Companion Spine

Back pain is one of the most common reasons people see a doctor, and for decades the surgical answer at the severe end has been the same: fuse the vertebrae together and accept the loss of motion. Companion Spine was built on a different premise. The company develops and sells implantable devices and interventional therapies that treat degenerative disc disease and lumbar spinal stenosis while preserving the spine's movement and anatomy.

Formed in 2020 by the Viscogliosi Brothers - a family merchant bank that has been building and selling orthopedic companies since 1999 - Companion Spine operates across two continents, with a base in New York and a headquarters in Mérignac, just outside Bordeaux, France. That geography is not incidental. The science behind two of its implants traces back to the School of Spine Surgery at the University of Bordeaux.

The company frames its work as a continuum rather than a single procedure: diagnose the source of pain, manage it, intervene minimally, and only operate - ideally in an outpatient center - when it is truly warranted. Its stated mission is plain: "Changing spine care for good."

Companion Spine is a B2B medical device business. Its customers are spine and orthopedic surgeons, hospitals, and ambulatory surgery centers - and, downstream, the patients they treat for degenerative disc disease and lumbar spinal stenosis. These are conditions that leave millions with chronic low back pain and limited options between conservative care and major fusion surgery.

The problem the company targets sits in that middle ground. Injections and physical therapy may stop working, yet fusion is an irreversible step that sacrifices motion and can strain the segments next to it. Companion Spine's portfolio is designed to give surgeons indication-specific choices for patients at each stage of disease progression, rather than defaulting to the most aggressive option.

Its lead device, DIAM, is indicated for moderate-to-severe low back pain from single-level degenerative disc disease in patients who remain symptomatic after at least six months of non-operative care - precisely the population that has historically had few good choices.

Most of the spine market's revenue flows through fusion hardware sold by large players. Companion Spine's differentiation is structural: it deliberately assembled a dedicated non-fusion, dynamic-stabilization portfolio and positions itself as a single, indication-specific source for surgeons who want to preserve motion.

Its strategy has been as much acquisition as invention. Rather than wait years for internal R&D across every indication, the company bought established, regulatory-cleared implant lines - Backbone SAS in Bordeaux in 2023, and Paradigm Spine's coflex and CoFix implants from Xtant Medical in 2025. The result, in the company's own framing, is the industry's most comprehensive offering in posterior dynamic stabilization and motion preservation.

The business model is classic medical devices: develop, acquire and commercialize implants sold per procedure to surgeons, hospitals and outpatient surgery centers worldwide. Growth comes from expanding proven devices into new territories and from folding in acquired product lines - each of which adds an indication, not just a logo.

Companion Spine's Series A opened at $55 million in February 2022 and closed at $60.1 million - its total funding to date. The capital was earmarked to push DIAM and LISA into new global territories, accelerate sales, and fund the FDA approval process for DIAM and APERIUS.

The payoff on the regulatory side arrived in December 2025, when the FDA granted DIAM full Premarket Approval - four years after the device first earned Breakthrough Device Designation.