Spinal Elements takes its debts to market


2020 has been a tough year for orthopaedics companies, the pandemic shutting down non-urgent procedures for months in spring. Spinal Elements, finding itself in need of cash to pay down debt, has decided to head to the stock market. The group has filed for a $100m Nasdaq IPO, and according to its prospectus has long-term debt of $152m, plus $20m of short-term debt, which has been under a forbearance agreement since July 2018, set against $13m of cash. 2019 revenues were $96m, making Spinal a top 10 player in spine, EvaluateMedTech data suggest. Its products include spinal fixation systems, interbody implants and biological grafts – allografts or synthetic biomaterials intended to augment or replace bone tissue – and it is focused on minimally invasive technologies. The company is not profitable, however, one factor for prospective investors to weigh, on top of the potential for future Covid-19-related shutdowns as the winter months approach. Still, medtech watchers will remember that the last group to file for a $100m Nasdaq IPO, the liquid biopsy company Grail, was bought out less than two weeks later; perhaps Spinal Elements, too, is hoping to scare up a buyer.

Top 10 groups in spinal devices
Company 2019 sales ($m)
Medtronic 2,104
Johnson & Johnson 1,595
Nuvasive 851
Globus Medical 767
Stryker 759
Zimmer Biomet 747
RTI Surgical 119
Alphatec Holdings 113
Spinal Elements  96
Orthofix Medical 95
Source: EvaluateMedTech, Spinal Elements' S-1

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