The Metamorphosis of Spine: The M&A Landscape

When challenged, spines are flexible.

Despite pandemic-related havoc (surgery cancellations, production halts, etc.), the spine industry was the best-performing sector in orthopedics during the COVID-19 pandemic of 2020. 

Approximately 24 months ago, we began to see a trend of consolidation and portfolio streamlining. Overall, the vast market consolidation has shifted the global spine economy rankings and positioned several companies for expanded market share and growth. 

Post-pandemic mergers and acquisitions (M&A) picked up slightly in 2022 with the Orthofix and SeaSpine merger agreement, a move aimed to foster synergies through combined R&D, better distribution networks, and enhanced innovation capabilities. 

In 2023, Globus Medical merged with NuVasive, a move which has been successful in mining the former’s strengths in robotics and implants and combining them with NuVasive’s expertise in minimally invasive spine surgery (MIS). Also in 2023, Zavation acquired CoreLink in order to combine that company’s engineering talent with Zavation’s manufacturing capabilities. That same year, Silony Medical International AG signed an agreement to acquire Centinel Spine’s Global Fusion Business with the goal of enhancing its spinal fusion offerings.

In 2024, Zimmer Biomet, which spun off ZimVie in 2022, announced that H.I.G. Capital has acquired the spine division of ZimVie and rebranded it as HighRidge Medical. 

In April 2025, Stryker exited the U.S. spine market with the sale of its spine business to VB Spine LLC, an agreement under which Stryker will provide the enabling technology, and VB Spine provides the implants. This move allows Stryker to focus on rapidly expanding markets and non-surgical solutions, with one prognosticator proclaiming that they are building a next-generation spine ecosystem.  

The benefits of spine consolidation are laid bare when evaluating a portfolio offering. Does the consolidated vendor now offer solutions to cover an entire formulary, when they may have previously lacked options? Is it now possible to leverage different service line contracts for better long-term value? Has a given consolidation truly moved the needle on clinical care?

When the spine behemoths divest their underperforming or non-essential businesses, they can then streamline operations and focus on high-growth areas. Now pared down, the spine unit may be more agile under private equity ownership, which may generate more targeted investments and operational efficiencies. 

Growth and What’s Driving It

While spine surgery volume continues to grow, it is doing so at a slower pace. The U.S. spine device market is expected to grow at a compound annual growth rate (CAGR) of 3.6% from 2024 to 2030. Global spine procedures are expected to be at an 8.3% CAGR during the same period, suggesting potential expansion opportunities outside the U.S.

Advanced Technologies

The latest medical technologies heighten surgical accuracy, improve patient safety, and enhance outcomes in the treatment of spinal disorders. Eying projected double-digit growth in the realm of enabling technologies, companies are increasingly focusing their resources on a cadre of these technologies—augmented reality, robotics, AI, intraoperative spinal imaging technology, and digital preop planning. 

But new product development is risky and pricey. Companies can sidestep these concerns by purchasing smaller companies that have already met the regulatory requirements and emerged with cutting-edge technologies.

Watching the winds, manufacturers continue to put resources into ambulatory surgery center-friendly devices, ensuring that their assistive technologies address the size and budget constraints associated with these facilities.

The Future

We expect the spine consolidation spree to continue for the foreseeable future as larger companies reach out for new markets, attempt to foster innovation (more likely given increased competition), and hopefully, offer enhanced clinical results for patients. 

Noted M&A Moves:
Stryker VB Spine LLC
Zimmer HighRidge Medical
Globus NuVasive