U.S. MIS Spine Market Will Outgrow Open Procedures Despite Headwinds, Says Report

Medical Device Market Intelligence Company Decision Resources Group expects the U.S.market for minimally invasive spine technologies to grow at approximately 6 percent annually through 2023. It’s not a great shock to see the company predict that this will be much faster than growth in the traditional open spinal implant market, but MIS technologies are not without their own headwinds.


An aging population, a growing number of procedures performed at ambulatory surgical centers (ASCs), an increasing number of insured patients as well as marketing efforts and product launches by manufacturers will stimulate minimal access spinal procedure volume growth, says Decision Resources Group. In particular it’s the ASC that underpins the prediction, MIS procedures of the spine being by nature more suitable as outpatient procedures that can be performed in ASCs compared to more traditional open spinal implant procedures.

While it’s obvious to most in the business that day-case MIS procedures are ultimately lower cost affairs than open cases, with reduced need for hospitalization, shorter recovery and fewer complications, there remain some structural headwinds. For example, while the Affordable Care Act (ACA) will increase the size of the insured population, industry sources indicate that reimbursement for newly insured patients is often insufficient to cover the additional cost of premium-priced minimally invasive devices. Paradoxically, reimbursement aligns more closely with the costs associated with open spine procedures, potentially putting a brake on adoption of minimally invasive spine procedures.

Then there’s Medicare and its own ACA-induced spending cuts which will also negatively affect minimally invasive spine procedures because a significant number of these procedures are performed on the Medicare population. Because of the premium price of minimally invasive spine procedures, cuts to reimbursement will make traditional open spine procedures more attractive.

That said, like night follows day, MIS procedure volume will still inevitably outgrow traditional open surgeries. The big players, with their marketing muscle, won’t let it happen any other way.

Analyst comments

Decision Resources Group Senior Analyst René Azeez stated; “Despite reimbursement challenges, leading competitors such as NuVasive, Medtronic and DePuy Synthes are continuing to invest aggressively in new product launches, physician training and marketing campaigns to stimulate market growth. This signifies the importance of this segment compared to the much more stagnant traditional open spinal implant market. In particular, companies are focusing on the large minimally invasive spinal fusion space and the fast-growing facet fixation market.”

“There is also significant innovation happening in complementary markets to minimally invasive spine technologies that could have a positive impact in the long term. For example, there is growing interest in robotic guidance, which can increase the accuracy of minimally invasive spine procedures. Companies are also launching bone graft substitutes designed specifically for minimally invasive procedures.”

Source: Decision Resources Group

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