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B. Braun Melsungen AG (Aesculap)
Biomet, Inc. (EBI, IQL)
Biorthex, Inc.
Centerpulse AG (Spine-Tech)
Corin Group PLC
Endius, Inc.
Interpore Cross International, Inc.
IsoTis SA/GenSci Regeneration Sciences, Inc.
Johnson & Johnson (DePuy AcroMed)
Kyphon, Inc.
Link Spine Group, Inc.
Medtronic, Inc. (Sofamor Danek)
Orquest, Inc.
Orthofix International NV
Orthovita, Inc.
Osteotech, Inc.
Raymedica, Inc.
Scient'x SA
Smith & Nephew, plc
Spinal Concepts, Inc.
Spine Network (Eurosurgical)
Spine Solutions, Inc.
Stryker Corporation (Howmedica Osteonics, Surgical Dynamics)
Surgicraft Limited
Synthes-Stratec, Inc.
Wright Medical Group, Inc.
EXECUTIVE SUMMARY
Procedure Trends
Fusion Instrumentation
Prosthetic Discs
Bone Graft Substitutes and Growth Factors
Vertebral Fracture Management
Other Spinal Technologies
Suppliers
Country Profiles
Summary Exhibit 1: European Spinal Products Market by Major Product Category, 2001-2008
Summary Exhibit 2: Major Spine Procedures, Forecast by Type, 2001-2008
Summary Exhibit 3: Fusion Instrumentation, Market Forecast by Major Type, 2001-2008
Summary Exhibit 4: Prosthetic Discs, Patient and Market Forecasts by Type, 2001-2008
Summary Exhibit 5: Bone Graft Substitutes, Market Forecast by Type, 2001-2008
Summary Exhibit 6: Vertebral Fracture Management, Procedure and Market Forecasts, 2001-2008
Summary Exhibit 7: Other Spinal Technologies, Procedure and Market Forecasts, 2001-2008
Summary Exhibit 8: Estimated Supplier Shares, 2002
Summary Exhibit 9: European Spine Market, Forecasts by Country, 2001-2008
1.0 OVERVIEW OF SPINAL DISORDERS
1.1 Anatomy of the Human Spine
1.1.1 Bone Physiology and Remodeling
1.1.2 Vertebrae
1.1.3 Intervertebral Discs
1.1.4 Spinal Cord
1.2 Spinal Conditions
1.2.1 Degenerative Disorders
1.2.1.1 Degenerative Disc Disease
1.2.1.2 Herniated Disc
1.2.1.3 Spinal Stenosis
1.2.1.4 Spondylosis
1.2.1.5 Spondylolisthesis
1.2.1.6 Osteoporosis
1.2.1.7 Osteoarthritis
1.2.1.8 Rheumatoid Arthritis
1.2.2 Spinal Trauma
1.2.2.1 Structural Spinal Trauma
1.2.2.2 Spinal Cord Trauma
1.2.3 Deformity Disorders
1.2.3.1 Scoliosis
1.2.3.2 Kyphosis
1.2.3.3 Lordosis
1.2.4 Spinal Tumors
1.2.4.1 Malignant Spinal Tumors
1.2.4.2 Spinal Hemangiomas
Exhibit 1-1: Structure of the Vertebrae
Exhibit 1-2: The Spine
Exhibit 1-3: Prolapsed Intervertebral Disc
Exhibit 1-4: Overview of Spine Conditions
Exhibit 1-5: Types of Spondylolisthesis
Exhibit 1-6: Overview of Osteoporosis
Exhibit 1-7: Comparison of Osteoarthritis and Rheumatoid Arthritis
Exhibit 1-8: Spinal Trauma
Exhibit 1-9: Comparison of Spinal Deformity Disorders
Exhibit 1-10: Cancers With Probable Bone Metastases, Deaths, 1996 and 1998
2.0 TREND IN EUROPEAN SPINAL FUSIONS
2.1 Clinical Goals and Outcomes
2.1.1 Failure of Fusion
2.1.2 Failure of Pain Relief
2.1.3 Long-Term Outcomes
2.2 Classification of Spinal Fusions
2.2.1 Spine Segments Fused
2.2.2 Levels Fused
2.2.3 Use of Instrumentation and Cages
2.2.4 Surgical Approaches
2.3 Specialists Performing Spine Surgery
2.4 Spinal Fusions by Segment and Instrumentation
2.4.1 Cervical Spine
2.4.2 Thoracolumbar Spine
2.4.2.1 Approaches
2.4.2.2 Instrumentation Preferences
2.4.2.3 Procedure Forecast
Exhibit 2-1: Methods of Categorizing Spinal Fusion Procedures
Exhibit 2-2: Major Surgical Approaches for Spinal Fusion
Exhibit 2-3: Spinal Fusions by Segment, Procedure Forecast, 2001-2008
Exhibit 2-4: Spinal Fusions by Country, Procedure Forecast, 2001-2008
Exhibit 2-5: Fusion Procedures by Surgical Approach, 2002 & 2008
Exhibit 2-6: Instrumented Fusions by Segment, 2001-2008
Exhibit 2-7: Instrumented Cervical Fusions by Modality, Procedure Forecast, 2001-2008
Exhibit 2-8: Total and Instrumented Cervical Fusions by Country, 2001-2008
Exhibit 2-9: Instrumented Thoracolumbar Fusions by Modality, Procedure Forecast, 2001-2008
Exhibit 2-10: Total and Instrumented Thoracolumbar Fusions by Country, 2001-2008
3.0 FUSION INSTRUMENTATION
3.1 Traditional Instrumentation Systems
3.1.1 Configurations
3.1.1.1 Hook/Screw and Rod Systems
3.1.1.2 Plate Systems
3.1.1.3. Wires and Clamps
3.1.2 Products and Suppliers by Segment
3.1.2.1 Thoracolumbar Instrumentation
3.1.2.2 Cervical Instrumentation
3.1.3 Procedure Forecast
3.1.4 Market Analysis
3.1.4.1 Cervical Instrumentation Systems
3.1.4.2 Thoracolumbar Instrumentation Systems
3.1.4.3 Supplier Shares
3.2 Minimally Invasive Spine Surgery
3.2.1 Laparoscopic Anterior Spinal Fusion
3.2.1.1 Procedure
3.2.1.2 Advantages and Limitations
3.2.1.3 Products
3.2.1.4 Clinical Experience
3.2.2 Percutaneous Spinal Fusion
3.2.2.1 Procedure
3.2.2.2 Advantages and Limitations
3.2.2.3 Products
3.2.2.3.1 GM Reis
3.2.2.3.2 Medtronic Sofamor Danek
3.2.2.3.3 NuVasive
3.2.2.3.4 Spinal Concepts
3.2.2.3.5 Synthes-Stratec
3.2.3 Port-Access Spinal Fusion
3.2.3.1 Procedure
3.2.3.2 Advantages and Limitations
3.2.3.3 Products
3.2.3.4 Clinical Experience
3.2.4 Procedure Forecast
3.2.5 Market Analysis
3.3 Bioabsorbable Spinal Implants
3.3.1 Clinical Rationale
3.3.2 Clinical Applications and Products
3.3.3 Market Assessment
Exhibit 3-1: Traditional Instrumentation Product Configurations
Exhibit 3-2: Selected Thoracolumbar Spine Systems, 2003
Exhibit 3-3: Selected Cervical Spine Systems, 2003
Exhibit 3-4: Spinal Fusions Using Traditional Instrumentation, Procedure Forecast, 2001-2008
Exhibit 3-5: Cervical Fusions Using Traditional Instrumentation, Procedure Forecast by Country, 2001-2008
Exhibit 3-6: Thoracolumbar Fusions Using Traditional Instrumentation, Procedure Forecast by Country, 2001-2008
Exhibit 3-7: Traditional Spinal Instrumentation, Market Forecast, 2001-2008
Exhibit 3-8: Traditional Instrumentation, Market Forecast by Country, 2001-2008
Exhibit 3-9: Traditional Cervical Instrumentation, Market Forecast by Country, 2001-2008
Exhibit 3-10: Traditional Thoracolumbar Instrumentation, Market Forecast by Country, 2001-2008
Exhibit 3-11: Traditional Spinal Instrumentation, Supplier Shares, 2002
Exhibit 3-12: Minimally Invasive Approaches for Spinal Fusion Surgery
Exhibit 3-13: Selected Percutaneous Implantation Systems and Instrumentation, 2003
Exhibit 3-14: Selected Percutaneous Fusion Technologies
Exhibit 3-15: Selected Port Access Spinal Fusion Products, 2003
Exhibit 3-16: Images of Selected Port-Access Spinal Fusion Products, 2003
Exhibit 3-17: Minimally Invasive Spinal Fusion, Procedure and Market Forecast, 2001-2008
Exhibit 3-18: Design Criteria for Medical Biodegradable Polymers
Exhibit 3-19: Emerging Spinal Applications for Bioabsorbable Implants
4.0 INTERBODY FUSION DEVICES
4.1 Performance Criteria and Goals
4.2 Materials
4.2.1 Metal
4.2.2 Carbon Fiber
4.2.3 PEEK
4.2.4 Bioabsorbable Polymers
4.3 Cage Designs
4.3.1 Cylindrical Cages
4.3.2 Rectangular Cages
4.4 Implantation Technique
4.4.1 Anterior Lumbar Interbody Fusion
4.4.2 Posterior Lumbar Interbody Fusion
4.4.3 Transforaminal Lumbar Interbody Fusion
4.5 Failure of Interbody Fusion Devices
4.6 Products and Suppliers
4.7 Allograft Implants
4.7.1 Benefits and Limitations
4.7.2 Materials Supply
4.7.3 Clinical Experience
4.7.4 Implantation
4.7.5 Products and Suppliers
4.8 Market Analysis
4.8.1 Cages
4.8.2 Structural Allografts
Exhibit 4-1: Comparison of Materials Used for Interbody Fusion Devices
Exhibit 4-2: Interbody Fusion Device Designs
Exhibit 4-3: Approaches and Techniques Used for Lumbar Interbody Fusion Devices
Exhibit 4-4: Reasons for Failure of Interbody Fusion Device Procedures
Exhibit 4-5: Selected Interbody Fusion Devices, 2003
Exhibit 4-6: Selected Structural Allograft Implants, Products and Suppliers, 2003
Exhibit 4-7: Spinal Fusions Using Cages, Procedure Forecast, 2001-2008
Exhibit 4-8: Cervical Cage Procedures by Country, 2001-2008
Exhibit 4-9: Thoracolumbar Cage Procedures by Country, 2001-2008
Exhibit 4-10: Cervical Cages, Market Forecast by Country, 2001-2008
Exhibit 4-11: Thoracolumbar Cages, Market Forecast by Country, 2001-2008
Exhibit 4-12: Interbody Fusion Cages, Supplier Shares, 2002
Exhibit 4-13: Structural Allografts, Procedure and Market Forecast, 2001-2008
Exhibit 4-14: Structural Allografts, Estimated Supplier Shares, 2002
5.0 BONE GRAFT SUBSTITUTES AND GROWTH FACTORS
5.1 Performance Properties
5.2 Bone Graft Substitutes
5.2.1 Types of Bone Graft Materials
5.2.1.1 Autograft
5.2.1.2 Base Allograft
5.2.1.3 Demineralized Bone Matrix
5.2.1.4 Ceramic and Synthetic Bone Graft Substitutes
5.2.1.5 Xenograft
5.2.2 Applications
5.2.3 Regulatory Issues
5.2.3.1 General EC Directives
5.2.3.2 Allograft Products
5.2.3.3 Xenograft Products
5.2.3.4 Bone Graft Substitutes
5.2.3.5 Demineralized Bone Matrix
5.2.4 Products and Suppliers
5.2.5 Procedure Forecasts
5.2.6 Market Analysis
5.2.6.1 Allograft
5.2.6.2 Demineralized Bone Matrix
5.2.6.3 Synthetic Substitutes
5.2.6.4 Xenograft
5.3 Bone Growth Factors
5.3.1 Background
5.3.2 Product Components
5.3.3 Autologous-Derived Growth Factors
5.3.4 Bone Morphogenetic Proteins (BMPs)
5.3.4.1 Medtronic Sofamor Danek/Genetics Institute
5.3.4.1.1 Advantages and Limitations
5.3.4.1.2 Clinical Experience
5.3.4.2 Stryker
5.3.4.2.1 Advantages and Limitations
5.3.4.2.2 Clinical Experience
5.3.4.2.3 Regulatory Status
5.3.4.2.4 Product Rights
5.3.4.2.5 Distribution
5.3.4.3 Orquest/DePuy/Biopharm GmbH
5.3.5 Local Gene Therapy for Spinal Fusion
5.3.5.1 Medtronic Sofamor Danek
5.3.5.2 Millenium Biologics
5.3.5.3 OrthoLogic
5.3.5.4 Osiris Therapeutics
5.3.5.5 Selective Genetics
5.3.6 Procedure and Market Forecast
Exhibit 5-1: Design Criteria for "Ideal" Bone Graft Product
Exhibit 5-2: Types and Features of Bone Graft Materials
Exhibit 5-3: European Community Directives Relating to Importation and Use of Animal Tissue
Exhibit 5-4: Selected Base Allograft Products, 2003
Exhibit 5-5: Selected Xenograft Products, 2003
Exhibit 5-6: Selected Synthetic Bone Graft Substitutes, 2003
Exhibit 5-7: Selected Demineralized Bone Matrix Products, 2003
Exhibit 5-8: Bone Graft Substitutes, Procedure Forecast, 2001-2008
Exhibit 5-9: Traditional Bone Graft Substitutes, Market Forecast, 2001-2008
Exhibit 5-10: Traditional Bone Graft Substitutes, Market Forecast by Country, 2001-2008
Exhibit 5-11: Approaches for Incorporating Growth Factors into Bone Graft Products
Exhibit 5-12: Selected Bone Growth Factor Programs, 2003
Exhibit 5-13: Comparison of Selected Platelet-Derived Growth Factor Technologies
Exhibit 5-14: Advantages and Limitations of BMPs
Exhibit 5-15: Bone Growth Factors, Procedure and Market Forecast, 2001-2008
Exhibit 5-16: Bone Morphogenetic Proteins, Market Forecast by Country, 2001-2008
6.0 PROSTHETIC DISCS
6.1 Approaches
6.1.1 Total Disc Replacement
6.1.1.1 Technology
6.1.1.2 Indications
6.1.2 Nucleus Replacement
6.1.2.1 Technology
6.1.2.2 Indications
6.2 Implantation Techniques
6.2.1 Total Disc Implantation
6.2.2 Nucleus Implantation
6.3 Total Prosthetic Disc Products
6.3.1 LDR Médical
6.3.2 Link Spine Group (DePuy AcroMed)
6.3.2.1 Background
6.3.2.2 Product Description
6.3.2.3 Implantation
6.3.2.4 Indications
6.3.2.5 Clinical Experience
6.3.2.6 Distribution
6.3.2.7 Additional Products
6.3.3 Medtronic Sofamor Danek
6.3.3.1 Maverick
6.3.3.2 Prestige
6.3.3.3 Bryan (Spinal Dynamics)
6.3.3.3.1 Product Description
6.3.3.3.2 Implantation
6.3.3.3.3 Clinical Experience
6.3.3.3.4 Regulatory Status
6.3.4 Scient'x
6.3.5 SpineCore
6.3.6 Spine Solutions (Synthes)
6.3.6.1 Product Description
6.3.6.2 Implantation
6.3.6.3 Clinical Experience
6.3.6.4 Regulatory Status
6.4 Nucleus Replacement Products
6.4.1 Centerpulse Spine-Tech
6.4.1.1 Product Description
6.4.1.2 Implantation
6.4.1.3 Indications and Benefits
6.4.1.4 Clinical Experience
6.4.1.5 Regulatory Status
6.4.2 Raymedica
6.4.2.1 Product Description
6.4.2.2 Implantation
6.4.2.3 Complications
6.4.2.4 Indications and Contraindications
6.4.2.5 Clinical Experience
6.4.2.6 Regulatory Status
6.4.2.7 Distribution
6.5 Disc Regeneration
6.6 Market Analysis
6.6.1 Procedure Forecasts
6.6.2 Market Forecasts
6.6.3 Competitive Analysis
Exhibit 6-1: Total Disc Replacement versus Nucleus Replacement
Exhibit 6-2: Overview of Indication Criteria for Total Disc Replacement
Exhibit 6-3: Selected Total Disc Replacement Products, 2003
Exhibit 6-4: LDR Médical's Mobidisc
Exhibit 6-5: Evolution of the LINK SB Charité Intervertebral Dynamic Disc Spacer
Exhibit 6-6: Sofamor Danek's Disc Replacement Technologies
Exhibit 6-7: SpineCore's FlexiCore Intervertebral Disc
Exhibit 6-8: Spine Solutions' ProDisc
Exhibit 6-9: Selected Nucleus Replacement Products and Programs, 2003
Exhibit 6-10: Centerpulse Spine-Tech's Newcleus Implant
Exhibit 6-11: Raymedica's PDN Prosthetic Disc Nucleus
Exhibit 6-12: Indications & Contraindications for the Prosthetic Disc Nucleus
Exhibit 6-13: Selected Disc Regeneration Programs, 2003
Exhibit 6-14: Market Drivers and Concerns of Prosthetic Disc Products
Exhibit 6-15: Recent Acquisitions of Prosthetic Disc Companies
Exhibit 6-16: Prosthetic Disc Products, Procedure Forecast, 2001-2008
Exhibit 6-17: Prosthetic Disc Products, Market Forecast, 2001-2008
Exhibit 6-18: Total Disc Replacements, Procedure and Market Forecast by Country, 2001-2008
Exhibit 6-19: European Market for Total Disc Replacements, Supplier Shares by Segment, 2002
7.0 MANAGEMENT OF VERTEBRAL FRACTURES AND TUMORS
7.1 Indications
7.1.1 Osteoporotic Compression Fractures
7.1.2 Vertebral Trauma Fractures
7.1.3 Malignant Spinal Tumors
7.1.4 Spinal Hemangiomas
7.2 Clinical Goals of Therapy
7.3 Techniques
7.3.1 Vertebroplasty
7.3.1.1 Technique
7.3.1.2 Setting and Specialties
7.3.1.3 Clinical Experience
7.3.1.4 Contraindications
7.3.1.5 Reimbursement
7.3.1.6 Regulatory Issues
7.3.1.7 Products
7.3.1.7.1 Bone Cements
7.3.1.7.2 Delivery Systems
7.3.2 Kyphoplasty
7.3.2.1 Technique
7.3.2.2 Setting and Specialties
7.3.2.3 Applications
7.3.2.4 Advantages and Limitations
7.3.2.5 Clinical Experience
7.3.2.6 Product Requirements
7.3.2.6.1 Disc-O-Tech Medical Technologies
7.3.2.6.2 Kyphon
7.3.2.7 Reimbursement
7.3.3 Vertebral Body Replacement
7.3.3.1 Technique
7.3.3.2 Indications
7.3.3.3 Contraindications
7.3.3.4 Complications
7.3.3.5 Product Requirements
7.3.3.6 Clinical Experience
7.3.3.7 Vertebral Body Replacement Devices
7.4 Procedure Forecasts
7.5 Market Analysis
7.6 Supplier Shares
Exhibit 7-1: Major Indications for Vertebral Intervention
Exhibit 7-2: Techniques for Managing Vertebral Fractures and Tumors
Exhibit 7-3: Relative Contraindications to Vertebroplasty
Exhibit 7-4: Performance Requirements for Vertebroplasty Bone Cement
Exhibit 7-5: Selected Vertebroplasty Bone Cements, 2003
Exhibit 7-6: Current and Emerging Vertebroplasty Cement Delivery Systems, 2003
Exhibit 7-7: Advantages and Limitations of Kyphoplasty
Exhibit 7-8: Selected Clinical Experience with Kyphoplasty
Exhibit 7-9: Indications for Vertebral Body Replacement
Exhibit 7-10: Cancers With Probable Bone Metastases, Deaths, 1996 and 1998
Exhibit 7-11: Contraindications for Vertebral Body Replacement
Exhibit 7-12: Potential Complications Associated with Vertebral Body Replacement
Exhibit 7-13: Selected Vertebral Body Replacement Devices, 2003
Exhibit 7-14: Images of Selected Vertebral Body Replacement Devices, 2003
Exhibit 7-15: Vertebral Fracture and Tumor Management, Procedure Forecast, 2001-2008
Exhibit 7-16: Vertebroplasty, Procedure Forecast by Country, 2001-2008
Exhibit 7-17: Kyphoplasty, Procedure Forecast by Country, 2001-2008
Exhibit 7-18: Vertebral Body Replacements, Procedure Forecast by Country, 2001-2008
Exhibit 7-19: Vertebral Fracture Management Products, Market Forecast, 2001-2008
Exhibit 7-20: Bone Cements, Market Forecast, 2001-2008
Exhibit 7-21: Kyphoplasty Disposables, Market Forecast by Country, 2001-2008
Exhibit 7-22: Vertebral Body Replacement Devices, Market Forecast by Country,2001-2008
Exhibit 7-23: Vertebral Body Replacement Devices, Supplier Shares, 2002
8.0 OTHER SPINAL TECHNOLOGIES
8.1 Surgical Technologies
8.1.1 Flexible Stabilization
8.1.1.1 Products
8.1.1.1.1 Centerpulse Spine-Tech
8.1.1.1.2 Mekanika
8.1.1.1.3 St. Francis Medical Technologies
8.1.1.1.4 Spine Next/Clinique St. Martin
8.1.1.1.5 Surgicraft (Graf Ligamentoplasty)
8.1.1.2 Procedure Trend
8.1.1.3 Market Analysis
8.1.2 Minimally Invasive Discectomy
8.1.2.1 Microdiscectomy Techniques
8.1.2.2 Indications
8.1.2.3 Site of Herniation
8.1.2.4 Risks
8.1.2.5 Technologies
8.1.2.5.1 Chemonucleolysis
8.1.2.5.2 Manual and Automated Removal
8.1.2.5.3 Laser-Assisted Discectomy
8.1.2.5.4 Electrothermal
8.1.2.5.5 High Intensity Focused Ultrasound
8.1.2.6 Products
8.1.2.7 Procedure Trend
8.1.2.8 Market Analysis
8.1.3 Emerging Surgical Approaches
8.1.3.1 Annulus Repair
8.1.3.2 Facet Joint Arthroplasty
8.1.3.3 Extra-Ligamentous Repair
8.2 Interventional Technologies
8.2.1 Intradiscal Heating (Thermal Therapy)
8.2.1.1 IntraDiscal ElectroThermal Therapy (Smith & Nephew)
8.2.1.1.1 Product
8.2.1.1.2 IDET Procedure
8.2.1.1.3 Clinical Experience
8.2.1.1.4 Indications and Benefits
8.2.1.1.5 Regulatory Status
8.2.1.1.6 Additional Products
8.2.1.2 Radiofrequency Annuloplasty (Radionics)
8.2.1.2.1 Product
8.2.1.2.2 Procedure
8.2.1.2.3 Clinical Experience
8.2.1.2.4 Indications and Benefits
8.2.1.3 Procedure and Market Forecasts
8.2.2 Ozone Therapy
8.2.3 Percutaneous Neuromodulation Therapy
8.2.3.1 Product
8.2.3.2 PNT Procedure
8.2.3.3 Clinical Experience
8.2.3.4 Indications and Benefits
8.2.3.5 Regulatory Status
8.2.4 Intradiscal Hypothermia Therapy
8.2.4.1 Product
8.2.4.2 Procedure
8.2.4.3 Indications and Benefits
8.2.4.4 Clincial Status
8.3 Spinal Bone Growth Stimulators
8.3.1 Product Technology
8.3.1.1 Electrical Bone Growth Stimulators
8.3.1.1.1 Direct Current
8.3.1.1.2 Capacitive Coupling
8.3.1.1.3 Pulsed Electromagnetic Field
8.3.1.1.4 Combined Magnetic Field
8.3.1.2 Ultrasound Bone Growth Stimulators
8.3.2 Spinal Applications
8.3.3 Impact of Graft Substitutes and Growth Factors
8.3.4 Products
8.3.5 Product Trends
8.3.6 Clinical Experience
8.3.7 Patient Forecast
Exhibit 8-1: Selected Flexible Stabilization Technologies, 2003
Exhibit 8-2: Centerpulse Spine-Tech's DYNESYS System
Exhibit 8-3: Mekanika Modulus 60C System
Exhibit 8-4: The X STOP Interspinous Process Distraction System
Exhibit 8-5: The Wallis System
Exhibit 8-6: The Graf System
Exhibit 8-7: Indications & Contraindications for Graf Ligamentoplasty
Exhibit 8-8: Flexible Stabilization, Procedure and Market Forecast, 2001-2008
Exhibit 8-9: Flexible Stabilization Systems, Supplier Shares, 2002
Exhibit 8-10: Intervertebral Discs
Exhibit 8-11: Comparison of Minimally Invasive Discectomy Techniques
Exhibit 8-12: Advantages and Limitations of Min. Invasive Discectomy Techniques
Exhibit 8-13: Indications for Minimally Invasive Discectomy
Exhibit 8-14: Risks Associated with Minimally Invasive Discectomy
Exhibit 8-15: Comparison of Current and Emerging Disc Removal Techniques
Exhibit 8-16: Selected Minimally Invasive Discectomy Technologies, 2003
Exhibit 8-17: Images of Selected Minimally Invasive Discectomy Technologies, 2003
Exhibit 8-18: Minimally Invasive Discectomy, Procedure and Market Forecast, 2001-2008
Exhibit 8-19: Overview of Emerging Surgical Approaches to the Spine
Exhibit 8-20: Selected Early Stage Annulus Repair Technologies
Exhibit 8-21: Selected Early Stage Facet Joint Replacement Programs, 2003
Exhibit 8-22: Emerging Approaches to Interventional Spine Care
Exhibit 8-23: Smith & Nephew's IDET Technology
Exhibit 8-24: IDET: Long-Term Clinical Improvements
Exhibit 8-25: Randomized, Double-Blinded, Placebo Controlled IDET Trial Results
Exhibit 8-26: Radionics' discTRODE Technology for RF Annuloplasty
Exhibit 8-27: Intradiscal Heating, Procedure and Market Forecast, 2001-2008
Exhibit 8-28: The Vertis PNT System
Exhibit 8-29: Types of Bone Growth Stimulation Devices
Exhibit 8-30: Selected Spinal Bone Growth Stimulators Marketed in Europe, 2003
Exhibit 8-31: Selected Spinal Bone Growth Stimulators, 2003
Exhibit 8-32: Spinal Bone Growth Stimulation, Patient and Market Forecast, 2001-2008
Exhibit 8-33: Spinal Bone Growth Stimulators, Supplier Shares, 2002
9.0 COUNTRY PROFILES
9.1 Overview of European Healthcare
9.1.1 Healthcare Spending and Reform
9.1.2 Healthcare Facilities and Manpower
9.1.3 Reimbursement
9.1.4 Impact of the European Community
9.1.4.1 EC Directives
9.1.4.2 Pricing
9.2 National Profiles
9.2.1 Germany
9.2.1.1 Health Care Statistical Overview
9.2.1.2 Emerging Legislation
9.2.1.3 Spinal Products Market
9.2.2 France
9.2.2.1 Health Care Statistical Overview
9.2.2.2 Medical Products Regulation
9.2.2.3 Spinal Products Market
9.2.3 Italy
9.2.3.1 Emerging Private Sector
9.2.3.2 Product Issues
9.2.3.3 Spinal Products Market
9.2.4 Spain
9.2.4.1 Structure of Health Care Funding and Delivery
9.2.4.2 Overview of Health Statistics
9.2.4.3 Ambulatory Care Reforms
9.2.4.4 Product Issues
9.2.4.5 Spinal Products Market
9.2.5 United Kingdom
9.2.5.1 National Health System
9.2.5.2 Medical Products Regulation
9.2.5.3 Prevalence of Back Pain
9.2.5.4 Health Statistics Overview
9.2.5.5 Spinal Products Market
9.2.6 Benelux Nations
9.2.6.1 Health Care Systems
9.2.6.1.1 Belgium
9.2.6.1.2 Luxembourg
9.2.6.1.3 Netherlands
9.2.6.2 Spinal Products Market
Exhibit 9-1: Health Care Expenditures by Country
Exhibit 9-2: Practicing Physicians by Country
Exhibit 9-3: Acute Care Hospital Beds and Utilization
Exhibit 9-4: Germany, Health Care Profile
Exhibit 9-5: Spinal Products Market in Germany, 2001-2008
Exhibit 9-6: France, Health Care Profile
Exhibit 9-7: Spinal Products Market in France, 2001-2008
Exhibit 9-8: Italy, Health Care Profile
Exhibit 9-9: Spinal Products Market in Italy, 2001-2008
Exhibit 9-10: Spain, Health Care Profile
Exhibit 9-11: Spinal Products Market in Spain, 2001-2008
Exhibit 9-12: United Kingdom, Health Care Profile
Exhibit 9-13: Spinal Products Market in the United Kingdom, 2001-2008
Exhibit 9-14: Benelux Nations, Health Care Profiles
Exhibit 9-15: Spinal Products Market in Benelux Nations, 2001-2008
10.0 COMPANY PROFILES
10.1 B. Braun Melsungen AG (Aesculap)
10.2 Biomet, Inc. (EBI, IQL)
10.3 Biorthex, Inc.
10.4 Centerpulse AG (Spine-Tech)
10.5 Corin Group PLC
10.6 Endius, Inc.
10.7 Interpore Cross International, Inc.
10.8 IsoTis SA/GenSci Regeneration Sciences, Inc.
10.9 Johnson & Johnson (DePuy AcroMed)
10.10 Kyphon, Inc.
10.11 Link Spine Group, Inc.
10.12 Medtronic, Inc. (Sofamor Danek)
10.13 Orquest, Inc.
10.14 Orthofix International NV
10.15 Orthovita, Inc.
10.16 Osteotech, Inc.
10.17 Raymedica, Inc.
10.18 Scient'x SA
10.19 Smith & Nephew, plc
10.20 Spinal Concepts, Inc.
10.21 Spine Network (Eurosurgical)
10.22 Spine Solutions, Inc.
10.23 Stryker Corporation (Howmedica Osteonics, Surgical Dynamics)
10.24 Surgicraft Limited
10.25 Synthes-Stratec, Inc.
10.26 Wright Medical Group, Inc.
APPENDIX: COMPANY LIST