Back pain is cited as the leading cause of disability in the world with experts estimating that 80% of the world population experiences it at some point in their lives. Some of these conditions are caused by degenerative spine diseases which occur due to the normal loss of structure of the spine. While most of these conditions do not require any surgery, some conditions can only be treated with surgical corrections and implants. In the case of certain conditions like degenerative discs, interbody fusion surgery has emerged as a means of treatment over the past few years. This has been due to advancements in the field leading to good recovery times and lesser risk. One of the firms which have been going from strength to strength in this field is Titan Spine. Founded in 2005 by Dr Peter Ullrich, Titan Spine works towards one goal – “getting patients back to health, activity and happiness as quickly as possible following interbody fusion surgery.”

The Market for Interbody Fusion Devices

The market for spinal fusion includes interbody devices, artificial discs, repair products, and spinal fusion instrumentation among others. The market is expected to grow to $9.0Bn in 2023 from $7.1Bn in 2016 at a CAGR 3.4% according to a GlobalData report. According to Allied Market Research, this growth will be driven by the “advent of minimally invasive spine surgery techniques and rise in incidence of spinal disorders. In addition, surge in geriatric population is anticipated to fuel the demand for spinal fusion devices, globally. (sic)”

While studies have concluded that patients who undergo spinal fusion surgery tend to be slightly better off compared to those who don’t (68.5% with surgery reported improvements in back pain compared with 53.4% who decided to forego an operation), their long-term effectiveness has been a subject of debate. The perceived effectiveness of spinal fusion surgeries and interbody devices is a challenge faced by players in this industry. Other factors that emerge as challenges are reimbursement approvals and regulatory processes.

The Story of Titan Spine LLC

Titan Spine LLC is trying to overcome these challenges with cutting-edge research that helps increase the confidence of the public in such devices. Titan Spine’s breakthrough has been designing products that promote natural bone growth by using titanium instead of plastic in their devices. Simultaneously, they have also worked on the design of the devices to make products which they claim work better at macro, micro, and nano levels.

The company has been growing at a rate of 40% over the last 10 years. Its 2017 revenue was $63M, up from $33.5M in 2015. They have achieved impressive sales figures with more than 70K implants of its devices and over 50 patents to its name. Titan Spine has received 10 FDA clearances for its products including one for its Endoskeleton device that included its nanotechnology surface. Dr Ullrich claims it was the first time ever that FDA gave the nanotechnology approval.

The industry has taken notice of the work Titan Spine was doing. It has been able to raise $50.6M over 5 rounds, the latest in November 2018. The first two venture rounds were in 2016 and 2017, bringing in $7.9Mn and $9.1Mn respectively. The company then went for Series B over three rounds – $1.8Mn in 2017, $15Mn in 2018 and $16.7Mn again in 2018. Southlake Equity group has been the major investor so far, having invested in the venture rounds as well as Series B rounds.

The Men behind the Mission – Dr Peter Ullrich and Kevin Gemas

Dr. Peter Ullrich, the founder and CEO, is a former spine surgeon who developed Titan Spine’s first endoskeleton lumbar interbody fusion device. He completed his medical degree from the Wisconsin Medical School and is also the co-founder of Spine-Health.com, an educational website. When he came up with his idea of interbody devices and decided to start Titan Spine, he had then turned to his school friend, Kevin Gemas, for managing the business side of things. Kevin today serves as the President of Titan Spine Surface technologies and is credited with having started three companies in the past.

After developing the Endoskeleton, Titan Spine went on to develop Original Surface in 2007, a technology where an interbody device helps promote bone growth. A little later, they developed the nanoLOCK ® which helped promote bone growth even more. These technologies have helped it compete in a market with competitors like Spinal Elements (revenue $12M) and Spine Wave (revenue $20.4M). With each of the players competing on research and technology – Spinal Elements, for example, also works in Tissue Grafting – we can only assume that this will mean better and better patient care and treatment.