A year ago at this time, a sale to another company was the last thing on the minds of senior executives at St. Francis Medical, one of the leading companies in dynamic stabilization. But interest by large spine companies put a halt to the company's plans to go public and led to an auction that was eventually won by Kyphon. Kyphon's acquisition of St. Francis Medical was one of the device industry's biggest deals in 2006--and just what everyone was waiting for.

Though the company's founders played a crucial role in the development of the first artificial lumbar disc replacements, LDR has itself always taken a somewhat conrtrarian view toward the promise of lumbar disc replacement. Rather the company is betting on the promise of cervical discs, while rounding out its lumbar line with more traditional fusion approaches.

Often overlooked in all the interest in orthopedics is the non-surgical side, a product area that includes a wide range of supports and braces--soft goods as opposed to hard implants--used to treat a number of musculoskeletal problems. Indeed, given that non-surgical approaches represent an important front line in treatment options for patients with such problems-in spine, for example, surgical interventions are used in barely more than 10% of all patients complaining of back pain-it's surprising that more attention isn't paid to this segment. One company that has made the non-surgical orthopedics market a focus is dj Orthopedics Inc. who, with its acquisition of Aircast Inc. further enhances what is already a number-one market share position in the $1.2 billion US rehabilitation products market.

Spine, one of the device industry's hottest, most fertile segments, has a history of quick adoption and quick retrenchment (read spinal cages) and standards of care that are anything but gold standards. Perhaps the most interesting example of spine's ambivalent attitude toward technology is artificial discs. Artificial discs caught fire a couple of years ago in the US and promised to be the device industry's next blockbuster technology. But before the first-generation discs had even made it to market, spine surgeons-and the companies that develop new technology-were already onto the next big thing: dynamic stabilization devices, which fall somewhere between the motion-preserving qualities of disc replacement and the stabilization that cages offer. Dynamic stabilization devices are too new for their role in treating spine problems to be fully assessed, but a host of companies are already lining up. One of the first: St. Francis Medical Technologies, which after a difficult struggle with the FDA to get its device approved, is ready to take on the US market and test the potential of at least one category of dynamic stabilization devices: interspinous spacer devices.