Spinal Surgical Robots: Market Shares, Strategies, and Forecasts, Worldwide,

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Felix Collins
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1 Spinal Surgical Robots: Market Shares, Strategies, and Forecasts, Worldwide, Table of Contents Spinal Surgical Robot: Executive Summary The study is designed to give a comprehensive overview of the Spinal Surgical Robot equipment market segment. Research represents a selection from the mountains of data available of the most relevant and cogent market materials, with selections made by the most senior analysts. Commentary on every aspect of the market from independent analysts creates an independent perspective in the evaluation of the market. In this manner the study presents a comprehensive overview of what is going on in this market, assisting managers with designing market strategies likely to succeed. Table of Contents Spine Surgical Robot Executive Summary 23 Spine Surgical Robot Mapping 23 Spine Surgery Robotics Market Driving Forces 27 Spine Surgery Robot Market Shares 28 Surgical Robot for Spine Market Forecasts Spinal Surgery Robots Market Description and Market Dynamics Key Elements Of Spinal Robot System Industry Overview - Spine Robot Assisted Surgery Spine Robotic Surgical Market Strategy Focus on Key Institutions Focus on Leading Surgeons to Drive Rapid and Broad Adoption 37 TOC-1

2 1.2.5 Maintain Market Leadership Spine Surgery Spine Surgical Robot Market Shares and Forecasts Spine Surgical Robot Mapping Spine Surgery Robotics Market Driving Forces Spine Surgery Robot Market Shares Mazor Surgical Robots for the Spine: Mazor Robotics Mazor Renaissance System Mazor Robotics Guidance System Maximizes Precision And Safety Surgical Robot for Spine Market Forecasts Surgical Robot Systems vs. Disposable Instruments Forecasts Shenzhen Advanced Institute Spinal Surgical Robot U.S. Minimally Invasive Spinal Implant Market To Outpace Growth In Traditional Spine Market Medical Robotic Surgery Challenges Key Players In The Global Medical Robots Key Players In The Global Spinal Implant Market Medtronic NuVasive SI-BONE Minimally Invasive Surgical Instruments Spinal Restorative Therapy Target Markets Spine Surgery Robot Prices Spine Surgery Robot Regional Market Segments US 93 TOC-2

3 2.7.2 U.S.-Europe Product Introduction Swap Asia-Pacific China Underdeveloped Regions Brazil Spinal Patients in Taiwan Receive Fast Care with Unique Reimbursement Structure; Market Led by DePuy Synthes, Medtronic Surgical Robots Product Description Mazor Robotics Mazor Renaissance In the Operating Room Mazor Robotics Ease of Use and Reduced Length of Stay Mazor Products: Components of the Renaissance System Mazor Mounting Platforms, Disposables, and Accessories Surgical Workflow Using Mazor Renaissance Mazor Three-Dimensional (3D) Synchronization Mazor Spine Surgical Execution Mazor Spine Robot Surgery Applications: Mazor Spine Robot Surgery Applications: Spinal Fusion Mazor Spine Robot Surgery Applications: Scoliosis Surgery Mazor Renaissance System For Robotic Guidance Mazor Renaissance Spine Procedures Mazor Robotics Spine Procedures Mazor Robotics Clinical Study Mazor Robotics Reduced Exposure to Radiation Medtronic Medtronic Spinal Fusion 121 TOC-3

4 3.2.2 Medtronic Cervical Artificial Disc Products Medtronic Biologics Products Medtronic Minimally Invasive Spinal Surgery Medtronic Posterior OCT Reconstruction Stryker Spine Surgery Stryker Spine Navigation Software Stryker's VertaPlex HV First PMMA to Receive Clearance for Treating Sacral Insufficiency Fractures Exactech Zimmer / Biomet Spine Medacta DJO Johnson & Johnson / DePuy Johnson & Johnson / Ethicon NuVasive Nuvasive Spinal Surgical Solutions Medical Robot Technology and Disease Statistics Healthcare Robotics Enabling Technology Robotic-Assisted Minimally Invasive Surgery Market Driving Forces Mazor Renaissance Surgical Spine Robot FDA Marketing Clearance 510(k) Robotic Surgical Clinical Applications Mesenchymal Stem Cells (MSC) Role In Regenerative Medicine Types of Spine Surgeries Minimally Invasive Spine Fusion: Scoliosis Correction Surgery: Vertebroplasty: 152 TOC-4

5 4.6.3 Spine Biopsies: Spine Surgery Device Market Mazor Renaissance Guidance System Technology Government Regulation California Regulation International Regulation Third Party Reimbursement Spinal Surgical Robots Company Description Accel Spine Alliance Spine Alliance Spine has Surgical Advisory Boards Alliance Spine Bone Marrow Concentrate System Alphatec Alphatec Spine Apollo Spine Ascendx Spine Back 2 Basics Spine Boston Scientific Boston Scientific Precision Plus Spinal Cord Stimulator System Boston Scientific Pain Medicine Brainlab AG Brainlab AG Revenue Brainlab Captiva Spine Centinel Spine Elekta Elekta Gamma Radio Surgery System 181 TOC-5

6 Elekta - Interim Report May October 2015/ Elekta Transformation Program On Track Globus Medical Globus Purchased Excelsius Surgical K2M Life Spine Mazor Robotics Mazor Robotics Creates Robotic Guidance Systems Mazor Robotics Strategy Research Agreement with Cleveland Clinic Foundation (CCF) Mazor Surgical Workflow Using Renaissance for Spine Procedures Mazor Robotic Pre-Operative Planning Medacta Medacta Business Medtronic Medtronic Revenue Medtronic Operating Segments Medtronic Sacroiliac Joint Fusion Device Spinal Implant Market Medtronic Spine Medtronic in the U.S. Spinal Implant Market Medtronic Acquisition of Covidian Medtronic Acquisition of RF Surgical Systems Medtronic Acquisition of Medina Medical Medtronic Pelvic Mesh Litigation Medtronic Restorative Therapies Group MicroPort Scientific Corporation 218 TOC-6

7 MicroPort Orthopedic Devices MicroPort Acquires OrthoRecon Business from Wright Medical Technologies Microport Hip Systems NLT Spine NuVasive NuVasive Full-Year 2015 Revenue Precision Spine Shenzhen Advanced Institute Spinal Surgical Robot Si-Bone SI-BONE ifuse Implant System SIGNUS Medical Spinal Elements Spineart SpineGuard Spine Frontier Spineology Spine Smith Partners Spine Surgical Innovations Spine Surgical Innovations MIMS Approach, Minimum Incision, Maximum Sight Spine View Spine Wave St. Jude Medical Stryker Stryker / MAKO Surgical Stryker Revenue 237 TOC-7

8 Stryker Results Of Operations Stryker Segment Orthopaedics Stryker Business Segment Operations Stryker Revenue Stryker Hip Recall: $1.4 Billion Settlement Stryker Regional Revenue Segment Stryker Robots Stryker / MAKO Surgical Stryker / Mako MAKO Surgical RIO Robotic Arm Stryker Endoscopy Mako Surgical Business Mako Products Mako Surgical Strategy Mako Surgical Revenue Mako Surgical Business Mako Products Mako Surgical Strategy Mako Surgical Revenue Wenzel Spine Wright Medical Technology Wright Revenue Wright Medical Group NV Revenue Wright Medical Group N.V. Revenue for 2015 Third Quarter Wright / Tornier 289 TOC-8

9 5.38 X-spine Zyga Technology Zimmer Biomet Zimmer Biomet Sales by Product Category Zimmer Biomet Zimmer Metal-on-Metal Hip Recall Spine Surgical Companies Spine Surgical Imaging 307 List of Tables and Figures Table ES-1 25 Robot-Guided Spine Surgery Benefits 25 Table ES-2 25 Spine Surgery Robot-Guidance Features 25 Table ES-3 26 Robot-Guide For Spine Surgery Components 26 Table ES-4 27 Robot Spine Surgery Market Driving Forces 27 Figure ES-5 29 Spine Surgical Robot Market Shares, Shipments, Dollars, Worldwide Figure ES-6 30 Spinal Surgical Robots Market Forecasts, Dollars, Worldwide, Table Key Elements Of A Spinal Robot System 32 TOC-9

10 Table Spine Disorder Market Driving Forces 33 Table Spine Surgical Robot Focus on Key Procedures 36 Table Spinal Surgery Scientific Advances 39 Table Robot-Guided Spinal Surgery Advantages: 39 Table Robot-Guided Spine Surgery Benefits 43 Table Spine Surgery Robot-Guidance Features 43 Table Robot-Guide For Spine Surgery Components 44 Table Robot Spine Surgery Market Driving Forces 45 Figure Spine Surgical Robot Market Shares, Shipments, Dollars, Worldwide Table Spine Surgical Robot Market Shares, Dollars, Worldwide, Table Principal Competitive Factors in the Robotic Spine Surgery Market 50 TOC-10

11 Table Mazor Revenue, Figure Mazor Leading Spine Surgery Innovation 54 Figure Spinal Surgical Robots Market Forecasts, Dollars, Worldwide, Table Spinal Surgical Robot Market Forecasts, Dollars, Worldwide, Table Spinal Surgical Robot Revenue by Segment, Robots and Disposables, Worldwide, Table Robot Spine Procedures, Number, Worldwide, Table Spinal Surgical Robot Units Shipped Forecasts, Surgical Robotic Procedures, and Number Procedures per Installed Unit, Worldwide, Table Spinal Surgical Robot Installed Base, Percent Spinal Procedure Penetration, and # Spinal Procedures, US and Worldwide, Table Spinal Surgical Patients with Chronic Back Pain and % Penetration Procedures Worldwide, Table TOC-11

12 Robot Spine Surgery Market Factors: 64 Table Robotics Market Aspects 65 Table Spinal Surgery Hospital Trends 66 Table Robotic Cost Savings with Spinal Surgical Units 67 Figure Surgical Robot Systems vs. Instruments Forecasts, Dollars, Worldwide, Table Benefits of Robotic Surgery For The Surgeon 71 Table Benefits of Robotic Surgery For The Patient 72 Table Benefits of Robotic Surgery For The Hospital 73 Table Challenges of Open Surgery and Minimally Invasive Surgery 76 Table Challenges of Developing Medical Robotic Surgery Systems 77 Table Surgical Robotic Product Development Challenges 78 TOC-12

13 Table Key Players In The Global Medical Robots Market 79 Table Key Players In The Global Spinal Implant Market 83 Table Advantages of Minimally Invasive Surgeries 86 Table Challenges of Minimally Invasive Surgeries 86 Figure Spine Surgical Robot Regional Market Segments, Dollars, Worldwide, Table Spine Surgical Robot Regional Market Segments, Figure Mazor 3D Visualization of Surgical Planning 99 Figure Mazor Planning Software / 3D visualization 100 Table Mazor Components of the Renaissance System 102 Table Mazor Renaissance System Component Tasks 103 Table MAZOR RBT Device Surgical Workflow Using Renaissance for Spine Procedures105 TOC-13

14 Figure Mazor Renaissance RBT Device Accuracy of the 3D Synchronization 3D Marker; C- arm in 2 Positions Taking Registration Images for 3D Synchronization Process 107 Figure Mazor RBT Device (with an arm connected to it) on Clamp Mount Ready To Guide The Surgeon 108 Figure Mazor Spine Robot Surgery Applications: 109 Figure Mazor Robotics Renaissance System For Guidance 112 Figure Mazor Renaissance Spine Procedures 113 Figure Mazor Robotics Spine Procedures Variety 117 Table Medtronic Spinal Conditions Treated 120 Table Medtronic Infuse Bone Graft/LT-Cage Lumbar Tapered Fusion Device Risks 123 Table Medtronic Minimally Invasive Spine Platform Enables A Variety Of Cervical, Thoracic, And Lumbar Procedures 126 Figure Medtronic Posterior OCT Reconstruction 127 TOC-14

15 Table Stryker Spine Navigation Software Key Advantages 129 Table Zimmer / Biomet Spine Surgical Solutions 132 Figure Biomet Sequoia Thoracolumbar Pedicle Screws with TM Ardis Interbody System 133 Figure DJO Cement Solutions 135 Table DJO Spine Devices 135 Table Nuvasive Surgical Solutions Procedures 140 Table Nuvasive Surgical Solutions NVM5 Nerve Monitoring System 141 Table Healthcare Robotics Enabling Technologies 142 Table Robotic-Assisted Minimally Invasive Surgery Market Driving Forces 143 Table 4-2 (Continued) 144 Robotic-Assisted Minimally Invasive Surgery Market Driving Forces 144 Table TOC-15

16 Types Of Procedures Performed Using Robotic Surgical Systems 145 Table Types of Spinal Pathology and Disorders 148 Table Types of Spinal Deformities 149 Table Types of Spinal Disorder Treatments 150 Figure Alliance Spine Nakoma SL Anterior Cervical Plating System 166 Figure Alliance Spine Alamo C 167 Figure Boston Scientific SCS System: 32 Contacts and 32 Dedicated Power Sources 173 Figure Brainlab Collaborative Workspace 174 Figure Brainlab AG Worldwide Presence, Headquarters in Germany 175 Figure Captiva Spine Pedicle Screw System 179 Figure Elekta Gamma Radio Surgery System 181 Figure TOC-16

17 Globus Medical Spine Surgery Products 187 Table Mazor Revenue, Table Mazor Robotics Strategy Key Elements 193 Table Mazor Robotics Commercialization of Renaissance System Strategy Key Elements 193 Table Mazor Robotics Utilization Of Installed Base Strategy Key Elements 194 Table Mazor Robotics Clinical And Financial Value Strategy Key Elements 195 Table Mazor Robotics Research And Development Strategy Key Elements 196 Table Basic Steps for Surgical Workflow Using Mazor Renaissance Robot 197 Figure Mazor Surgical Planning Software Provides A Slice-By-Slice Image Display 199 Figure Mazor Surgical Robot: 3D Marker; C-arm in 2 positions taking registration images for 3D Synchronization process 200 Figure TOC-17

18 Mazor RBT Device (with an arm connected to it) on Clamp Mount ready to guide the surgeon 201 Figure Medtronic / Covidian Integration 205 Table Medtronic Principal Products Offered by Spine Division: 213 Table Medtronic Spine Division Principal Products 217 Table MicroPort Advanced Technology Product Segments Addressed 218 Table Microport Hip Systems 220 Figure Precision Spine Cervical Spine Devices 224 Figure SIGNUS Medical Sacroiliac Joint Medical Device 229 Figure Stryker Joint Implants 246 Figure Stryker Patient Specific Pre-Operative Planning 248 Figure Stryker Patient Specific Pre-Operative Planning 249 TOC-18

19 Table Stryker Better Fit Orthopedics 250 Table Stryker Osteoarthritis Affects Compartments Of The Knee 251 Figure Stryker / MAKO Surgical RIO Robotic Arm Interactive System 252 Figure MAKO Surgical Restoris 260 Figure Mako Robotic Arm Technology Assists in Total Hip Replacement 262 Figure MAKO Surgical 263 Figure MAKO Surgical Implants 264 Table MAKO Robotic Surgery Benefits 269 Figure Mako Robotic Arm Technology Assists in Total Hip Replacement 273 Table MAKO Robotic Surgery Benefits 278 Figure Zyga Technology SImmetry System 292 TOC-19

20 Table Zimmer Biomet Musculoskeletal Healthcare Offerings 298 Table Zimmer Metal On Metal Hip Replacement Difficulties and Side Effects. 300 TOC-20

Hip and Knee Orthopedic Surgical Robots: Market Shares, Strategies, and Forecasts, Worldwide,

Hip and Knee Orthopedic Surgical Robots: Market Shares, Strategies, and Forecasts, Worldwide, 2016-2022 Table of Contents Hip and Knee Orthopedic Surgical Robots: Executive Summary The study is designed