16 Jan Companion Spine acquires Backbone SAS, expanding its portfolio of medical implants dedicated to treating spine and back pain

• The LISA® implant, developed by Backbone SAS and CE marked, is the key reason for the acquisition. It helps alleviate an unstable spine while maintaining controlled motion for the treatment of lumbar stenosis and degenerative disc disease.

• The deal strengthens Companion Spine’s presence in Bordeaux with the acquisition of an expert company, resulting directly from more than 35 years of clinical research initiated by Professor Jacques Sénégas and the school of Spine Surgery of the University of Bordeaux, a center of worldwide reference for research and training in back surgery.

• The combination of the companies creates an innovative and leading international industrial platform for the treatment of pain resulting from degenerative spine diseases, one of the main causes of disability in the world. Companion Spine has a portfolio of solutions capable of diagnosing and treating spine pain conditions along the continuum of disease progression.

Bordeaux, France, and New York (New York), Memphis (Tennessee) and Manchester (Connecticut), January 10th 2023 at 9.30 am ET – Companion Spine LLC, the French-American specialist in diagnostic and interventional spine pain-management surgery, today announced the acquisition of Backbone SAS, a company based in Bordeaux, France, that designs, develops, manufactures and markets functional motion restoration implantable devices to treat spinal disorders. The acquisition expands Companion Spine’s portfolio of medical implant solutions with the inclusion of Backbone’s main medical device, the LISA® implant (a Lumbar Implant for Stiffness Augmentation).

This acquisition allows Companion Spine to complete its line of treatment solutions for spine diseases, most notably lumbar stenosis and degenerative disc disease, matching implants to the degree of severity of the disease. 2

Degenerative spine diseases are one of the leading causes of disability in the world, with nearly 403 million cases of symptomatic disc degeneration, more than 5% of the world’s population, and 103 million cases of spinal stenosis per year worldwide. 1

Founded in 2020 by the American investment company Viscogliosi Brothers, LLC, which specializes in financing disruptive therapeutic innovations in spine, orthopedic and other healthcare indications, Companion Spine is a specialist in back pain management, motion preservation, precision diagnostics and interventional care that enables comprehensive management of spine diseases. Companion Spine’s solutions provide patients and the medical community with a continuum of care for better management of spine conditions.

The LISA® implant, the main medical device from Backbone, is an effective solution that meets the growing need to treat progressive spinal pathologies more effectively. The device reduces chronic pain related to degenerative diseases of the lumbar spine, preserving form, function and motion, while balancing and restoring the patient’s freedom of movement.

The LISA® implant has been CE marked since 2018. Backbone conducted a clinical study on 137 patients in 5 centers in Europe to demonstrate its safety and efficacy, and to provide scientific support for its commercial development in lumbar degenerative disc disease.

With the integration of this unique device into itssolution set, Companion Spine is expanding its system of solutions for physicians to appropriately treat every stage of disc and stenotic degenerative diseases, preventing unnecessary pain or limitation of motion, and without over treatment.

The acquisition of Backbone by Companion Spine also strengthens the company’s scientific link with the School of Spine Surgery of the University of Bordeaux, founded by Professor Jacques Sénégas. A pioneer in the research of medical devices for the treatment of pathologies related to the spine and more generally to the vertebral column, the school is an institution whose national and international reputation is well established. The school’s activities in the research of medical devices and less invasive surgery began in the 1990s, and its work led to the origination and development of Companion Spine’s DIAMTM and Backbone’s LISA® devices, as well as earlier generations of devices.

LISA® is the culmination of more than 30 years of clinical practice, offering today a light, safe, effective, and quick – the procedure takes only a few minutes – interventional treatment solution (ambulatory surgery) that is less traumatic for the patient. Postoperative care is simple, less expensive and preserves the patient’s anatomy as well as future therapeutic options for both patient and physician.

Erick Cloix, CEO and co-founder of Companion Spine, said: “The acquisition of Backbone and its leading technology, the LISA® implant, is a further development and solidification of Companion Spine’s industrial effort. We are very pleased to be able to expand the continuum of solutions aligning the proper spine implant for the therapeutic goals of the patient. Our DIAMTM implant is oriented towards.

1 Vijay M. Ravindra, MD, MSPH, Steven S. Senglaub, MS, Abbas Rattani, MBe, Michael C. Dewan, MD, MSCI, Roger Härtl, MD, Erica Bisson, MD, MPH, Kee B. Park, MD, and Mark G. Shrime, MD, MPH, PhD, Degenerative Lumbar Spine Disease: Estimating Global Incidence and Worldwide Volume, Global Spine Journal 8(117):219256821877076-April 2018 3 a lesser spine pain pathology, while the LISA® implant provides a more solid support controlling both flexion and extension of the back. The complementary nature of these two products allows Companion Spine to offer a full range of therapeutic solutions, in response to the whole range of pathologies involving the spine, from lumbar stenosis to degenerative disc disease, and for each degree of severity.”

Anthony G. Viscogliosi, Principal at Viscogliosi Brothers, LLC, and Co-founder and Executive Chairman of Companion Spine, continued: “This acquisition is perfectly in line with Companion Spine’s strategic ambition to develop a new generation of medical tools and implants to address the needs of back pain and spine diseases, which solve real public health issues worldwide. We are working to improve, innovate, and commercialize alternatives to invasive surgeries that are currently the standard treatment for spinal diseases. Backbone’s medical and technological expertise is a valuable asset that will allow us to treat more patients with an appropriate, less burdensome, implant that matches the implant to the patient’s needs.”

Nazanine Sahami, Founder, President & CEO of Backbone commented: “This new collaboration with Companion Spine is a great opportunity for Backbone. We are expanding French technological and medical know-how and expertise, as well as Backbone’s therapeutic influence, through the LISA® implant. This new step is in line with our focus to develop Backbone’s positioning on an international scale in order to bring appropriately matched therapeutic benefits to patients suffering for a long time from back pain. We are enthusiastic to join forces with the most experienced and competent team in this space to make early-stage spine pain relief with motion preservation the standard of care for spinal pathologies.”

Jean Michel Petit, Investment Director of IRDI Capital Investissement, Backbone’s main institutional shareholder, added: “We are delighted to see our investment in Backbone come to fruition through this acquisition by Companion Spine, a leading medical company in the development of a comprehensive treatment and support method for all forms of back pain. We also welcome this complementary positioning, which expands and affirms Companion Spine’s offering, while promoting Backbone’s unique expertise to physicians and patients alike, and we renew our full confidence in the new structure of these companies.”

Professor Vincent Pointillart, spine surgeon at the Bordeaux University Hospital, concluded: “Patients desire maintaining motion in their spine while relieving back pain. The LISA® device is a firstclass medical technology that adapts to the patient’s situation at any given moment. It is a lessinvasive, more effective, and reversible medical device, in contrast to the gold standard treatment for spinal pathologies, spinal fusion, which involves heavy, invasive, sometimes painful, and irreversible surgery. While the DIAMTM implant alleviates pain by off-loading the disc in between the bones of the spine, the LISA® implant alleviates the pain associated in a more unstable spine pathology.” He added. “The development of cutting-edge medical devices that will improve the treatment of back pain and spine diseases is one of the top priorities of the University of Bordeaux’s School of Surgery. The acquisition of Backbone by Companion Spine, intrinsically links innovations stemming from the University of Bordeaux’s academic research and work, continuing this historic focus.”

Companion Spine’s approach has always been to become the reference platform for less invasive interventional pain treatment of degenerative back diseases and lumbar spinal stenosis on an international scale. With the acquisition of Backbone, the Franco-American takes a big step toward becoming one of the leading European players in the back pain and spine disease markets.

4 About Companion Spine: Founded in 2020 in New-York, United States, and Bordeaux, France, Companion Spine is a company specialized in the diagnosis and interventional and surgical treatment of spine conditions. Companion Spine’s comprehensive system of technologies and solutions target degenerative disc disease and lumbar spinal stenosis, two of the most common indications for back pain worldwide. Companion Spine is developing a portfolio of medical solutions that will allow back pain specialists to offer their patients earlier, effective and reversible alternatives to spinal fusion, the current standard surgical approach and strategy to address the most severe back pain. For more information, please visit: www.companion-spine.com

About Backbone: Founded in 2015 and based in Bordeaux, France, Backbone designs, develops, manufactures and markets implantable medical devices for spine surgery. Backbone is dedicated to creating innovative and effective motion preservation solutions by working closely with surgeons to treat the root cause of spinal pathologies. The solutions developed address the needs of all healthcare stakeholders (patients, surgeons, hospital staff and payers) for less invasive surgery. Backbone has a team of spine surgery experts and experienced entrepreneurs with over 20 years of experience in the field, whose work has led to the launch of many effective and efficient products that have become gold standards in the treatment of spine diseases.

For more information, please visit: www.backbone.pro

About Viscogliosi Brothers, LLC: Viscogliosi Brothers, LLC (VB) was established by Marc R. Viscogliosi, John J. Viscogliosi, and Anthony G. Viscogliosi in 1999 as the first venture capital/private equity and merchant banking firm dedicated to the neuromusculoskeletal/orthopedics sector of the healthcare industry. VB is headquartered in New York City. Today, VB is an independent firm with a mission to create, build and finance companies founded on innovations that are uniquely focused on life changing neuromusculoskeletal/orthopedic technologies globally. VB has founded, invested in, and built more than 35 companies in the sector. VB specializes in merchant banking activities in the neuromusculoskeletal industry as a full life cycle investor, investing in all stages of a company from inception through growth capital and IPO or sale to a strategic buyer, all the while helping hundreds of thousands of people lead better lives through the orthopedic and spinal innovations developed, marketed, and sold by the companies VB has assisted in financing. VB has effected 18 exits over its 23 years generating more than $2.5 billion in capital returned to its lenders, partners, and itself.

For more information, please visit: www.vbllc.com

Contacts: International media relations – Bogert-Magnier Communications James Connell jim@bogert-magnier.com 5 +33 (0)6 2152 1755 Media relations France – NewCap Nicolas Mérigeau / Arthur Rouillé nmerigeau@newcap.fr / arouille@newcap.fr +33 (0)1 44 71 94 98 / +33 (0)1 44 71 00 15 Companion Spine Erick Cloix – Chief Executive Officer & Founder erick.cloix@companion-spine.com Backbone Nazanine Sahami, Founder, President & CEO nsi@backbone.pro Viscogliosi Brothers Anthony G. Viscogliosi – Executive Chairman, Founder & Principal aviscogliosi@vbllc.com

SOURCE: Companion Spine, January 10, 2023.

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