While products for fusing the spine remain the backbone of the booming market for spinal implants and instruments, there's a new focus on motion preservation. These technologies--for lumbar and cervical disc replacement, nucleus replacement, posterior stabilization,and pedicle screw-based systems--promise a host of new procedures to treat patients with symptomatic back pain who are earlier in the degenerative process.

CoreSpine Technologies LLC is diving into the center of the spine market. The start-up is developing a tool that will more effectively clear out the nucleus of the spinal disc creating a cleaner platform upon which to perform nucleus replacement or other spinal surgeries.

TranS1 is pioneering a radical approach to both fusion and minimally-invasive spine surgery. At the same time, TranS1 is also pioneering a new business model in spine, one that rests on what the company calls "transcending the surgeon/rep relationship."

The founders of Small Bone Innovations believes the device industry is entering the decade of small bones and joints, and has embarked on a consolidation strategy to prepare for dramatic innovation and change in what today is a fragmented marketplace.