Once a small manufacturer of custom products, Alphatec was acquired by HealthpointCapital in 2005 with the goal of turning the company into a major player in spine. Alphatec's strategy has been to target important new technology areas, such as minimally invasive surgery and biologics, with a special focus on elderly patients and the specific problems they face. A merger with Scient'x brought Alphatec additional products for its pipeline and, more importantly, a commercial infrastructure in Europe. Like other spine companies, Alphatec faces a host of issues, including pricing pressures, pushback on covered procedures by payors, and uncertainty at the FDA. Adding to the challenge for Alphatec: its role as a publicly traded company. A company whose product development efforts more closely resemble that of a venture-backed start-up went public, partly to raise the capital to fuel strong growth. But like any publicly traded company, Alphatec's stock has been on a roller coaster since its IPO in 2006. Last spring, the company missed its numbers and the stock took a huge hit. Critics charge that the company has lagged in product development; while company officials insist that the pipeline is rich, believing that the strong pipeline will push Alphatec into the front ranks of the industry.

The PFO (patent foramen ovale) closure market has certainly traveled a long and twisted road over the years. And the journey isn't over yet. Although some large companies have pulled back on their US commercialization efforts or decided to exit the field entirely, othrs continue to stick it out, hoping the eventual opportunity will far outweigh the risks and costs involved. In Europe, where percutaneous PFO closure following stroke/TIA is more widely accepted and performed, there are nine CE marked PFO closure devices available from eight different manufacturers, with two more devices expected to be added to the mix in the near future. But despite widespread European acceptance, manufacturers have so far failed to achieve the ultimate goal: US regulatory approval.

Vertebral compression fracture repair is one of the fastest growing segments of the spinal market. New developments in VCF repair promise continued growth, but a shakeup of competitive dynamics is probably also in the future.

In this issue, we present another installment of our quarterly review of medical device and in vitro diagnostics/research dealmaking-for July-September 2007. Our data are derived from Windhover's Strategic Transactions Database.