At a time when several large medtech companies are stepping back from the spine market, the Viscogliosi brothers — pioneers, investors, and key architects behind some of the most relevant spine innovations of the past two decades — are quietly executing a bold consolidation strategy that deserves closer attention.
From Pioneers to Strategic Builders
Marc, John, and Anthony Viscogliosi are no strangers to the spine world. In the late 1990s and early 2000s, they were instrumental in the development and commercialization of breakthrough technologies like total disc replacement (ProDisc), dynamic stabilization (Coflex), and small joint arthroplasty (STAR ankle). Their model was clear: identify promising innovations, build focused companies around them, scale them quickly, and eventually exit through acquisition.They launched Spine Solutions (sold to Synthes in 2005), Small Bone Innovations (acquired by Stryker in 2014), and Paradigm Spine, which was acquired by Xtant Medical in 2019. Yet the Viscogliosi name never disappeared from the field. In parallel to the family’s broader investment activity, John Viscogliosi has played a key leadership role at Centinel Spine, a company focused on cervical and lumbar disc arthroplasty.
A New Phase: VB Spine and Companion Spine
In 2024 and 2025, the Viscogliosis entered a new phase: buying back, regrouping, and rebuilding. In April 2025, they announced the creation of VB Spine, following the acquisition of Stryker’s U.S. spine business. The deal gave them access to a robust distribution network, a solid implant portfolio, and innovative technologies such as Mako Spine and Copilot, both geared toward robotic guidance and surgical navigation.In parallel, this week, another of their ventures — Companion Spine — reacquired the Paradigm Spine portfolio from Xtant Medical, including the Coflex and CoFix systems. These dynamic stabilization devices have come full circle, returning to the group that originally developed and launched them in the early 2000s.
A Strategy That Defies the Trend
While companies like Stryker, Zimmer, and Xtant have been scaling down or divesting their spine units, citing pricing pressure, regulatory complexity, and increasing competition, the Viscogliosi brothers — as a group and individually — are moving in the opposite direction: doubling down on spine.
Their strategy appears to rest on three core pillars:
- Vertical Integration: Through VB Spine and Companion Spine, they are combining external innovation with internal distribution capabilities, a presence in both MIS and open surgery, and the use of enabling technologies such as imaging, navigation, and robotics.
- A Broad and Specialized Portfolio: Through VB Spine and Companion Spine, the Viscogliosi Brothers’ network now encompasses a wide and clinically relevant range of spine technologies. This includes fusion systems, advanced motion-preserving implants such as artificial discs and dynamic stabilizers, as well as minimally invasive decompression solutions. This comprehensive offering allows them to address diverse surgical needs while remaining aligned with evolving clinical trends and surgeon preferences.
- Financial Agility and Clinical Focus: With smaller company structures and deep knowledge of the field, their initiatives maintain agility, faster decision-making, and strong alignment with surgeons.
The Emergence of a New Global Player?
With VB Spine managing the legacy of Stryker’s spine business, Companion Spine relaunching a best-in-class dynamic stabilization portfolio, the family is once again shaping the future of spine care.They are not operating under a single corporate umbrella — but together, these efforts reflect a coherent and ambitious vision that brings together clinical relevance, surgical innovation, and entrepreneurial execution.
Challenges on the Horizon
Of course, the road ahead is not without challenges. Integrating newly acquired operations, aligning go-to-market strategies, and competing with major players like Medtronic, Globus Medical, or even NuVasive (now part of Globus) will require sustained innovation, commercial strength, and strategic patience.The spine market is also evolving rapidly. Robotics, outpatient surgery, value-based care, and cost pressures are reshaping how new technologies are evaluated and adopted.The Viscogliosi brothers are back — not just as investors, but as experienced builders and long-term thinkers in the spine space. Whether through direct ownership or ongoing leadership roles, their combined presence across VB Spine, Companion Spine, and Centinel Spine is reshaping the landscape.If they succeed in realizing the full potential of these platforms, we may not only be witnessing a comeback — but the emergence of a new, independent force in spine care.
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COVER IMAGE: Freepik.com