studies in spine instrumentation, as well as preliminary findings from our work at the London Implant Retrieval Centre (LIRC).
Preliminary results from an international repository for retrieved total disc replacements showed wear in both metal-on-poly and metal-on-metal disc replacements. Chemical reactions such as corrosion in metal components and oxidation in poly components were identified. The histological examination of tissue concluded inflammatory response to metal and poly debris after fusion [14].
Spinal rods made of SS from 11 patients were revised and retrieval analysis was performed. Corrosion and fretting were present at the rod–screw junctions in all constructs, but were more evident on implants with longer time of implantation. The authors suggested that corrosion can be more rapid in cases where spinal fusion is not achieved compared with fusion cases [15].
Surface analysis of retrieved spine implants made of SS, Ti and CoCr alloys suggested that all components were corroded; however, implants made of SS were found to be more susceptible to corrosion and wear than the Ti and CoCr implants. The types of corrosion identified were fretting and crevice; no signs of galvanic corrosion were found [16].
Preliminary results of the forensic analysis in retrieved spine implants received in our centre showed fretting and pitting in most of the components, regardless of the time of implantation and the material alloy. Macroscopic and microscopic inspection has identified rod–fixture junctions as areas of potential fretting, pitting and corrosion. Scanning electron microscopy (SEM) together with energy dispersive X-ray spectroscopy (EDX) are used to identify surface changes and deposit composition, respectively. Analysis of elemental composition of debris and deposits will help us identify their either corrosive or biological origin.
We are working on identifying the role of corrosion and wear in the failure of the magnetically controlled growth rods. Published and anecdotal reports of metallosis presented intra-operatively suggest that the rods are subject to wear and corrosion, while debris migrates to surrounding tissue and causes staining.
In the running example, we macroscopically and microscopically assessed the retrieved components for signs of fretting and pitting. We identified 15 sites of interest on the rod, which were caused from screws, nuts, hooks and connectors. Most of the junctions on the rods were moderately to severely damaged. In comparison with CoCr rods revised for infection, the junctions were more damaged in terms of severity and extension, suggesting a link between tissue reaction and corrosion and wear due to implantation. Microscopic analysis showed fretting and pitting, while EDX showed Ti transfer from the Ti fixtures to the CoCr rods. On the other hand, there were no signs of increased corrosion due to galvanic coupling when compared with constructs made of Ti rods with Ti fixtures. We aim to proceed with the retrieval analysis with measurements of material loss to quantify the volumetric loss on the junctions.

Identifying the risk factors for corrosion and wear of spine implants
Research in retrieved hip replacements suggests that implant failure is multifactorial; the same is true for corrosion and wear of spine components.

Surgical risk factors
Spine surgery is more complex than hip surgery because of the complexity of the spine anatomy compared with the hip, the variety of deformities and diseases that affect the spine column and the increased forces applied to components, especially in the case of deformities. Research into hip retrievals provided guidelines and recommendations for better monitoring of patients and improved pre-surgical planning [17–20]. Similarly, retrieval analysis combined with analysis of clinical, imaging and laboratory data, will improve pre-operative planning and monitoring by identifying the warning signs of potential or early failure of spine instrumentation.

Implant risk factors
Research on hip components revealed that implant material and design, including the combination of dissimilar materials in the same construct, can be a decisive factor for the failure or not of the implant [7,21]. There have been some case reports in the literature suggesting that increased modularity in spine instrumentation is suspected to be linked with the presence of metallosis – by providing more junction sites for wear and corrosion, thus increasing the amount of metal release [2], especially in the case of movement in the junctions. The implant factors for corrosion can be stratified as low, medium and high risk as seen in Table 1.

Current clinical practice allows the use of components made of dissimilar materials, especially in the treatment of adult deformities, making the most of physical and chemical properties of the materials. The galvanic coupling of different alloys in a corrosive environment is assumed to accelerate the degradation of components; however, pre-clinical testing and preliminary results of retrievals show no evidence of galvanic corrosion for different combinations of materials [22,23].

Patient risk factors
Research into hip implants reveals that some patients are more sensitive to metal debris than others, suggesting that these patients are more prone to present with adverse tissue reactions [8,9]. In spine surgery, however, there is very sparse data available on this subject.
One possible patient risk factor is bone quality, which can determine the time required for spinal fusion. Wear and corrosion debris are linked with osteolysis [6,14,24], but it is not clear how poor-quality bone is affected by wear and corrosion compared with good-quality bone [24]. Smoking is suspected to have an effect on the process of bone fusion, but has not yet been correlated with the failure of spine implants [25].

References
1. Takahashi S, Delécrin J, Passuti N. Intraspinal metallosis causing delayed neurologic symptoms after spinal instrumentation surgery. Spine. 2001;26(13):1495-8
2. Tezer M, Kuzgun U, Hamzaoglu A, et al. Intraspinal metalloma resulting in late paraparesis. Arch. Orthopaedic Trauma Surg. 2005;125(6):417-21
3. Gaine WJ, Andrew SM, Chadwick P, et al. Late operative site pain with isola posterior instrumentation requiring implant removal: infection or metal reaction? Spine. 2001;26(5):583-7.
4. Goldenberg Y, Tee JW, Salinas-La Rosa CM, Murphy M. Spinal metallosis: a systematic review. Eur. Spine J. 2016;25(5):1467-73
5. Senaran H, Atilla P, Kaymaz F, et al. Ultrastructural analysis of metallic debris and tissue reaction around spinal implants in patients with late operative site pain. Spine. 2004;29(15):1618-23
6. Botolin S, Merritt C, Erickson M. Aseptic loosening of pedicle screw as a result of metal wear debris in a pediatric patient. Spine. 2013;38(1):E38-E42
7. Jones CS, Stokes OM, Patel SB, et al. Actuator pin fracture in magnetically controlled growing rods: two cases. Spine J. 2015 //details needed//
8. Cheung A, Banerjee S, Cherian J, et al. Systemic cobalt toxicity from total hip arthroplasties. Bone Joint J. 2016;98(1):6-13
9. Zywiel M, Cherian J, Banerjee S, , et al. Systemic cobalt toxicity from total hip arthroplasties. Bone Joint J. 2016;98(1):14-20
10. Zatta P, Lucchini R, van Rensburg SJ, Taylor A. The role of metals in neurodegenerative processes: aluminum, manganese, and zinc. Brain Research Bulletin. 2003;62(1):15-28
11. Tomljenovic L. Aluminum and Alzheimer’s disease: after a century of controversy, is there a plausible link? J. Alzheimer’s Disease. 2011;23(4):567-98
12. Yao J, Cs-Szabo G, Jacobs JJ, et al. Suppression of osteoblast function by titanium particles. J. Bone Joint Surg. Am. 1997;79(1):107-12
13. Kasai Y, Iida R, Uchida A. Metal concentrations in the serum and hair of patients with titanium alloy spinal implants. Spine. 2003;28(12):1320-26
14. Kurtz SM, Steinbeck M, Ianuzzi A, et al. Retrieval analysis of motion preserving spinal devices and periprosthetic tissues. SAS J. 2009;3(4):161-77
15. Akazawa T, Minami S, Takahashi K, et al. Corrosion of spinal implants retrieved from patients with scoliosis. J. Orthopaedic Sci. 2005;10(2):200-5
16. Kirkpatrick JS, Venugopalan R, Beck P, Lemons J. Corrosion on spinal implants. J. Spinal Disorders Techniques. 2005;18(3):247-51
17. Hothi HS, Berber R, Panagiotopoulos AC, et al. Clinical significance of corrosion of cemented femoral stems in metal-on-metal hips: a retrieval study. International Orthopaedics. 2016:1-8
18. Hart A, Muirhead-Allwood S, Porter M, et al. Which factors determine the wear rate of large-diameter metal-on-metal hip replacements? J. Bone Joint Surg. Am. 2013;95(8):678-85
19. Berber R, Skinner JA, Hart AJ. Management of metal-on-metal hip implant patients: Who, when and how to revise? World J. Orthopedics. 2016;7(5):272
20. Berber R, Henckel J, Khoo M, et al. Clinical usefulness of SPECT–CT in patients with an unexplained pain in metal on metal (MOM) total hip arthroplasty. J. Arthroplasty. 2015;30(4):687-94
21. Hothi HS, Whittaker RK, Meswania JM, et al. Influence of stem type on material loss at the metal-on-metal pinnacle taper junction. Proceedings of the Institution of Mechanical Engineers, Part H: J. Eng. Med. 2015;229(1):91-7
22. Mali SA, Singh V, Gilbert JL. Effect of mixed alloy combinations on fretting corrosion performance of spinal screw and rod implants. J. Biomed. Mater. Res. B: Applied Biomaterials. 2016.//details needed//
23. Serhan H, Slivka M, Albert T, Kwak SD. Is galvanic corrosion between titanium alloy and stainless steel spinal implants a clinical concern? Spine J. 2004;4(4):379-87.
24. Hallab NJ, Cunningham BW, Jacobs JJ. Spinal implant debris-induced osteolysis. Spine. 2003;28(20S):S125-S38
25. Boden SD, Sumner DR. Biologic factors affecting spinal fusion and bone regeneration. Spine. 1995;20:113S

Authors
Vasiliki C. Panagiotopoulou, Harry S. Hothi, Johann Henckel, Hanny A. Anwar, Sean Molloy, Stewart K. Tucker, John Sutcliffe, John A. Skinner, Alister J. Hart

Lead author:
Vasiliki Panagiotopoulou is a postdoctoral research associate with a background in chemical and biomedical engineering. She is currently in charge of developing a spine retrieval project at the LIRC, which is based at the Royal National Orthopaedic Hospital. This has led to the submission of the first retrieval paper for the analysis of the failure mechanism of magnetically controlled growth rods, and the submission of the first retrieval paper for corrosion in similar and dissimilar materials (CoCr and Ti components), collaborating with 16 consultant surgeons from 10 hospitals in the UK and abroad.
e: [email protected] /
[email protected]

London Implant Retrieval Centre (LIRC)
Our multidisciplinary group of engineers and surgeons is working on investigating the potential surgical, implant and patient risk factors for different types of spine implants, by combining clinical, imaging, histological and retrieval analysis.
LIRC is based at Royal National Orthopaedic Hospital (RNOH), working in close collaboration with the RNOH spinal unit, which is a centre for referrals of complex cases, both in a national and an international level. We are also collaborating with senior spine surgeons and several hospitals across the country, including Great Ormond Street Hospital and Queens Medical Centre (Nottingham). Our project has led to the collection of more than 500 components of spine instrumentation, from pedicle screws and magnetically controlled growth rods to intervertebral bodies and disc replacements, with relevant clinical and imaging data, all consented by the patients. We are using state-of-the-art engineering methods to inspect retrieved components and to identify signs of corrosion and material loss, using facilities at UCL. We currently have four abstracts under review for upcoming international conferences (AAOS, ORS and ICEOS), with nine spine surgeons as co-authors. We have two podium presentations at the Annual Meeting of British Scoliosis Society in October.
Since LIRC was founded in 2007, its impact on hip reconstructive surgery has been well established. We have published more than 80 papers with over 200 co-authors in peer-reviewed journals, at a rate of a paper a month, and presented more than 200 times in national and international conferences. Our research has influenced the monitoring of patients with hip implants, as we are working towards identifying the SIP factors for hip implants. We have provided guidelines and recommendations to surgeons about who, when and why to revise. Our group is closely collaborating with MHRA and Beyond Compliance in order to improve the life of patients with orthopaedic implants. We have established an NHS service for retrieval analysis (www.rnoh.nhs.uk/our-services/retrieval-analysis), from secure storing of implants to detailed report on retrieval findings which can identify the cause of failure of the implant.

The Complete List of Spine Startups

Welcome to OrthoStreams where you can research the Orthopedic industry through free lists, stories and interviews with leaders.

(alphabetical A-Z)
3Cor Medical, Inc. (Redwood City, CA) Distraction screws for plating and interbody fusions, founded in 2002
Aaxter  (Taiwan)  instrumented fusion http://www.aaxter.com/english/index.php
Accel Spine (Dallas) Pedicles screws and plates, eight 510(k) clearances so far http://www.accelspine.com/
Acme Spine, LLC (CA) 510(k) submissions, but no public information for a few years
Adaptive Specialty, LLC (Portland, OR)  510(k) clearances for cages, interbody devices in 2009
Advanced Biologics (Ladera Ranch, CA) biologics products designed for spinal applications, OsteoAMP, OsteoGEN, OsteoMEM.   http://advancedbiologicscorp.com
Advanced Spine Fixation Systems Inc. (Irvine, CA) [ACQUIRED] early spinal cage implant company started in 1998. Osteoimplant (UK) acquires them in 2003
Advanced Vertebral Solutions – AVS (Alpharetta, GA)  510(k) clearance for steerable TLIF PEEK cage http://www.steerabletlif.com/
Aegis Spine (Denver, CO) PEEK cages and fixation http://aegisspine.com/
Alligator Spine  (Miami Beach, FL)   German-made basic instrumentation  http://www.alligator-medical.com/
Alphatec Spine (San Diego) HealthPointCapital took them public in Jun 2006 – ATEC, non-excl with Isotis for DynaGraft II, licensed MIS patents from Dr Jackson. HealthPointCapital conveniently merged them with Scient’x (another spine holding), Licensed V-Stent (Stout Medical Group) expandable titanium cage for vertebral compression fractures; in 2010 AlphaTec found itself under tremendous scrutiny for potentially manipulating and misleading investors that purchased ATEC stock only to watch it collapse.    http://www.alphatecspine.com/
Alethea Spine (Akron) Chuck Burchall’s new company that is teasing the market with a disk replacement with an anatomic modulus of elasticity.  http://www.aletheaspine.com/
Allure Spine (Charlotte, NC) Spondylos Spinal Fixation System; won a defense contract
Altiva Corp (Charlotte, NC)  [ACQUIRED] early 2008 acquired by Exactech for $25M, contour spinal system, some bio DBM, the old S+N Simmons plating system, agreement with Curasan and RTI for OsteoBridge DBM graft, Frazier Healthcare Ventures, implanted 100 ant. buttress plates so far, Craig Corrance   http://www.exac.com/products/spine
Altus Spine (Newtown Square, PA) plating and IBF systems, launched 2015  http://www.altus-spine.com/
Amedica (Salt Lake City, UT) Brought a new material to Orthopedics for the first time – Silicon Nitride is a super strong and durable ceramic used in industrial applications; cervical Ceramic-on-ceramic spacer made of Silicon Nitride is FDA approved, four rounds of funding so far, IPO planned then pulled back, CEO change from founder, Ashok Khandkar to various CEOs, acquired US Spine   http://www.amedicacorp.com/
Amendia (Marietta, GA) Niche spine products including Savannah Pedicle screw/rod system, Phenix interbody cages, and temporarty screws for stereotactic procedures, also a distributor for Spineology’s OptiMesh   http://www.amendia.com
Anatomica Spine (Sweden) instrumented fixation
http://www.anatomicaspine.com/
Angtrom Medica (Mass) Bio, having trouble finding more funding, no press releases after 2006, some products now sold by Pioneer Surgical  http://www.angstrommedica.com
Anulex Technologies, Inc (Minnetonka MN) Inclose Surgical Mesh system for annulus repair (510k Sep05), Mike McCormick (CEO), Matt Burns (founder) Exactech pres on board – Dr Petty, 1,200 procedures in 2007, Xclose annular repair, 24 direct reps, $20M raised in Series E   http://www.anulex.com/
ApiFix (Israel) developed MIS device for scoliosis deformity correction system with a miniature ratchet mechanism to captures incremental corrections while the patient bends in the corrective direction. The deformity correction process spans several months to allow the soft tissues to accommodate any minor correction.  http://www.apifix.com
Apollo Spine (Newport Beach, CA)  Cervical plate, Cervical Spacer, Lumbar Spacer http://www.apollospine.com
Applied Spine Technologies (New Haven) [FAILED] MIS M-Brace, $47M raised in three rounds, VC De Novo Partners, IDE trial of Stabilimax non-fusion system stopped and started again, Yale partnership, selling Stabilimax in Eu, Craig Corrance replaces Tom Wood at CEO, Asset sale started Sept 2010  http://www.appliedspine.com/
APTO Orthopaedics (Akron) 1st spinout of Austen BioInnovation Institute in Austin, video debut, has developed a device designed to help children who need spinal implants because of spinal deformities, main technology is a rotating magnet to turn a screw from outside the patient, eliminating the need for a 2nd surgery.
Arca Medica (Germany)  PEEK cages, facet decompression, synthetic grafting material
http://www.arca-medica.com/sites_eng/
Archus Orthopedics (Redmond, WA) [FAILED] abruptly went on life support May 19, 2009, Disolved the company assets Sept 3, 2009, Facet Solutions purchased all of their IP including the TFAS Total Facet trial in US, rec’d CE mark Mar05 for spinal stenosis, JNJ Depuy invested $35M into Archus   http://www.archususa.com/

Ascendx Spine – fka AOI Medical (Orlando) USF incubator,  Ascendx VCF Repair cement delivery system, raised $4.8 mixed financing Aug 2011   http://www.ascendxspine.com/
Astura Medical (Carlsbad, CA) PLIF system, biologics, instrumentation, neurological monitoring http://asturamedical.com/
A-Spine (Taiwan) alternative Kyphoplasty technique called Vesselplasty using Vessel-X Bone Filling Container System http://www.aspine.com/
Atlas Spine (West Palm Beach) fka Innovative Spinal Design; plating/screws  http://www.aspine.net/taiwan.html
Augmenta Spine (Port Washington, WI) founded by Dr. David Mitchell,  VAD is a simple, less expensive and elegant device for performing the kyphoplasty procedure. The system eliminates the need for balloons, dye, guide wires, rotating curettages or multiple filling devices.  http://www.augmentaspine.com/
Axial Biotech (Salt Lake City) scoliosis focus, genetic testing + non-fusion implants, x-Depuy Spine chairman on board   http://www.axialbiotech.com/
Axiomed Spine Corp (Cleveland) cervical disc and lumbar disc with metal endplates and a viscoelastic core, KICVentures bought the assets of the company after Axiomed went bankrupt    http://www.axiomed.com/
Axis Surgical Technologies (Menlo Park, CA) Funded by BioStarVentures   http://www.biostarventures.com/portfolio.htm
Baxano, Inc. (Mountain View, CA) [ACQUIRED] Founded 2005, instrumentation to restore spine function and preserve healthy tissue,$12M Series B, technology allows for an innovative a-coccygeal axial approach to the spine sometimes referred to “trans-sacral”. This MIS access is limited to the L5-S1 level of the spine only (at this time!), but the  technique allows for clearing out the nucleus without having to puncture the annulus, $25 million funding by institutional VCs and some recent hires from the Kyphon sales armada, most successful IPO in 2007, 2010 partnership with LifeSpine$30M in Series C in mid-2010, acquired by TranS1 in 2013, filed bankruptcy in 2014, Assets acquired in 2015 by Amendia http://www.baxano.com/
Benvenue Medical (Mountain View) $15M in Series B from Three Arch, Versant and De Novo, flexible implant for VCFs   http://benvenuemedical.com/
Binder Biomedical (Boca Raton, FL) NEWTON line of PEEK lumbar spinal spacers, X-graft from U of Miami Tissue Bank, Lawrence Binder is President http://www.bindermed.com/
Biorthex (Montreal)  [ACQUIRED] Actipore Ti-N porous metal cages, acquired by SBI (equity investment got them exclusive rights to Actipore)   http://www.biorthex.com/
BioSpine LLC (Fort Wayne, IN) vertebral body patents filed, based in the The OrthoVation Center incubator affiliated with Micropulse Inc., a manufacturer of orthopedic implants and surgical instruments – need website information – please email [email protected]
Blackstone Medical (Springfield, MA)   [ACQUIRED] non-fusion Motion Preserving Rods, Orthofix acquired for $333 cash   http://www.blackstonemedical.com/
Bonutti Technologies   [IP ACQUIRED] Dr. Bonutti’s incubator for MIS spine IP, partnering with Stryker, Kyphon, Tyco   http://www.bonuttitechnologies.com/
Bright Spine (Boca Raton, FL) need information – please email [email protected]
http://brightspine.com
Calvary Spine (Lutherville, MD) PEEK cages – PETRA Lumbar Interbody Fusion cages, INTEGRA Cervical Interbody Fusion cages
http://calvaryspine.com
Camber Spine Technologies (Wayne, PA) Focused on design, development and manufacture of minimally invasive products to treat complex spinal pathology. Incorporates 3D printing technology. Notable products: Orthros™, a polyaxial screw that is blunt-tipped for bi-cortical purchase, with a low profile of 62° conical angulation; DIAGON anatomic TLIF; VERTA VBR Corpectomy System, COVERIS Anterior Cervical Spacer and TLS 5.0 Interbody Cages  http://www.cambermedtech.com/
Captiva Spine (Jupiter, FL) PEEK cages, pedicle screws, plating, Dale Mitchell is CEO
http://www.captivaspine.com/
Cardinal Spine, LLC (Louisville, KY)  510(k) for interbody fusion device, received FDA 510(k) clearance of the C-VBR vertebral body replacement—reportedly the second cervical vertebral body replacement device to be cleared by FDA and the first such device designed with no possibility of reduction in height after surgery. http://www.cardinalspine.net/wordpress/
Carevature  Medical Ltd (Tel Aviv, Israel) Founded in 201, disposable spine instrumentation for lumbar and cervical spine procedures, scope is proprietary device platform for performing direct decompression with an indirect approach for preserving healthy tissue – spine today, joints tomorrow  http://www.carevature.com/
Cardo Medical, Inc. (Beverly Hills, CA) Cardo Medical was formed in February 2007 when it acquired the assets and operations of Accin Corporation, a product development company founded in 2005, products include  reconstructive joint devices and spinal surgical devices – SSP Semi-Constrained Cervical Plate, PSS Pedicle Screw System   http://www.cardomedical.com
Centinel Spine (Minneapolis) startup fka Raymedica from 1990 to 2008, HydraFlex Nucleus Arthroplasty System, disc nucleus, John Viscogliosi, (Chairman/CEO)   http://www.centinelspine.com
Cervitech (Rockaway, NJ) [ACQUIRED] Nuvasive acq Apr09, a LINK development company (Germany), Helmut Link is Pres, poly/CoCr disc replacement, no bone grafting products, patient enrollment complete in PCM Artificial Cervical Disc study   http://www.cervitech.com/
CG Spine Limited ( Dunedin, New Zealand) developing a cervical laminoplasty plate system for use in cervical spinal stenosis; CEO is John Galvin – need website information – please email [email protected]
ChoiceSpine (Knoxville, TN) 2007 US startup bringing Eu patents to use for plating, rods, PEEK cages
http://choicespine.net/
CHM (Poland) Pedicle screw and rod systems, CharSpine System 6.0, Bialstab System 5.0
http://www.chm.pl
Clariance Spine (Danville, France) Founded by Alain Tornier who found and sold the successful extremities leader Tornier, sell Fusion products and Motion Preservation products, nucleus replacement is in development
http://www.clariance-spine.com
Clarus Medical (Minneapolis, MN) spinal pain management, a leader in endoscopic minimally-invasive products for the treatment of spinal pain   http://www.clarus-medical.com/
CoAlign Innovations (Brisbane, CA)  fka Innvotec Surgical AccuLIF metal cages that go in transforaminally and expand like a car jack
http://www.coalign.com
coLigne AG (Switzerland) proprietary carbon composite biomaterial, ostaPek, and 15 years of clinical experience with it, latest product is ostaPek LCFRP longitudinal rods, polyaxial screw recently cleared by FDA, mature Eu company that is bringing products to the US   http://www.coligne.com
CoreLink Surgical (St Louis, MO) Stealth mode. http://www.corelinksurgical.com/
Corentec (Seoul, Korea)  founded in 2000, AGES I and II pedicle screw systems, PLIF titanium cages
http://www.corentec.com
CoreSpine Technologies (Prior Lake, MN) a tissue-selective, articulating, mechanical device used for complete nucleus removal in the spinal disc, Christine Horton (Pres)   http://www.corespinetech.com/
Cousin Biotech (France) resorbable cage, dynamic interlaminar device, dura coverings  http://www.cousin-biotech.com
Covision Medical Technologies Ltd (UK) pedicle screws, rods, hooks http://covision-medical.co.uk
Creaspine (France) PEEK interbody spacers, founded in 2003, selling in Eu and looking to sell in US   http://www.creaspine.com/
Crocker Spinal Technologies (Salt Lake City, UT)  founded by BYU President’s Leadership Council member Gary Crocker and headed by BYU MBA graduate David Hawkes, David Hawkes is president; developing a disc replacement with completely natural motion   http://crockerspinaltechnologies.com/
Crosstrees Medical Inc.  (Boulder, CO) developing a minimally-invasive spinal implant for the non-fusion treatment of scoliosis, funded by DeNovo   http://xtreesmed.com
CTL Medical (Dallas, TK) in house manufacturing and design https://www.ctlmed.com/
Custom Spine (Parsippany, NJ) no compelling technology and changing management, ISSYS Inverted Polyaxial Pedicle Screw System, Lew Bennett takes over as President Jan09, new Board members added in Jul09   http://www.customspine.com/
Cutting Edge Spine (Charlotte, NC) founded 2011 by John Kapitan and Randy Roof, lower priced PEEK cages http://cutting-edge-spine.com/
Cytori (San Diego, CA) cell re-implantation, developing and commercializing stem and regenerative cell therapies for reconstructive surgery   http://www.cytoritx.com/
Degen Medical, Inc (Florence, SC) Modular pedicle screw system, cervical plates and cages http://www.degenmedical.com/
DFine (Cupertino,CA) [ACQUIRED] bone cement for vertebral FXs, whistleblower reports surgeon kickbacks and costs company $2.39M, acquired by Merit Medical in 2016 for $98M http://www.dfineinc.com/
DiFusion Technologies (Austin, TX) reducing the rising incidence of Surgical Site Infections (SSIs) in spinal surgeries, CleanFUZE is an antimicrobial PEEK spinal interbody cage capable of stopping biofilm formation in the bone graft site   http://difusiontech.com
Dio Medical (Milwaukee, WI & Korea)  the Rexious System is FDA approved and actively sold in the US, the Rexious and Fixpine systems are sold in the EU   http://www.dio-us.com
Disc Dynamics (Eden Prairie, MN) [FAILED] After failure to obtain FDA approval for it pivotal study, on Dec 31, 2009 terminated all employees and discontinued clinical studies. Back in 2000, they raised $65M to fund the development of DASCOR, a disc arthroplasty system., $65M in total VC funding, David Stassen was Chairman of Board, longterm CEO Steve Healy resigned, longterm VP Ron Burke was acting as temporary CEO   http://www.discdyn.com/
Disc Motion Technologies (Boca Raton) founded in England, pres is Kelly Smallridge, TrueDisc and TrueDyne, Jud Carlson (x-CEO, now Managing Dir), Andy Greenberg (CEO)   http://www.discmotion.com/
Discogen (Weston, FL) [ACQUIRED] an emerging medical device co specializing in the development of technologies to treat early disc degeneration, acqd by SpineOvations Dec07   http://www.spineovations.com/
DiscGenics (Salt Lake City) 2012 startup useing tissue engineering and regenerative medicine to repair discs, technology can isolate stem-like progenitor cells from human adult intervertebral disc tissue, animal work has shown some success in regenerating new disc material.   http://discgenics.com
Dynamic Spine (Baldwin,WS)  registered by spine surgeon Dr. Glenn Buttermann, patent applications for disc replacement
http://dynamicspine.net/
Eden Spine (Orlando, FL) Guillaume Viallaneix X-Scientx marketing, The company acquired the Swiss R&D organization FlexisMed SA and its portfolio of dynamic technologies. In 2007 FlexisMed SA changed its name to become Eden Spine Europe SA positioned in Europe as Eden Spine’s wholly owned subsidiary dedicated to motion preservation   http://www.edenspine.com/
EDGe Surgical (Chicago, IL) Ortho EDG, a single-use electronic depth gauge that assists surgeons in placing orthopedic screws in trauma and spine cases. http://www.edgesurgical.com
EgiFix Medical (Egypt) PEEK cages, plates, rods, pedicle screws
http://www.egifix.com
Ellipse Technologies (Irvine, Ca) [ACQUIRED] Scoliosis treatment available US and OUS, MAGnetic Expansion Control (MAGEC) system allows a physician to remotely modify the length of the rod and the force applied to the spine throughout the implanted period as the patient responds to therapy; the purpose of the device is to eliminate the amount of repeat surgical procedures, which can in turn reduce the amount of complications and costs associated with this practice;  Mike Henson of MedFocus was the Chairman, acquired by NuVasive in 2016 for $380M http://www.ellipse-tech.com/
Eminent Spine (Leander, TX) 510(k) clearance for spine plating system, all products are named after snakes
http://www.eminentspine.com/
Endius (Plainville, MA) [ACQUIRED] Zimmer acquired 2007, MIS, Founded in 1997, Atavi®, the Atraumatic Spine Surgery System, which obtained FDA clearance of its 510(k) in October 2000, is currently being utilized in hospitals nationwide. Atavi is the only fully integrated system that enables surgeons to perform lumbar spine surgery minimally invasively, with one access portal, while preserving the fundamentals of the traditional open surgical technique.   http://www.endius.com
ESM Technologies (Scottsdale, AZ) T1 Anterior plate and T2 Anterior plate is a a novel approach to the treatment of Isthmic Spondylolisthesis and Degenerative Disc Disease http://www.esmtech.com
Surgical Technique –> http://www.esmtech.com/uploads/Why_Now_ESM_TechniqueA.pdf
Expanding Orthopedics (Caesarea, Israel) founded in 2001 by Dr. Mark Levy, an orthopaedic surgeon whose vision is to develop devices which focus on simplicity of use, investors include Opal Ventures, MD Venture Partners, and Triathalon Medical Ventures, technology includes pedicle screws with molly bolt like expansion to improve screw fixation in poor quality bone for patients undergoing thoraco-lumbar fusion surgery   http://exortho.com
Expandis (Israel) starting clinical trials for spinal fractures on a MIS implant that uses a scaffolding and glue combination, product name is Bidex – need website information – please email [email protected]
FacetMed (Israel) DualAxis pedicle screw system is a non-rigid, multi-axial spinal fixation system for posterior stabilization and fixation of thoracic, lumbar and sacral regions; non-rigidity in the screw reduces stress tenfold at the bone-screw interface and improves load transfer between vertebrae; company expects to reduce the surgical failure rate and the need for secondary procedures; in 2008 was folded into Israeli incubator; 510(k) submission planned in 2012   http://www.facetmed.com/
Facet Solutions (Boston) [ACQUIRED] anatomic facet arthroplasty, strong patents, IDE approval, clinical trial start late 2008, FDA clearance target 2011-2013, acquired by Globus Medical in 2011 for undisclosed sum   http://www.facetsolutions.com/
FlexSpine (Singapore) $13M spinoff from SpineVision in Atlanta, dynamic stabilization, launched FLEXPlus in Eu   http://com.spinevision.net
Flexuspine (Pittsburgh, PA) $9M in Series B including Warburg money, Erik Wagner/Vin Jannety’s new startup after founding Spinal Concepts    http://flexuspine.com/
FloSpine (Boca Raton, FL)  Peter Harris founded in 2011. Instrumentation and pedicle screws, soon will have PEEK cages and cervical plating http://flospine.com/
Gentis Inc (Philadelphia, PA) U of Penn spin out, DiscCell in-situ polymerizing spinal nucleus augmentation technology, Pivotal trial start 2009?, $10M in A round, DiscCell pilot in Brazil May06   http://gentisinc.com/
Genysys Spine (Austin, TX) Genesys Spine is located in Austin, TX. two products on the market approved by the FDA; the TiLockTM Pedicle Screw System and the ApacheTM IBFD/VBR.  Genesys has an Anterior Cervical Plate targeted for an August/September release.  All sales are executed via contracted distributors in the US. – need website information – please email [email protected]
Gerraspine AG (Switzerland)  FENIX Facet joint replacement, Horace Hale is the owner. Quiet company with very little activity. http://gerraspine.com/
Globus Medical (Phoenixville, PA) from $16M to $44M sales 2005 to $130M in 2007 to $200M in 2009, >1% share of all spine, posterior stabilization system launched, trying to raise $10M, $110M in series E so far   http://www.globusmedical.com/
Gold Standard Orthopaedics (Louisville, KY) 510K for GSI implant   http://gsortho.net/
Highgate Orthopedics (Boston) startup focus is 2nd generation fusion and disc replacements, founded by Spray Ventures in Boston   http://www.spraypartners.com/port_ortho.html
Hoogland Spine (Germany) cervical disc prothesis, maxMorespine Spinal System   http://www.hoogland-spine.com/
[FAILED]
Hydrocision (Billerica, MA) Fluidjet devices for open/MIS spine procedures including fusion, discectomy, artificial nucleus, and disc procedures, HydroDiscectomy   http://www.hydrocision.com/
HydroSpine (Boston, MA) founded in 2005 as a spin-off of Cambridge Polymer Group, Inc., who licensed several hydrogel inventions to Hydrospine for spine applications, technology involves an injectable hydrogel system that forms a load-bearing nucleus pulposus analog, President is Stephen Spiegelberg PhD   http://www.hydrospine.com/
IB Medical LLC (Longmont, CA) static compression device technology in spine surgery, patent filed – need website information – please email [email protected]
[FAILED]
Inion (Finland) went on life support March 26, 2009, Inion laid off employees, delisted from London Stock Exchange (LSE: IIN.L), selling off assets. At one time Inion was a promising trauma company with resorbable bone plates. Stryker distributed their implants in the US, Aesculap and Citagenix distributed OUS. Richard Wolf Medical Instruments distributed resorbable Sports Med products in the US. Inion raised a total of $100M in VC funding   http://www.inion.fi/
InnoSpine [ACQUIRED] acquired by Kyphon for ~$30M   http://devicelink.com/mx/issuesupdate/06/01/Kyphon.html
Innovasis (Salt Lake City, UT) Acquired Spine Works (Orange County, CA) in 2014. Experienced executive team. Focused on surgeon innovation, outcomes, and medical mission work. Portfolio includes Cranial, TL Fixation, Cervical, Interbody, Lateral, and Deformity. MIS in Q1 2015.  http://www.innovasis.com/
Innovative Spinal Technologies (Boston) [FAILED] BANKRUPT Jan 2009, Assets purchased by Integra LifeSciences for $9.25 in Sept 2009, a total of $75M was raised since it was spun out of Texas Back Institute in 2002, opinion is that a series of poor management decisions lead to its downfall including relocating the company from Dallas to Boston, out-of-control spending and a complete change in their distribution model, Paul Thomas (X-Lifecell CEO) was on the Board
Integral Spine Solutions (Carlsbad, CA) MIS interbody fusion products using PLIF approach, raising money from individuals  http://www.integralspinesolutions.com
Integrity Implants (Jupiter, FL) expandable PEEK cage http://www.integrityimplants.com/
InteliFUSE, Inc. (New Orleans, LA) Nitinol memory-shape staples for spine fusion   http://www.intelifuse.com/
Intelligent Implant Systems, LLC (Charlotte, NC) products for fusion, non-fusion, and scoliosis, Marc Richelsoph is CEO   http://www.intelligentimplantsystems.com/
Intralink-Spine (Georgetown, TX) is a company formed to develop, manufacture, market, and sell a tissue modifying reagent that can be injected into the intervertebral disc of the human spine to increase crosslinking in the native collagen matrix. The NEXT device is designed to immediately strengthen and stabilize the disc, reducing disc bulge and pain without the costs and risks associated with surgery. Dr. Hansen Yuan, M.D., a leader in spine surgery, added: “This injectable tissue reinforcement procedure can provide an effective treatment for patients who are either early in the disease process or adverse to surgery.”   http://www.intralink-spine.com
International Spinal Innovations – licensed ALIF patents to Alphatec Spine – need website information – please email [email protected]
I-Spine (Irvine,Ca) fka Triage Medical, Teleport MIS instruments, selling off trauma to fund spine, Walter Cuevas CEO, Series C $24M in 2007,   http://www.i-spineinc.com/
Intrinsic Therapeutics (Woburn, MA) 2000 startup, soft tissue focus, Greg Lambrecht, CEO Walter Cuevas, $21M in series D, annulus patch with MIS technique   http://www.in-or.com/
Ionics Medical Corp (Ether, NC) Levanted Intervertebral Pillar, expandable vertebral body, replacement prothesis
Joimax (Irvine, CA) MIS endoscopic spine systems for surgery on herniated discs an spine stenosis http://www.joimax.com/us/
Jemo Spine (Murray, Utah) Delta low profile fusion system   http://www.jemospine.com/
K2M (Leesburg, VA) screws, PEEK cages, plans to carry biologics in the future, $21.6M raised, 3Q06 stabilization system to launch, Range spinal system is combination of Denali and Mesa systems, 2010 sold majority ownership to Welsh, Anderson, Carson, and Stowe and will be positioned for sale in the future   http://www.k2m.com/
Korea Bone Bank (Seoul, Korea) Korean allograft company, acquires Endotec to add total joints, developing a new rhBMP-2 growth factor to compete with Medtronic’s INFUSE in the US, expects FDA clearance in 2010, Daniel Shim (CEO)   http://www.kbbcom.co.kr
Lanx, Inc. (Broomfield, CO) [ACQUIRED]  Surgeon owned, Aspen Spinous Process System is a posterior, non-pedicle supplemental fixation device, intended for use at a single level in the non-cervical spine (T1-S1), acquired by Biomet  http://www.lanx.com/
LDR Spine (Austin) [ACQUIRED] Founded in 2000 in France, 1% share of all spine, porous ceramic blocks, IDE start 2006 with Mobi-C Cervical Disc (poly-CoCr) finish IDE around 2008?, www.secondgenerationdisc.com, Christophe Lavigne is CEO, opened office in Bejing, $25M in round C to support Mobi-C trial, acquired in 2016 by Zimmer   http://www.ldrspine.com/
LFC Sp Zo.o (Holland) [IP ACQUIRED] IP for InSwing interspinous spacer licensed by Orthofix/Blackstone   http://www.blackstonemedical.com/
Life Spine (Hoffman Estates, IL) PEEK interbody, MIS screw system, clearance for dynamic anterior cervical plating, cleared Neo-SL ant cerv plate, 2010 partnership with TranS1  http://www.lifespine.com/
LinkSpine (Rockaway, NJ) FacetLINK MIS facet fusion system http://www.linkspine.com/
Loukas Medical, Inc (Franksville, WI) Owned by veteran orthopedic instrument designer Jim Rinner, acquired pedical screw patents from Orthopedic Screw, LLC and Launch Medical, LLC of Memphis TN http://www.loukasmedical.com
Lucero Medical, LLC (Richfield, OH) cost effective titanium cage spacers for spinal trauma and tumor patients; product is called Enduramesh  http://www.luceromedical.com/
Macropore Biosurgery [ACQUIRED] Hydrosorb resorbables distibuted by Medtronic, acquired by Kensey-Nash 2007  http://www.macropore.com/index.asp
Magellan Spine (Irvine, CA) Disc Annular Repair Technology (DART)   http://magellanspine.com/
Magen Medical Solutions (Israel) founded in 2007, developing unique anti-adhesion devices for orthopedic applications, SpineShield, is CE Marked and will be commercially available in the second half of 2010, future products, the TendonShield and NerveShield, will be submitted for regulatory approval in EU during 2010. All products will be submitted for FDA clearance in the future, inventor is Dr. Hamid Sharim, Former Head of the Spinal Surgery Unit at Wolfson Hospital, Israel   http://www.magenmed.com
Mazor Surgical Technologies (Israel & Atlanta) SpineAssist mini robot that allows surgeons to scroll thru slice by slice, works like mini-GPS in OR   http://www.mazorst.com/
Medical Device Advisory Development Group (CA) need information – please email [email protected]
Medicrea (France/NYC) polyaxial screws, established a US subsidiary, company intends to conduct development of Granvia, a dynamic posterior stabilization system, in the U.S. Following FDA clearance, Granvia could launch in 2010   http://www.medicrea.com/
Medovex (Alphareta, GA) DenerveX™ is a rotational, monopolar, radiofrequency denervation device, powered by a dedicated DenerveX™ Pro-40 generator. It is designed to ablate the nerve and capsular tissue on the posterior surface of the facet joint. Denervation is achieved through Rotacapsulation™, a combination of high heat and rotational tissue shaving. OUS at this time. http://medovex.com/
Medyssey Spine (Korea) full product line of pedicle screws, Ti cages, interspinous spacers, semi-rigid rods, recent 510(k) for their Zenius Thoracolumbar System
http://www.medyssey.com/
Mekanika (Boca Raton, FL) Mekanika will offer the spine surgeon three procedural options using the Modulus System: Fusion, Stabilization and/or in combination to augment support of fusion, cages and artificial discs. http://mekanika.com/
Merlot OrthopediX (Cleveland, OH) Founded in 2004, spun out of Cleveland Clinic Foundation in 2005, focused on bone-anchoring plates invented by Izador Lieberman, M.D., of Cleveland Clinic for application in spine and trauma, currently lead by Paul Erikson   http://merlotorthopedix.com/
MI4 Spine LLC (Bloomfield, MI) 16 patents filed for Stem cell enabling device/method, Next Generation Dynamic system, Bone harvesting device for autograft, Cervical Plate and Method, MIS Pedicle Screw, MIS Interspinous Process Spacer and Method   http://mi4spine.com/
Mighty Oak Medical (Denver, CO) Dr George Frey’s company in an incubator that is developing an affordable and disposable option for surgical navigation called FIREFLY that is derived from a patient’s 3D imaging data and utilizes 3D printing for a custom guide that creates an optimal screw trajectory. FIREFLY is both accurate and cost-effective, and enables surgeons to tackle complex spinal surgeries with greater confidence. http://medtechinnovator.org/company/mighty-oak/
Minimus Spine (Austin, TX) A quality-based system that injects ozone gas into a herniated spinal discs which oxidizes the herniation and allows it to shrink in size, relieves pressure on the nerve and provides the patient relief from pain, Angel investors so far   http://www.minimusspine.com/
minSURG (Clearwater, FL) TruFUSE posterior fusion system http://minsurg.com/
Moller Medical (Switzerland)  pedicle screws & cages
http://www.bricon.ch/
N-Spine (San Diego, CA) [ACQUIRED] non-fusion MIS dynamic posterior stabilization fixation called Motion Preserving System, $2M Series A late 05, acqd by Synthes for $75M   http://www.n-spine.com/
Nanovis (Fort Wayne, IN) spine cages constructed of PEEK + Ti http://nanovisinc.com/
Nbi Development Inc (San Francisco/Rochester/St. Paul) Neuromodulation, the use of electrical impulses to manage activity in the nervous system, $5.5M raised in 2006   http://ow.ly/gmTE
New Era Orthopaedics (Hummelstown, PA) basic spine fusion implants  http://www.neweraortho.com/
NexGen Spine (Whippany, NJ) spinal implants utilizing elastomeric polymers for non-fusion treatment of disc degeneration, CEO Alastair J.T. Clemow, PhD was past president of the Society for Biomaterials and a member of the society’s Orthopaedic Biomaterials Special Interest Group   http://nexgenspine.com/
Nexxt Spine (Indianapolis, IN) anterior cervicle plates, pedicle screws, Andy Elsbury is Pres  http://www.nexxtspine.com/
NiCast Ltd (UK) Polymer nanofabrics developer NiCast Ltd. has obtained a three-year €4 million grant from EU Seventh Framework Progamme for Research and Development to head a consortium that will develop a spinal disc product. NiCast will head a group of ten companies and research institutes, and the company’s share of the grant is €600,000   http://www.nicast.com/
NLT Spine (Israel) fka Non-Linear Technologies, developing MIS techniques for lumbar spinal canal stenosis, the Prow Suite includes spinal implants and tools offering motion-preservation and percutaneous alternatives to surgery for treating a wide range of lumbar spine degenerative conditions, company has raised $10M to date
http://www.nonlinear-tech.com/
NovaSpine (Elmsford, NY) no current information
Nuvasive (San Diego) Not really a startup anymore, NeoDisc IDE approved, sales growing 10-20% per year, trying to reach $1B in annual sales   http://nuvasive.com/
NV Cromed – need website information – please email [email protected]
NVision Biomedical Technologies (San Antonio, TX) PEEK cages launched 2105 http://nvisionbiomed.com/
Intellirod Spine (Akron, OH) fka OrthoData in Louisville, diagnostic system that allows orthopedic surgeons to monitor the progress of spinal fusion surgeries by reading data from strain gauges on spinal rods, raised $6M in funding by YE 2016, collaboration with University of Louisville – need website information – please email [email protected]
Ortho Development (Draper, UT) weak product line in spine with total joints, weak management with turnover, Japanese ownership   http://www.odev.com/
Ortho Kinematics (Austin, TX) diagnostic and imaging startup, KineGraph VMA is a new functional diagnostic test for the spine that uses fluoroscopy to capture the spine in motion pre-operatively, measuring motion between the vertebrae, recipient of a $1.5 million State of Texas Emerging Technology Fund Award, funded by PV LifeSciences  http://orthokinematics.com/
OrthoMEMS, LLC (Menlo Park, CA) measuring the pressure in damaged spinal discs using MEMS and wireless technology – need website information – please email [email protected]
Orthonex, LLC (Minneapolis)  growing intellectual property portfolio that includes new devices and methods for: dynamic stabilization of the spine; wirelessly-controlled post-surgical skeletal adjustment; and intra-operative spinal measurement
http://www.Orthonex.com
Orthonics, Inc. (Atlanta, GA) cell-based spinal disc repair and spinal cartilage repair, receives funding from Viscogliosi Bros and GRA VentureLab, Steve Kennedy (CEO), Barbara Boyan PhD @ Georgia Tech, no new information
Orthopedic Development Corporation & minSURG (Clearwater) TruFUSE posterior facet fusion procedure limited release 2006, $8M in startup   http://investing.businessweek.com/research/stocks/private/snapshot.asp?privcapId=30868784
The Orthopaedic Implant Company- OIC (Reno) Founded in 2010.  OIC implants cost 50 to 60 percent less than the average market price of premium implants. OIC’s high-quality, low-cost implants and products can be used for a variety of procedures, including treatment of orthopedic trauma and spinal injuries. All OIC products are FDA approved and manufactured in FDA approved facilities. http://orthoimplantcompany.com/
OrthoTec (Beverly Hills, CA) Plates, rods, screws. http://orthotec.net/
OrtoWay (Stokholm, Sweden) founded in 2006 by LinkMed and a group of five experts in biomaterials & spinal surgery, products include a very adaptable hydraulic OrtoWell Distractor and OrtoMixer cement mixer for vertebroplasty, CEO is Stan Mikulowski   http://www.ortoway.com/
OSD – Orthopaedic & Spine Development (Avignon, France) Development and marketing of implants for the spine and orthopaedic fields. OSD is launching only innovative implants with safe operating techniques. In addition to innovative implants, OSD is matching training centers where experienced surgeons are training new users to safe operating techniques   http://en.osdevelopment.fr/
Osseon Therapeutics (Santa Rosa, CA) incubated at the University of Northern California’s Science and Technology Innovation Center in Santa Rosa, ts first-generation steerable VCF cement products have received both FDA clearance and CE Mark for product distribution in the US and EU, Dr. John Stalcup is CEO http://www.osseon.com/
OuroBoros (Pleasanton, CA) developer of an expandable torroidal mesh which circumferentially reinforces the inner surface of the annulus, raised $1.17 million in a planned $4 million first funding round, PE Wire reports, citing a regulatory filing. The deal was led by Ascent Medical Ventures – need website information – please email [email protected]
Pantheon Spinal, LLC (Austin) Founded by  Dr. Scott W. Spann and Andrew Morgan –  “L5 S1 is the holy grail of lateral access, but many systems didn’t have any consistent way of getting there,” says Dr. Spann. He decided to create a consistent way. He worked with a number of different techniques and methods until he had created a device that could be used in a repeatable, consistent way and exceeded reward over risk”, story of co formation, patents, http://pantheon-spinal.com/
Paradigm Spine (NY) ownership by Viscogliosi Bros, $14M Series C (2006), $14M in Series D (2007), $21.5M funding (2009), U-shaped Titanium dynamic interspinous non-fusion Coflex system, IDE start 2006, German data presented at SAS May06, funding study in Montreal to find secret to genetic cause of scoliosis, IDE approval for coflex dynamic interspinous implant, IPO planned $16M rev, Chris Hughes was Pres of US Operations, is the company moving its headquarters? http://www.paradigmspine.com/
PercuFlex Corp – need information – please email [email protected]
Phygen Spine, LLC (Irvine, CA)  [ACQUIRED] fka Allez Spine, name changed to connote “PHYsician GENerated” products, pedicle screw systems and cervical plating systems for use in spine surgery, started by surgeon in Calif in 2003, lawsuit with JNJ over pedicle screw patents, acquired by Alphatec Spine   http://www.phygenspine.com
Pinnacle Spine Group (Dallas) InFill PEEK cages, Direct Lateral system, TLIF, MIS graft delivery http://pinnaclespinegroup.com/
Pioneer Surgical Technology (Austin, TX and Marquette, MI) [ACQUIRED] founded in 1992, plating systems, IDE approval for NUBAC device for disc arthroplasty, $30.5M in new equity Dec06 to support NUBAC trials, acquired Encelle which develops tissue regeneration products including E-Matrix™, a sterile, injectable biopolymer designed to repair or regenerate diseased or damaged tissue, acqd AlpineSpine LowTop Pedicle screw system, Jan07 acq’d Encelle E-Matrix injectable biopolymer, acquired Angstrom Medica, Jeff Millin (CEO), acquired by RTI   http://www.pioneersurgical.com/
PNIR, LLC (Waltham, MA) focused on Peripheral Nerve Injury Repair, a joint venture with Cyberkinetics Neurotechnology Sys., Inc. and NeuroMetrix, Inc.to develop a therapeutic product for peripheral nerve injury based on Cyberkinetics’ Andara Oscillating Field Stimulator (OFS) neurostimulation technology platform, initial $2M investment by NeuroMetrix
Precision Spine (Parsippany, NJ) hardware in cervical, thoracolumbar, interbody, anterior lumbar, acquired SpineUSA manufacturing in Jackson MS http://www.spinalusa.com/
Premia Spine (Israel) fka Implaint LTD, no-fusion TOPS system is a polymer posterior shock absorber, early 1-yr success in clinicals in Eu   http://www.premiaspine.com/
ProSpine Inc (Germany) – http://www.pro-spine.de/
Providence Medical Technology (San Francisco)  DTRAX Facet System is a facet system for the cervical spine patients with radiculopathy; the premise is to decompress and stabilize the affected cervical level via a minimally invasive approach;  founded by X-Kyphon guys  Art Taylor and Jeff Smith.    http://www.providencemt.com
Ranier Technology LTD (UK) polyurethane CAdisc compliant artificial spinal disc for total disc replacement, $7.3M from HealthPointCapital   http://www.ranier.co.uk/
RE Spine, LLC (NJ) patents filed for intervertebral disc and facet joint prosthesis
Reduction Technologies, Inc  (Corte Madera, CA) developing a minimally-invasive spinal implant for the non-fusion treatment of scoliosis, funded by DeNovo, CEO is Matt Thompson   http://reductiontechnologies.com
Reliance Medical Systems (Bontiful, UT) POD business founded in 2006, that fought the DOJ in 2012 http://www.reliance-medical-systems.com/
Relievant Medsystems (Redwood City, CA) raises $20M to develop Intracept System to treat low back pain
Replication Medical (New Brunswick, NJ) hydrogel nucleus, Abbott Spine funded $15M   http://replicationmedical.com/
RSB Spine (Cleveland, OH) founded in 2001, formerly known as R&B Surgical Solutions, LLC. first-generation steerable VCF cement products have received both FDA clearance and CE Mark for product distribution in the US and EU, products include InterPlate Vertebral Body Replacement System, a spinal implant that is designed to facilitate spinal fusion process and is used in conjunction with graft material to fuse two or more vertebrae together, Dr. John Stalcup is CEO   http://www.rsbspine.com
Safe Orthopaedics (Paris/Memphis) French startup founded 2010 by Dominique Petit, Pierre Dumouchel, Thomas Droulout to lower the cost of implants to hospitals by providing single-use, sterile, traceable procedure kits; Pedicle Screw kit launched in 2012  http://www.safeortho.com/
SafeWire  (Miami, FL)  Improved MIS procedures with safe advancement of wires, Y-Wire & Tiger Needle.  http://safe-wire.com
Sanacor (Pleasant Grove, UT) Founded in 2004, small product line, nothing too innovative looking, cervical plates, pedicle screws, interbody cages   http://www.sanacor.com
Scient’X (France, Lakeland FL, & Philly) [ACQUIRED] Alphatec Spine (HealthPointCapital) conveniently acquired 100% in early 2010 and planned to move operations to San Diego, Isobar TTL semi-rigid rod system, 1,000 Discovery Cervical Discs implanted in trials, Scient’x has been a pioneer in the promising field of motion preservation for more than 15 years and has been the first company to get approval for a dynamic implant on the US market. Scient’x leadership in dynamic systems -Dos, Twinflex, Isobar TTL and Aladyn  http://www.scient-x.com/
Scorpion Surgical Technologies (Israel) Interlocking Curved Nail System for spinal stabilization surgeries, unique spinal anchoring concept for dynamic stabilization and fusion, pre-clinical testing only   http://www.scorpionsurgical.com/
SeaSpine (Vista, CA) $20M sales in 2006 and growing, Alphatec to market Sea Spine’s Cross Link adjustable bridge spinal product under ATEC’s private label   http://www.seaspine.com/
Skeletal Kinetics (CA) [ACQUIRED]  Aug06 acquired by Colson Assoc for private group of companies (Osteomed, Acumed), synthetic bone graft Callos (calcium phosphate) for cancellous bone voids http://www.skeletalkinetics.com/
Skeltex (Boucherville, QC, Canada) a VentureMD company, Skeltex Integrated System for Vertebroplasty (ISV) provides remotely controlled motorized delivery and a cement cure monitoring during kyphoplasty, providing a more predictable and controlled procedure for the physician and potentially improved safety for the patient   http://www.skeltex.com/
Showa Ika Kohgyo (Tokyo & Memphis TN) founded in1974, spinal fixation, Arristos Spinal System  http://www.innovationmedical.com/showaika.html
Signus Medical (Minneapolis) Pioneering the introduction of new biomaterials such as PEEK-Optima®, and research into the next generation of materials, PEEK cages, Bob Heinrich VP Marketing, Thomas Hoghaug CEO   http://www.signusmedical.com/
Simpirica Spine (San Carlos, CA) founded in 2006 to develop minimally invasive, flexion-restricting stabilization devices.   LmiFlex Spinal Stabilization System is a minimally invasive, flexion-restricting stabilization system; CE marked; raised $22M in Series C  http://www.simpirica.com
Simplify Medical, Inc. (Mountain View, CA)  Non-metallic cervical disc with advanced polymers and ceramic core, new patents for MRI-friendly disc, private Series A, Simplify Cervical Disc receiving CE Mark in February 2015. US IDE trial to begin in Q3 2015.http://www.simplifymedical.com/
Sintea Biotech (Milano, Italy) lumbar instrumentation   http://www.sinteabiotech.com/
Smart Disc, Inc. (Allen Park, MI) patented artificial disk design http://www.smartdsc.com/
Solco Biomedical (Korea) need information   http://eng.solco.co.kr/Pr/Pr03.aspx
Sotiera (Natick, MA) raised $6.6 million in Series C funding, developing a treatment of vertebral compression fractures in patients with osteoporosis, cancer or traumatic injuries, design provides a superior biomechanical structure and better control of cement flow than other solutions, Competitive Technologies granted Soteira exclusive license to their nanotechnology-based bone biomaterial for spine
SparTek Medical, Inc. (Alameda, CA) founded in 2007 by successful serial entreprenuer Henry Klyce (Klyce founded Surgical Dynamics in 1985, and founded St. Francis Medical Technologies in 2007), patents filed for motion preserving spine fusion implant that is inserted minimally invasively for treatment of degenerative disc disease   http://www.spartekmedical.com/
Specialty Spine Products – need information
Spinal Balance (Toledo, OH) Libra no touch Pedical Screw system, procedure specific sterile-packed kits for reduced implant handling and less infections, startup that came from the U of Toledo incubator, launched at 2015 NASS http://spinalbalance.us/
SpinalCyte (Houston) Technology is autologous regrowth of the spinal disc nucleus using human dermal fibroblasts, currently in research and patent mode.   http://spinalcyte.com/
[ACQUIRED]
Spinal Dynamics (CA) acquired by Medtronic for $270M in 2002   http://www.sofamordanek.com/
Spinal Innovations (Memphis) [ACQUIRED] Mark Richelsoft was president, acquired by Aesculap for undisclosed sum   http://www.aesculap.com/
Spinal Kinetics (Sunnyvale, CA) Founded in 2003, developing the M6 artificial disc that seeks to mimic the dynamics and composition of the natural disc, cervical and lumbar products under development, De Novo Ventures, Discs for treating DDD, Tom Afzal is president   http://www.spinalkinetics.com
Spinal Edge LLC (Chicago) –  510(k) clearances in 2009 for ATLAS cage, TITAN Pedicle screw
Spinal Modulation (Menlo Park, CA) – spinal cord modulation & pain management, in stealth mode, raised $30M in Series D to fund clinical trials in US and EU, Medtronic investment  http://spinalmodulation.com/
Spinal Resources (Harbor Beach, FL) – spine distributorship that turned into a manufacturer, first product is the Swedge Pedicle Screw System, http://spinalresourcesinc.com/
Spinal Restoration (Austin) – [FAILED] soft disc in clinical trials, Gary Sabins (CEO), Kevin Thorne, John Wheeler, non-exclusive license to Baxter’s fibrin sealant TISSEEL, cervical plating   http://spinalrestoration.com/
Spinal Simplicity (Kansas City) founded in 2008 by Dr. Harold Hess, self funded, the Minuteman device is a minimally invasive posterior fixation implant that can be implanted in 15-minutes on an outpatient basis, no FDA approvals  http://www.spinalsimplicity.com/
SpinalUSA (Jackson, MS) [ACQUIRED] Founded in 2005, full line of plating, cages & grafts, opening a new Product Development office in NJ, acquired by Precision Spine  http://www.spinalusa.com
Spine 21 (Princeton, NJ) CTO is Uri Arnin, previously CTO of Impliant, developed a dynamic posterior stabilization device
Spine360 (Austin, TX) [ACQUIRED] Talon Spinal Fixation System, acquired by Amendia
http://www.spine360.com/
SpineAlign Medical (San Jose, CA) fka SpineWorks, started IDE for nitinol implant for VCF fractures that is implanted through the pedicle, new CEO Gary Grenter   http://www.spineworksmedical.com
SpineArt (Geneva, Switzerland and Irvine, CA) need information, artsy animated website with very little information   http://spineart.ch/
SpineCore (NJ)  [ACQUIRED] in 2004 SpineCore was acquired by Stryker Corporation for $360 million in cash, including $120 million up front and $240 million in milestone and royalty payments upon U.S. commercialization of the company’s products   http://www.warburgpincus.com/portfolio/ViewCompany,id,220.aspx
SpineCraft (Westchester, IL) a privately-held, US medical device company offering a wide range of products for deformity and complex spine correction, minimally invasive techniques, cervical fusion, degenerative conditions, interbody fusion, non-fusion applications, and orthobiologics & bone substitutes    http://www.spinecraft.com
Spine Elements fka Quantum Orthopedics (Carlsbad, CA) – Zyre Facet System arthroplasty system IDE start 2006, Zyre is sold OUS, In cadaveric spine specimen testing, “the Zyre Facet Replacement System exhibited endurance under repeated loading with no evidence of device wear in or around the anatomic structures where the device was implanted.” Todd Andres-Pres   http://www.spinalelements.com
SpineForm, LLC (Cincinnati, OH) scoliosis treatment, raised $1.25M in Angel funding in 2009   http://www.spineform.com
Spine Frontier (Malden, MA) founded in 2006, facet screw, interbodies, SIJ fusion, plating, biologics and some patent apps in the works, Kingsly Chin is listed as one of their inventors   http://www.spinefrontier.com
SpineGuard (France) raised $11M in Series A and $4M in Series B. Proceeds were used to acquire the PediGuard Business Unit from SpineVision. SpineGuard’s focus is safer pedicle screw placement in spine surgery   http://www.spineguard.com
SpineLab (Germany) – Precimed to co-develop instruments   http://www.spinelab.com/
SpineMark – need information
SpineMatrix (Akron, OH) Non-invasive diagnostics equipment used in the differential diagnosis of disc or facet mediated low back pain, closed $ 8M in Series B for new hires and manuf or CERSR that detects muscle tension in the back to locate source of pain, Bill Christy was the new CEO after Ben Shappley http://www.spinematrix.com/
SpineMedica (Atlanta) – $10.6M spinoff from SaluMedica in 2005, focusing on spine cartilage, SaluDisc based on a hydrogel spine license for Salubria, Pete Petit (Pres), Rebeccah Brown PhD (COO), Lew Bennett was CEO for a short time, no news for a least a year?   http://www.mimedx.com/SM/
Spineology (St Paul, MN) Spineology Inc. provides innovative, anatomy conserving spinal technologies for surgeons and their patients. Spineology surgical techniques conserve spinal bone, ligament and muscle tissue. Spineology is committed to increasing procedural efficiency, reducing surgical morbidity and accelerating patient recovery. Learn more at spineology.com.
SpineOvations (San Diego) Ross Simmons, named Robert R. Anglea to its Board of Directors. DiscSeal(TM) is a percutaneous injection treatment for patients with Internal Disc Derangement (IDD) and suffering from chronic, discogenic lower back pain, acqd Discogen (FL) Dec07   http://www.spineovations.com/
SpineSelect (Tupelo, MS) Lumbar Cages  http://www.spineselect.com
SpineSmith, LP (Austin, TX) develops and markets implants and biologics for surgical fixation, correction and tissue regeneration of the spine, Kevin Dunworth (Founder) Steve Melchiode (Pres)   http://www.spinesmithusa.com/
SpineSource (St Louis) distributing A-Spine products in US, raised $1.2M to fund launch of 3 products. Tom Mitchell president, PEEK cage, AT plating made by Taiwan-based ASpine   http://spinesource.net/
Spine Solutions [ACQUIRED] acq by Synthes for $175M in 2003, ProDisc   http://www.synthes.com/
Spine Surgical Innovation (Boston, MA) spine tubular retractor systems; Holmed Swivel Port System http://www.spinesurgicalinnovation.com/
SpineView (Fremont, CA) minimally-invasive technologies aimed at improving spinal decompression and fusion with a host of spine-related interventional and surgical products and procedures, enSpire Interventional Discectomy System is a needle-based tool designed to cut, grind, and aspirate disc tissue for lumbar discectomy procedures   http://spineview.com/
SpineVision (Paris & San Francisco) – lumbar system for dynamic stabilization without fusion, also discs and MIS systems, free-hand electronic pedicle preparation instrument, Gérard Hascoët is now CEO, Direct sales in UK   http://www.spinevision.net/
Spine Wave (Shelton, CT) quickly raised $125M in four rounds, IDE approval in 2006, StaXx expandable PEEK interbody, StaXx FX repair system, NuCore injectable nucleus trial underway, Mark LoGuidice (founder), John Pafford (founder)   http://www.spinewave.com/
Spinofix X Technologies (Irvine,CA) seeking FDA clearance for pedicle screws, cross-connectors, intradisc spacer, adjustable rod systems http://spinofix.com
SpinX Technologies (Geneva) programmable lab-on-a-chip platform for applications ranging from drug discover to consumer diagnostics  http://www.spinx-technologies.com/
Spring Back, Inc (Palo Alto, CA) exhibited at EuroSpine 2009, need more information   http://www.springbackinc.com/
Surgical Biologics (Kennesaw, GA) developing bioimplants manufactured from human amniotic membrane, which can be used for a wide range of spine indications. Purion, a patent pending process created by Surgical Biologics, is specifically designed for the manufacture of human amniotic membrane   http://www.surgicalbio.com/
Surgicraft PEEK cages, need information   http://www.surgicraft.co.uk/
Synergetics USA instruments, need information   http://www.synergeticsusa.com/
St. Francis Medical (San Francisco) [ACQUIRED] Kyphon acq $185M, X STOP Interspinous Process Decompression System, great reimbursement at $4,400, IPO late 2006   http://www.medtronicsofamordanek.com/
SyncMedical (Stroughton, MA) Part of a consortium of med device startups lead by Steve Tallarida (vascular surgery, endo surgery, cardio surgery, and joint preservation surgery) that includes ArthroSurface and STD Medical;   Ethos Pedical Screw system is available in Latin America
http://www.syncmedical.com
The 4th Column (San Diego)  no current information
Theken (Akron, OH)  [ACQUIRED] Integra Life Sciences acquired for $75M + possible $125 in earnouts in Aug08 (2.2X sales), PEEK cages, e-Disk with MEMS chips with feedback, FDA warning letter re torque wrench, eDisk trials start late 2007   http://www.theken.com/
Titan Spine (Milwaukee) Peter Ulrich inventor, ENDOSKELETON Vertebral Body replacement, Charanpreet Bagga, Vice President of Operations & Research, Steve Cichy, Vice President of Sales & Marketing, Kevin Gemas, President   http://titanspine.com/
TranS1 (Denver, CO) Its not often that a spine company makes the startup list twice.  In 2015, Jeff Schell rescued the AxiaLIF technology from bankruptcy during the Baxano dissolution.  He has restarted TranS1 by making the AxiaLIF technology available again to spine surgeons and patients. He is also developing newly innovative spine approaches under the new TranS1 (which I like to call TranS2.0).  Q&A with Jeff Schell   http://www.trans1.com/
TransCorp Medical (Grand Rapids, MI) focused on neurosurgical and orthopedic instruments and implants, founders are Dr. Scott Tuinstra, Roger Veldman, and Des O’Farrell, 2008 funding from EDF Ventures and Grand Rapids-based Hopen Therapeutics and Grand Angels, FDA approved Anterior Cervical Fusion Plate System and PEEK Interbody Fusion implants http://www.transcorpspine.com/ , MassDevice article.. http://ow.ly/4WvMj
True Motion Spine (Gainesville, FL) cervical disc for non-fuisons in development – Cervical D6, plans also for lumbar disc also http://www.truemotionspine.com/
Tyber Medical (Morristown, NJ) offers private label spine cages (Ti plasma on PEEK) and cervical plates that are already FDA cleared  http://tybermedical.com/
Ulrich Medical USA (Chesterfield MO) bought a spine distributorship…SpineSource, Obelisc vertebral body, expandable VBRS, cages, rods, screws & plates.   http://www.ulrichmedicalusa.com/
Ultimate Spine (Los Angeles) FDA registered, Selective Axis posterior non-cervical plating system, need information
US Spine Technologies (Boca Raton, FL) [ACQUIRED] Acquired by Amedica Sept 2010, minimally invasive, rapid-delivery facet fixation via a disposable, trigger-operated gun; third-generation polymer artificial disc, Element TCP/HA, received FDA 510(k) clearance for the Facet Fixation System, an alternative to pedicle screw fixation for 1 and 2-level spine fusions, Doris Blake (CEO), Paul Sendro hired as VP Sales after failing as Vertebron CEO   http://www.us-spine.com/
Valorem Surgical  (Chicago) cervical plating, thoracolumbar screws, biologics, cranial PEEK implants  http://valoremsurgical.com/
Vertebral Technologies, Inc – VTI (Minneapolis) focus is less invasive fusions, InterFuse Interbody Fusion Device made from modular PEEK spacers, over 3,000 Fuse Interbodies implanted, InterCushion disc nucleus, Jeff Felt is CEO, strong connection to ABS, plans to raise $3M funding   http://vti-spine.com/
Vertebration (Columbus, OH) MIS techniques   http://vertebration.com/
[FAILED]
Vertebron (Stratford, CT) BANKRUPT in March 2009, Asset Sales later in 2009, Vertebron should have cashed out when CardoMed offered them $25M, MoM disc in dev, acquired 9 patents spanning spinal implant and instrument systems, including bioabsorbable cervical plating and interbody fusion devices, non-metallic screw locking and chemical bonding technologies, X-Surgical Dynamics leader, distributes medARTIS TCP/HA, most profitable quarter was 1Q07   http://www.vertebron.com/
Vertera Spine (Atlanta, GA) [ACQUIRED] COHEREÔ is the first porous PEEK interbody fusion, acquired by NuVasive in 2017 http://www.verteraspine.com/
Vertical Spine, LLC (Lafayette, CA) startup http://www.verticalspine.com/
Verticor (Midland, TX) fka Interbody Innovations, PEEK cages, PEEK vertebral body spacer, cervical plating, partnerships with Spine 360 and X-Spine for their metal implants, cervical plate in future
http://www.verticorspine.com/
Vertiflex (San Clemente, CA) a developer of medical devices for spinal surgery, has quietly raised around $28.3M in venture funding, sold MIS patents to Exactech   http://www.vertiflex.net/
Vertos Medical (Aliso Viejo, CA) $15.5M in Series D, MILD instruments for perform percutaneous lumbar decompressure procedures, early clinical data looks good, experienced CEO Jim Corbett from Ev3   http://www.vertosmed.com/
Vexim SAS (France) minimally-invasive anatomical treatment of vertebral compression fractures, clinical trials in Europe of the SpineJack   http://www.vexim.fr/
VG Innovations (Winston-Salem, NC) VerteLoc Minimally Invasive Spine Stabilization System for facet fusion, over 500 US implantations so far   http://vginnovations.com/
VGI Medical (St Petersburg, FL) – founded in 2008, PEEK lumbar cages and an SI spacer. http://www.vgimedical.com/
VTI Spine, Inc. fka K Spine (Minnetonka, MN) initial market is scoliosis; the Kspine system allows surgeons to reduce the morbidity of deformity surgery with a procedure that is quicker, safer, and more cost-effective than existing techniques; CE Mark, and are currently recruiting patients for a clinical trial OUS; investors include Split Rock Partners and Abingworth; raised $2,5M in 2010; need website information – http://www.vti-spine.com/
Wenzel Spine, Inc. (Austin, TX) – founded in 2008, and fully operational by the fall of 2009, Wenzel’s products were previously marketed by Encore Medical. Encore Medical purchased Osteoimplant Technology in 2005. Osteoimplant Technology marketed spine products from Advanced Spine, which included the VariGrip and VariFix and VariLift, Chad Neely (CEO), MAB is composed of David Attia, M.D., Thomas Kingman, M.D., and Frank Fichtel, M.D.   http://wenzelspine.com/
Xtant Medical (Miamisburg, OH) combination of Bacterin an X-Spine https://orthostreams.com/2015/07/bacterin-acquires-x-spine-for-86m-and-renames-it-xtant-medical/, surgeon-driven philosophy, products are Capless screw systems, Spider Cervicalfixation system,  and Butrex Lumbar buttress plating system http://xtantmedical.com/
Zimmer Spine (Austin) (fka Spinal Concepts)[ACQUIRED] acquired by Abbott Labs for $160M, then Abbott acquired SpineNext (France), then Abbott sold both spine companies to Zimmer for $360M, non-fusion Wallis system, ISD cervical disc replacement made of elastomer core in woven cover, owns an interest in Replication Medical’s hydrogel nucleus, 210 employees in Austin   http://www.zimmerspine.com
Zyga Technology, Inc (Minnetonka, MN) SImmetry Sacroiliac Joint Fusion System and Glyder Facet Restoration Device, $9.75M from Split Rock Partners and Domain Assoc, founded in 2008, https://zyga.com/

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