Companion Spine LLC (“Companion Spine” or “the Company”), the French-American specialist in spine pain-management surgery, announced that it has entered into a definitive agreement to acquire the Coflex® Interlaminar Stabilization® device (“Coflex®”) and CoFix® Posterior MIS Fusion System (“CoFix®”) implants, Paradigm Spine GmbH, its subsidiaries and all Paradigm Spine-related business activity globally (“Paradigm Spine”) from Xtant™ Medical Holdings, Inc. (NYSE:XTNT) (“Xtant Medical”).
Paradigm Spine GmbH is headquartered in Wurmlingen, Germany and designs, develops, markets and distributes a comprehensive range of spine implant solutions for the treatment of spine pain-related disorders. Coflex® and CoFix® are available in the United States—Paradigm Spine has been commercializing these systems for 12 years within the U.S. and 20 years outside the U.S. These are two of the most widely used, successful posterior dynamic spine stabilization implants globally, with distribution to more than 60 countries, and with more than 280,000 Coflex® devices implanted, treating more than 265,000 patients globally. More than 130,000 CoFix® systems have been used to treat more than 125,000 patients globally.
The Paradigm Spine products available only outside of the U.S. are the HPS™ 2.0 Hybrid Performance System (“HPS™ 2.0”), DSS™ Dynamic Stabilization System (“DSS™”) and DCI™ Dynamic Cervical Implant (“DCI™”).
Together with the portfolio of Companion Spine products, including the DIAM™ Spinal Stabilization System (“DIAM™”), LISA™ Lumbar Implant for Stiffness Augmentation (“LISA™”) and the APERIUS™ Percutaneous Interspinous Spacer (“APERIUS™”), the Company will be in the position to treat the full range of lumbar spinal stenosis (“LSS”) and degenerative disc disease (“DDD”) conditions across the spectrum of disease progression.
With this acquisition, Companion Spine continues to expand its mission to safely and effectively treat spine pain through treating lumbar and cervical diseases. The Company will offer a full range of minimally invasive surgical (“MIS”) implant systems tailored to each stage of the disease condition and focused on delivering the systems for use in the outpatient care setting.
This acquisition positions Companion Spine to be the holder of the world’s largest and most comprehensive product portfolio of MIS posterior dynamic spine stabilization and motion preserving solutions, dedicated to restoring form, function, motion, balance and stabilization while reducing or eliminating pain. This is the essence of the Company’s commitment to innovation and excellence in spine care.
“This is an incredible opportunity to bring together two highly complementary product offerings to enhance Companion Spine’s ability to provide solutions across the full spectrum of pathological stages of LSS and DDD,” said Anthony G. Viscogliosi, Executive Chairman and Chief Executive Officer of Companion Spine. “We are confident we will create value for our stakeholders, building on our shared history with the most experienced management team in posterior dynamic spine stabilization and motion preservation. Paradigm Spine was previously part of the Viscogliosi Brothers portfolio and sold in 2019. We are now re-acquiring it, bringing it back into our portfolio through Companion Spine. We know the business, its customers and its talented team very well. There is much to look forward to as we build upon this momentum to realize our vision and continue to support patients and surgeons globally.”
Mr. Viscogliosi continued, “Companion Spine, co-founded by former CEO Erick Cloix, may he rest in peace and joy, was formed through the acquisition of a dynamic stabilization and motion preservation product portfolio from Medtronic, which included DIAM™, APERIUS™ and other implants. Then, the Company was complemented by the acquisition of Backbone SA and its LISA™ dynamic stabilization business. Now, with the planned acquisition of Paradigm Spine, the Company will become the largest posterior and cervical dynamic stabilization franchise business in the world.”
Mr. Viscogliosi was elected CEO following the passing of former CEO Erick Cloix on March 29, 2025. Viscogliosi Brothers, LLC, the controlling shareholder and largest shareholder of Companion Spine, will support the acquisition close and transition period for the combined company, bringing deep domain expertise to ensure long-term business stability and growth. Already recognized leaders in disc replacement and spine fusion, the Viscogliosi Brothers continue to establish themselves also as a global leader in the posterior dynamic spine stabilization and motion preservation market through this expansion opportunity of Companion Spine.
“This is a terrific transaction for both organizations,” said Sean Browne, Chief Executive Officer of Xtant Medical. “For Xtant, the sale of these business units allows us to strategically focus on our core business, while meaningfully reducing our debt and improving our balance sheet. Moreover, these fantastic motion preservation technologies such as Coflex®, HPS™ 2.0 and DCI™ will get the kind of focus only the Viscogliosi Brothers and Companion Spine can provide to optimize their commercial development. This type of development is in the DNA of the Viscogliosi Brothers, while it is far afield of Xtant Medical’s core competencies; so we expect big things for Companion Spine in the years ahead.”
The acquisition is poised to accelerate Companion Spine’s global market expansion, strengthening its presence in the U.S. and enhancing its competitive positioning in high-growth international markets to create the largest footprint in the posterior dynamic spine stabilization market. It also reinforces Companion Spine’s strategy, focusing on ambulatory surgery centers, catering to spine surgeons and dynamic stabilization and motion preservation specialists, and on indication-specific, U.S. FDA Premarket Approval products, with the longest clinical history of success—as seen by Coflex®’s 90% patient satisfaction and the more than 150 papers published on the device.
Following the close of the acquisition, Companion Spine will become the first sole source provider of a full range of an indication-specific product portfolio for customers using dynamic stabilization and motion preservation implants. The range of products and uses include: APERIUS™ for early stage LSS, Coflex® when a decompression is required for LSS or CoFix® when a larger decompression is needed and there exists a significant amount of instability for LSS, or HPS™ 2.0 or DSS™ when there is significant instability but a desire to preserve adjacent segments. In the cervical anatomy, DCI™ is designed as a Coflex® concept applied in an anterior interbody fashion, for maintenance of motion. Lastly, Companion Spine’s DIAM™ product is designed for use in DDD patients.
The companies expect to complete the acquisition in the third quarter of 2025, subject to closing conditions. Innovatus Capital Partners is the current senior lender to Companion Spine. Companion Spine is advised in this acquisition by Dorsey & Whitney, LLP as lead legal counsel, McDermott Will & Emery as tax and German legal counsel, Farber LLC as intellectual property legal counsel, Natixis Partners as capital access financial advisor, FTI Consulting as strategic communications advisor, Deloitte Finance as financial due diligence advisor, MCRA as regulatory, clinical and reimbursement advisor, and UHY LLP as U.S. auditor. Xtant Medical is advised by Fox Rothschild LLP as legal counsel and LifeSci Partners as investor relations advisor.
