Tuesday, May 24, 2011

Who's Next?

We'll be fighting in the streets, with our children at our feet
And the morals that they worship will be gone
And the men who spurred us on, Sit in judgement of all wrong
They decide and the shotgun sings the song

I tip my hat to the new constitution, take a bow for the new revolution
Smile and grin at the change all around me, pick up my guitar and play
Just like yesterday, and I'll get on my knees and pray
We don't get fooled again, don't get fooled again

The change it had to come, we knew it all along............................


Yes fellow bloggers, some of you would love to imitate The Who and urinate on a monolithic slab while singing we won't get fooled again. The last couple of weeks have established a precedent in spine, whereas, more acquisitions are coming.  Protecting and solidifying market share is the primary concerns of the Medtronics, DePuys, Strykers, Biomets, Zimmers and Smith and Nephew. These are the companies that hold the key to the Emerald City. DePuys acquisition was a diversification strategy, adding strength across the board, rather than just focusing on spine.  Double D and the BOD at Zimmer must do something or be laughed out of spine.  Smith and Nephew needs to flex its muscle and finally pull the trigger on a spine company.  All talk and no action makes for a bad reputation.  Stryker not only enhanced its portfolio with the recent acquisition of Orthovita,  Vitagel and Cortoss will add more leverage in negotiating deals with its customers.  So, Who's Next?  Who will be the next company to be acquired?  All of these companies have cash reserves that allows each one of them to pull the trigger. Why?  Because contrary to popular belief, they know that a change is coming to the way healthcare will be delivered in the next ten years.

Will it be Globus?  Will it be Nuvasive?  Will it be K2?  If the price is right, TSB believes that someone like Stryker will pull the trigger on another company, unfortunately, TSB does not believe it will be Nuvasive because the Purple People Eaters believe their stock is worth upwards of $50 per share, and contrary to the accusations directed at TSB, Nuva still has the best lateral device in the industry, and until they are unseated, it's good to be king.   So why Stryker? Because they almost pulled the trigger on Globus once before. Because there is too much uncertainty and anxiety exhibited by many people in the industry.  No one is sure whether they will have a long-term job until there is some stability, and that will only happen when all the deals are done. TSB wants to know what our bloggers think, Who's Next?

Remember what Roger Daltry sang;  I'll move myself and my family aside, if we happen to be left half alive, I'll get all my papers and smile at the sky for I know that the hypnotized never lie...... meet the new boss same as the old boss.

118 comments:

  1. Under and over for the first mention of a POD is 4-posts not counting this one.

    Good questions and discussion points!!!

    Not defending or bashing NV but one could only wish every CEO thought his companies stock was worth more than the market does.

    Are you listening Warsaw?????

    HINT

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  2. Stryker will buy globus once they go public!

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  3. the bar just got lowered....Seaspine for $89M which is between 1 to 2x revenue...and I believe they were profitable....for all those me too companies thinking they will be acquired for ridiculous sums of cash, this is your wake up call...oh, and BTW, POD

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  4. Revenue for Seaspine last year was in the low 50's if I can remember correctly in talking with Kurt. They have always been profitable.

    The news was given to the employees yesterday.

    I guess the rumors on here were true about an Integra-Seaspine merger.

    I feel sorry for the Seaspine distributors who probably will get squeezed out in this deal.

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  5. How many "me2's" had an opportunity 3-5 years ago to cash out only to be blinded by their greed and false hopes? $89 million for a $50 million dollar company is definitely a wake up call that the times they are a changin'

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  6. Seaspine.....why would integra do this? Aquire just to acquire? And will they keep the consultant agreements under integra? Maybe a good thing for competition but bad for both companies.

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  7. Integra has some good, solid systems, but what does SeaSpine have that would be a benefit to Integra? Another pedicle screw system or two? So-so interbody? Oy Vey!

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  8. Integra is all about cash flow....this acquisition is not strategic rather a positive cash flow event....$50M in revenue that is profitable, strip out middle management, manage downside movement in revenue due to distributor change out and this thing is a little piggy bank...strategically makes no sense but financially makes all the sense in the world....

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  9. Give me a break about this being a big wakeup call for valuations taking even more of a dump. Yes, the days of 10x are over, but 3 to 4x of revenue is still probably more the norm for good products and legit revenue. SeaSpine must have been distressed or the shareholders just wanted out, because this is a typical Integra deal and multiple. Now let's see if they can execute and hold on to the revenue they are projecting ($20ml in the second half of the year). I bet they lose more than that.

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  10. Who's next? Paradigm Spine. . .

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  11. 5:56

    1.5x to 2x is the going rate for companies that fit a specific profile. Don't flatter yourself that companies like Life Spine, X-Spine, or Custom Spine would get 3-4x. These companies are "me 2's,' with nominal IP and a dysfunctional business model. What do you think a one-trick pony like Vertiflex or a Paradigm is going to receive as consolidation becomes the norm? The reality is that an interspinous process device was novel 3-4 years ago today, nearly everyone has one in the fire or one on the books. Profitable revenue, market share, minimum debt and a well run organization with stability adds value versus a company that is in constant flux. So keep believing that your company is worth 3-4X because I've worked for a few of those so-called entrepreneurs and today, they will never admit it, they are kicking themselves in the ass for not taking a deal when it was offered.

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  12. It was cheap, but Integra got what they paid for. No I.P. to speak of, no new product categories, only more of what they already had. Time will tell if those revenues actually transfer over to Integra.

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  13. I agree the itersponous space is flooded. What I disagree with is that it is a fad. The numbers don't lie that market is a 80-90 million dollar market and growing. It unfortunately is going to continue to grab screw business. 2-3X return would be fair to say. I do wonder with the Data coming out about Coflex if that will help Paradigm? The market seems to be looking for an X-stop replacement with good sound clinical data and experience.

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  14. MM
    "good products and legit revenue", as in decent IP, improvement on existing implant systems and no consulting agreements. I don't think that 1.5 to 2x would be the norm for that. Integra pays the lowest price of any company out there, so using them as your new norm is probably not correct.

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  15. With Medtronic Spine's disastrous quarterly results (already anticipated), the silence discussing their results is deafening...

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  16. Is this why Stryker stopped development of their lateral system?

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  17. It seems like K2M would be a great acquisition for a company like Smith and Nephew. Some unique products, full line (soon), much IP. I know this was the rumor before WACS purchased K2M. What are the chances now?

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  18. Paradigm Spine has no chance of being acquired.

    The revenue numbers are terrible and the company has had well over $100 million invested in it with profitability nowhere to be seen.

    With the VBs in charge no reasonable deal will ever be reached.


    The coflex is a fad device- most of the interspinous devices are just worthless pieces of metal- the decompression surgery is responsible for all the patient improvement.

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  19. Time for a multiple-math delusionectomy:
    J&J/Synthes - 5.8X, new markets, strategic play
    Stryker/Orthovita - 3.3X, IP, strategic
    MDT/Osteotech - 1.3X, Grafton brand
    Baxter/Apatech - 5.5X, mostly back loaded and won't happen
    Integra/SeaSpine - 1.8X, me2, market share
    Integra/IST - 4.2X on mini revs, IP?
    Zimmer/Abbot - 3.3X at the peak of valuations, how's that working out for 'ya?
    MDT/Kyph - 9.6X revs then, approaching a division by zero error now?

    Hopefully the point is obvious. Unique technology or strategic value can get in the range of 3X in the current market. Lacking either (ie all of the acquirable spine co's) 2X is looking pretty rich. If you're not profitable, if you're revenues are at risk in transition (consultants, POD's, surgeon investors), if you don't have IP then even that is probably a pipe dream.

    Good luck out there!

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  20. http://beckersorthopedicandspine.com/orthopedic-spine-practices-improving-profits/4035-dr-stephen-hochschuler-6-points-on-healthcare-spending-for-spine-and-orthopedics

    Anyone read this? Hochshuler says that you can use Skype and get rid of reps in the OR :)

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  21. SeaSuckers just got taken for a ride. They could have made more cashing out to a private equity firm (and management would have kept their jobs). Enjoy the move to Akron, guys!

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  22. What's the surf report for Lake Erie?

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  23. Hochshuler isn't he the genius that helped IST burn through 70 plus million only to provide investors with a sculpture from the foyer in Massachusetts. Another von artist in the magical world of spine

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  24. Hochschuler was also deeply involved in Archus...we know how that one turned out...

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  25. Lake Erie is smooth as a baby's butt right now - just overlook the raw sewage floating around from 45+ days of rain.

    Brown is a tropical color isn't it????

    Look at the bright side....the traffic in Akron is always lighter than the 15 in SoCal.

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  26. Sign of the times. In 2003, Spinal Concepts sold for $250M on <$50M of revenue, and was unprofitable. In 2011, SeaSpine sold for $80M on $50M of revenue, and was profitable. The take-home message: enterprise value for spine companies is not good.
    I think it will be a long time before any of these spine-only companies are purchased. Most of them will fall out during diligence due to sleazy sales/consulting tactics. Remember, most of the big ortho companies have gone through DPA's with the federal government, and must stay squeaky-clean. Orthofix and Arthrocare are both still being tortured due to the sins of spine companies they acquired.

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  27. Coflex clinical presentation at SAS was real. not just metal between spinous processes.

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  28. Whoa, whoa, whoa. For all you naysayers - Akron is an awesome place!!

    ...to visit
    ...during the World Golf Championships-Bridgestone Invitational @ Firestone CC
    ...the rest of the year it is a pit

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  29. 7:55 AM - You forgot the others:

    Integra / Theken Spine/Disc/Therics - a little over 2x sales - entry into spine

    Amedica / US Spine - 0X sales - anyones guess

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  30. The good ole days.
    2004 Biomet acquired Interpore Cross for $280M. Net sales in 2003 of around $67.5M - 4.1X

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  31. Good luck to the Seaspine folks’ applying to Alphatec and Spinal Elements down the road. Roll the dice!

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  32. You all worry about being acquired, pods taking over, and worry way too much about the future of globust. Can't we start talking about what fascinates us most and why we are truly in the industry?? Let's talk about access, and specific bone qualities of some tougher to fuse patients, or what's with the disc always poking out on the right instead of the left side in the lower lumbar region. I mean come on, let's talk about what matters! Heresay is what liberals thrive on.

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  33. All SeaSpine employees are said to be keeping their jobs. The press release even said SeaSpine's president is now going to be president over Integra's U.S. spine division. What Integra bought was not any unique products, but a profitable company that sold 50M last year. Why would they start getting rid of the ability to get 50M or more this year by firing distributors/reps? Makes no sense.

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  34. 10:32 and you were probably preparing for the end of the world this past Saturday, you dumb shit

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  35. 9:31

    Coflex is worthless metal. Same as all of the interspinous spacers.

    All of the improvement in patient outcomes is due to the decompression surgery- the metal is just there to justify Paradigm's existence.

    If you perform a decompression without Coflex the patients will do just as well.

    If you implant a Coflex without the decompression then the patient will show no improvement.

    The interspinous market is going to end up as a niche market at best. Paradigm Spine is just another hype machine for the VBs.

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  36. As a follow up to 11:28:

    Best solution is to combine any ISP device w/ a decompression using iO-Flex. An excellent 1-2 punch,, works very well.

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  37. What kind of guy is Kirt Stephenson? Seems like he landed a pretty good job.

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  38. hochshuler, what a class act....all of a sudden he cares about the 'cost of implants' to the patient....He is the poster child for what is wrong with this industry...TBI has tried (and failed miserably) at being a VC group, an incubator, a medical device company, an education group and now they want to be a distributor (it's like it is a sin to just practice medicine)....I have no argument with the need to lower costs and costs are out of control..but, coming from TBI's mouthpiece is just a bit ridiculous....It was ok to charge high prices when TBI had investments/company reaping benefits, but now that those have gone away, TBI has 'found religion'.....Dr. Hochshuler, your phone is ringing, it's the pot, he's calling about the kettle...

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  39. He smiles a lot and is a great golfer. Also knows how to run an amazing company in a profitable way.

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  40. That you Kirt? Your golf game is not that good.

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  41. Ha! I know Kirt professionally. I thought 89M was a little on the low side, but congratulations are still due him for the job he did at SeaSpine.

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  42. Kirt is good people - CONGRATS!!!!

    What do you expect he's from Ohio!!!!

    GO TRIBE!!!!

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  43. I know Kirt and he is a true friend and I should know, I used to work for him. Class act and leader. Integra should be proud to have him at the helm.

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  44. wird up to all you homies in the biz ! where do i get a removal kit for some shiznit called medtronix legacy.
    sinseriously,
    luda da spine be livin' da dream

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  45. When is Choice Spine going to go public???

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  46. "Along with Mr. Stephenson, the management of SeaSpine will join the leadership team at Integra."

    Yup, that is what they always say to ensure a smooth transition..then it hits the fan as the need to "eliminate redundancies" becomes the guiding policy. Been there done that.

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  47. @1:46

    Choice Spine is a freaking joke with joke products, joke reps, and joke consulting agreements.

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  48. Zimmer aquires _________

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  49. Zimmer has only 2 options as I see. Either say 'good bye and good night' to Spine (market) in next 6-18 months or acquire some companies (unfortunately, for them...none decent company left) and stay alive. However, looking at their mentality (at least in spine)...they are probably going to sit wondering what to do...then do nothing but think & think until it is too late for either(and, allow the spine division to nosedive in the process)!

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  50. Zimmer is now in a situation where they must pull the trigger on a company sooner rather than later or they will be left out in the cold. Biomet could be a nice fit... Would add to trauma, recon, spine, bio, and create a cmf division. It would be a big move, but put them right back in the conversation.

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  51. If Bryan Clauseman is still there nothing constructive ever happens. BC is a nice guy, but you know what they say..... Years ago they did due diligence on Orthovita while Terry S was at the helm immediately following the Centerpulse acquisition, NADA, then they got rid of some decent Centerpulse people because Famous Ray needed his own people, BAD MOVE, then they looked at Custom Spine, supposedly offered big bucks, if true, bet Mahmoud and his surgeon investors are kicking themselves in the ass, acquired Enduis, screwed the pooch, acquired Spinal Concepts screwed the pooch, ouch, that poor dawg, So who do you think they can acquired and screw up a wet dream? They might know joints, but like trauma they know squat about spine.

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  52. K2M would give Zimmer a nice deformity system to go with the universal clamp and some solid trauma products. Not too big of a purchase, but could be a nice fit. Just have to figure out how much of the revenue is due to consulting contracts.

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  53. Zimmer is looking at purchasing Amedica flat out for their techology to bolster sales in spine through licensing and to purchase the next generation of hip and knee implants. You heard it here on TSB.

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  54. "Heresay is what liberals thrive on" May 24, 2011 10:32 AM

    Why do some people have to turn any f*cking discussion on here into a political rally or soap box?

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  55. Sounds like a good fit if Si3N4 is the real thing when it comes to joints, or could this be another trabecular metal FUBAR? First pull the trigger, then show us that you can finally integrate something successfully. Stop resting on your total joint laurels, your time is coming to an end.

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  56. Claseman was booted a number of years ago and as you mentioned, nothing ever happened. Terry was out of his element in (a) Spine and (b) Minnesota that ultimately led to problems. At least he lasted longer than Robert Cohen and his 2 weeks in MN

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  57. @ 11:28am Regarding Coflex:

    "All of the improvement in patient outcomes is due to the decompression surgery"

    No Sh$t. The benefit comes from not having to expose the pedicles and/or gutters to stabilize and fuse. Often cannot get away with a simple Lami sans screws for decompression. IDE data showing statistical significance to fusion in this group is compelling. Will be interesting to see how this one trick pony pans out with so much coin invested.

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  58. Interesting take on Stryker. While the move to grab Orthovita will help, it is certainly not the answer they needed. They are still lagging behind in technology in a major way, and it's catching up to them as evidenced by their negative growth numbers

    The problem with Stryker Spine is that overall, the division is PROFITABLE for Stryker. They make the company money. MacMaiilan and Co are taking what they can get from the Spine division and loving life....which is why the acquisitions/product development for them has been few and far between. They could however, become a major player quickly with another big pickup to fill the bag

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  59. 1:46...I thought Choice had crappy products also when they bought the old REO gig but their products now are actually above average...falcon cervical plate and new Starfire pedicle screw system along with full line of peek interbodies have made some of my surgeons pretty happy! Just sayin....

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  60. Why isn't anyone talking about artificial nucleus replacements? Huge gap in the continuum of care and a couple of companies working on interesting products i.e. Spinewave. First to market here with something legit is going to clean up! i would think good research and strong IP here would make you an extremely likely target for acquisition.

    Anybody? Bueller? Bueller?

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  61. Kind of off topic, but I just saw some implants from a company named Coligne. Anyone know much about them?

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  62. Zimmer needs to make a move fast or they will continue fading into oblivion. I don't think the Amedica purchase makes sense as they have trabecular metal and they believe in that technology. If they bought Amedica it would be admitting that TM is not the best for bony in growth.

    I used to work for Zimmer and am so happy to be away from that dysfunctional company. Nobody knows what the hell they're doing in Minneapolis or Warsaw, and it's kind of a shame for the reps because there are actually some good ones that have to pray Zimmer will make an acquisition better than Endius or Abbott. Those two were a disaster. My prediction is that they buy Biomet as that would satisfy the joint side, although if I had to put money on it I go with one of the previous posters that they will just sit on the sidelines while other companies actually do something.

    Go Longhorns!

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  63. Pioneer Surgical would be a key purchase.

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  64. 6:17

    In your dreams...just another "me too" company and "me too" people!

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  65. Pioneer a key purchase??? Do you even work in spine???

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  66. Question is.... Will Pioneer complete their IDE this century. More importantly will they do anything before they are 100 percent VC owned in January 2012?

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  67. Good thread. Integra won't combine sea spine and their other spine as the integration will lower revenues. Big companies don't have that option so I don't see the value for mdt, Stryker etc in buying fusion as the integration will remove all incentive.

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  68. Who at Zimmer could make a decision regarding a Spine purchase? Nobody there knows squat about Spine. Look at that disaster, leaderless, rudderless division and tell me ANYONE in Warsaw gives a crap.

    Rumor is Z looked at K2M but backed off because of the % of sales by surgeon owners.

    Rumor is Z looked at LDR but backed off because LDR had a high price tag.

    Looking forward to the Q2 analyst call when DD again issues the same lame excuses as to why his Spine division sales suck and the same lame forecasts for "resolving internal issues" within this division.

    Z's best move now would be to dump this boat anchor division and their pathetic UNFOCUSED distribution network. I used to have sympathy for my Z Spine friends but now I look at them as a bunch of losers who stick around believing the next "leaders" can't lie again. Good luck losers with that bag of antiques in a this market. You all had your chance to get out and you didn't. Shame on you.

    Zimmer will soon be passed by Orthofix and Alphatec in marketshare. Nice work DD!!

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  69. The race for consolidation is on. Any halfway decent spine company with some marketable I.P. and/or sustainable revenues is going to go to the higest bidder within the next 12 months. Get em before they're gone!

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  70. 4:40 - first to market in nucleus replacement is 10-15 years away. The companies that will compete in that space haven't been started yet. If I have to explain the path these products must take to the market, then you just don't get it.

    SpineWave has been around for 10 years and there is a reason they haven't been purchased. They aren't unique anymore, their revenues are pathetic, and it seems there always 3 months away from going belly up.

    Unclear FDA approvals, weak IP defense, and little solid clinical data = the next fire sale or bankruptcy sale.

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  71. It's a little surprising that Spinal Elements hasn't found a buyer. Rumors are that they have been for sale for awhile. Why no takers? Are they just holding out for a fat multiple, or is there something rotten under the hood?

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  72. Interested in opinions as to which company makes the most sense as a Stryker acquisition?

    Would LDR Spine be a good fit, as it would fill some of the holes in Stryker's bag?

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  73. Spinal Elements, nee Quantum Orthopedics train left the station a long, long time ago. Fat multiple? Are you serious or Milagro Anejo delerious?

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  74. Choice Spine is great for making doctors happy, but that has nothing to do with the cervical plate...

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  75. what's the latest on the J&J-Synthes deal?

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  76. 6:33 "MeToo-ShmeeToo" Business 101: Pioneer been generating revenue since 92.
    http://www.pioneersurgical.com/index.php?option=com_content&view=article&id=55&Itemid=18

    6:38 Yes, and in it for the long haul.

    Is Globus or Alphawreck a better purchase, or the company you work at?
    P.S. TSB Rules!

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  77. In my opinion the day Zimmer Spine hired Paul Graveline was the last day of any chance for success. Zimmer at best is destined for mediocrity and likely outcome is a fire sale. He has a complete lack of vision in spine, has no R&D commitment, and after the Abbott Spine debacle – I’m sure Zimmer Corp has no stomach for acquisition. Since when is an ortho branch manager qualified to lead a spine company. Good luck...

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  78. Spinal elements has better products than SeaSpine. They claim they are not for sale. What about LifeSpine, Custom Spine?

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  79. Spinal Elements has been hoping ZMH would buy them for some time...and failing that...anyone else who will pay a price. Product line similar to most others. Every company has a price.

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  80. Integra is going to be a top five spine company within the next couple of years. Its a young and aggressive conglomerate - like JNJ only smaller and faster. They will either beat you or buy you - and they have the money to do it. Just look at what they did in the neuro space.

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  81. John Winge with Integra vs Steve Rybka Sea Spine Two VP Sales. Who stays?

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  82. My predictions for more consolidations coming:
    Zimmer looks at buying Globus, hesitates, loses out, buys Lanx.
    Stryker buys Globus for IP.
    J&J buys LDR - Provides standalone & all the distributors already carry.
    Smith & Nephew buys K2M - puts them into spine with good momentum and IP in the pipeline.

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  83. 10:10
    Yes, Globus or Nuva would be a much better fit with having total lines. Pioneer or Alpha-pod are great if you want a pawn shop deal!
    As for my company .... No it sucks!

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  84. Smith & Nephew could get bought out by another ortho company as they are having a lot of trouble at the top. Don't count on them buying anyone, other than a better compliance officer.

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  85. 4:01

    IDE data presented was compelling only in that it added additional support for decompressions against fusion.

    Justify the benefit of interspinous spacers. It certainly wasn't presented at SAS!

    You can't and there is NO clinical data quantifying the benefit of these devices!

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  86. Paradigm has a study going on in the Netherlands that shows decompression & Coflex vs decompression alone. It is significantly better then decompression alone. I agree the VB's won't be reasonable when selling but this is different. I sense some of the hatred is based on being involved at some point or not having a option for this in your bag

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  87. Paradigm Spine Employee

    I call your bullshit bluff and did a search of PUbMED. There is ALREADY a publication out by Richter comparing the two.

    His conclusion:

    "Because there is no current evidence of the efficacy of the Coflex™ device we need further data from randomized controlled studies for defining the indications for theses procedures. To the best of our knowledge this is the first prospective controlled study which compares surgical decompression of lumbar spinal stenosis with additional implanting of an interspinous Coflex™ device in the treatment of symptomatic LSS."

    HAHAHAHAHA!!!

    I sense your insecurity is tied to having to defend one-trick losers.

    Try working at a REAL Spine Company like Medtronic where you have a complete portfolio of products that really work!!

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  88. I absolutly LOVE hearing and reading all you dumb asses post comments and cut each other up on this blog and dont have the balls to post your fucking names rather you post Anonymous!I was told by my rep about this site and it absolutly facinates me and really makes me laugh. Bunch of wet the bed crying fucking babies is what you are. Have the balls and step up to plate if you want some!!

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  89. 9:21 My money is on Rybka! Boomer Sooner!

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  90. Theodore - Whoop-de-do for you for posting with your supposed name on the last two blog postings. Real tough guy there

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  91. 1:34 Is that Theodore Eric Hansen of Inovasis?

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  92. 1:4q you sound like a typical MSD rep. underworked and overpaid??? I am suprised you could even spell whoop-de-do. Real tough guy...please post your name? That's what I thought!! Dip shit!

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  93. The few posts talking about coflex (positively & negatively) are speaking from conjecture, opinion, hype and whatever BS your (internal or competitive) marketing has spun for you to parrot. The data will be out soon enough and as a surgeon, I always prefer for Level 1 data to speak for itself.

    BTW - the Medtronic rep post doesn't surprise me. My rep is a jerk also and that's why I don't use them - they all seem to possess the same type of arrogance and that is why they continue to lose market share I think.

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  94. Enjoy the decompression (opening everything up and your not 80 years old for 5 years out) and enjoy the fusion (your 5 years out and holding everything in). Realty is in the data.

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  95. 2:28

    1:04 and 1:41 are 2 different people.

    3:02

    I agree with your last sentance

    The data is already showing Coflex has no benefit!

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  96. 9:21

    I don't know Winge, but the Integra spine division couldn't go wrong with Rybka.

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  97. Enjoy that pedicle screws were the wrong decision besides scoliosis 30 years ago.

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  98. Spine Blogger

    How about a blog post on interspinous spacers? What are your thoughts?

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  99. Butt head. It's not a spacer. It's interlaminar. It gets close to the scene. Coflex is not bone metal bone like a dumbass implant. It's interlaminar and it's controlled dynamIc.

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  100. John Winge? Are you it's not John Winger from the movie "Stripes'? Rybka will go "Sgt. Hulka" on him.
    "Chicks dig me, because I rarely wear underwear and when I do it's usually something unusual. But now I know why I have always lost women to guys like you. I mean, it's not just the uniform. It's the stories that you tell. So much fun and imagination."

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  101. Zimmer will leverage the recon business to make a major move that will give them a real chance in spine. The question is, how will they handle this move and will they make it work in the long run? Hearing some good things from them, but the proof is in the pudding.

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  102. 90% of these comments were worthless and completely off-topic. i was interested in the topic and now i regret ever "clicking" on this thread. if i hear "Seaspine" one more time i'm going to beat my wife...

    MDT buys S&N

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  103. 6:16, Ummmm, the topic was about who would get acquired next. It was SeaSpine, hence all the SeaSpine talk. Please beat yourself, leave your wife alone.

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  104. I believe Integra Spine / Theken will honor the consulting agreements of SeaSpine just as they themselves pay docs for "trialing" for years on end; especially at $500/hour.

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  105. 5:22 What good things are you hearing about Zimmer? I'm not hearing too many positive things about their Spine dvision.

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  106. Ive posted a comment a few weeks ago calling what is going on the "consolidation era" so i elaborate a little more now. We all area that with the recent depuy purchase spots 1 and 2 are far aheadof 3 and beyond. At this point people with cash have no choice but to acquire.

    Personally i feel Stryker will not make another move, and if they do it will be an irrelevant company(meaning not moving market share). Someone posted earlier McMillan makes his 100 million or so off his spine division and is happy. Stryker isnt a "spine" company they are a succesfully ran company. The question is do they need to be a company that puts more focus on spine or are they doing just enough to stay profitable, and will succeed cause they are as you call them " the almighty stryker"

    I think Zimmer makes a play and for some odd reason i think it will be big. Maybe Nuva? I know everyonethinks they arent gonna be bought but talk about making a splash. Zimmer all of a sudden becomes VERY relevant! Knowing Paul Gravline he didnt go to Zimmer to sit around and not make a few powers. He knows how to buy distributors and he's been with a company during its successful years. He know what it takes and he knows what wont work. Gut feeling watch for a big move out of them.

    smith and nephew i cant really speak on but i agree if they want to get involved in spine, K2 maybe globus someone who is JUST a spine company will set the in the right direction.

    2011 prediction
    1. Medtronic
    2. Depuy
    3. Zimmer
    4. Stryker
    5. Smith and Nephew(assuming and acquistion)
    6. Globus

    7 and beyond see if there are any custodial jobs at your local high school.

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  107. 4:49

    Either way it doesnt do anything of any real value for patients.

    It must really suck knowing that your entire comopany is based on a spacer that has no clinical benefit.

    HAHAHAHAHA!!

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  108. After almost 10 years Zimmer has never done the right thing. Nobody sticks around for a reason. The only consistent face is DD. DD has been great for the stock, but horrible for Spine.

    I don't expect another move in Spine beyond divesting itself of Spine.

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  109. But isn't that all the CEO really give a rats ass about, the value of his stock?

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  110. 6:20 you hit it right on the head. I was with Spine Tech/Zimmer for over 8 years. I saw the good and the bad (well let’s say horrible). 4 Spine Presidents in 4 years. One that lasted about 2 weeks. Terry Slaughterback was the first one out of the gate and he was out of his element with Spine and Minneapolis. Hell he didn’t even have a home there, he would come in for mtgs. Then David D tried to run things from his chair in Warsaw and that was a mess. There has been no solid leadership there for over 7 years, hence why a total joint company should stay just that..a total joint company. We went from having great National Sales meetings to have "break out" sessions to go over what?? BAK C cages and a stupid portal from Endius. Now if that doesn’t get you excited, than what will! Who knows what their next move will be but if I were them, I would dump spine on an actual Spine Co. They have been stumbling for years trying to get Dynesys approved and only to have a product that is still used off-label as a high priced pedicle screw system.

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  111. 9:58 hey Karen, a little bitter?

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  112. Hi 2:13, its not Karen. Not even close dude. Try lloking more West Coast!

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  113. 6:42 PM Seaspine doesn't have a lot of consulting docs for Integra to worry about, but they do have a lot of royalties to continue paying out...

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  114. Sea Spine pays a lot of royalties to all the UCLA surgeons "Wang's cronies" for screw development. Truth be told Wieser, Timon or none of the other guys including Jeff Wang had one thing to do with the SS screw other than agreeing to put them in.

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  115. Sea Spine ebitda was so low it killed the sales price! Who the hell said Kirt runs a profitable company and what is your definition of profitable? Smiles alot puftttt!!! who the hell cares.. 6M profits on a 50M gross sales- I scoff loudly!

    Junk in junk out!

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  116. What about spinalmotion? anyone interested in having a disc in their portfolio anymore or is this a fad?

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