Hoogland Spine

What Hoogland Spine does

Hoogland Spine Products GmbH, doing business as MaxMoreSpine, is a German-headquartered medical device company founded in 2006 by orthopedic surgeon Dr. Thomas Hoogland. The company designs, manufactures, and distributes endoscopic instrumentation for minimally invasive spine surgery, addressing herniated discs, spinal stenosis, disc degeneration, facet joint pathology, and — more recently — endoscopic lumbar interbody fusion. Its product portfolio includes the PTED (Percutaneous Transforaminal Endoscopic Discectomy), PSLD (Percutaneous Stenoscopic Lumbar Decompression), BESS (Biportal Endoscopic Spine System), MAXDISC, MINI cervical, MaxFusion TLIF, and J@blation RF systems, all featuring proprietary gold-soldered endoscopes manufactured in Germany with CE and FDA certification. Technology differentiation rests on patented manual bone drills (TOM Shidi needle system), miniaturized 2.1mm endoscopes, threaded cervical cannulas enabling mallet-free insertion, and an expandable-cage Trans-Kambin fusion approach that preserves the facet joint.

MaxMoreSpine sells primarily to neurosurgeons, orthopedic spine surgeons, and pain physicians at hospitals and ambulatory surgical centers, with secondary reach into medical device distributors. The go-to-market combines direct field sales through US (San Diego) and German (Frankfurt am Main) offices, a regional distributor network, and a strong medical-education engine anchored by cadaveric workshops in Bangkok and other training centers, plus main-sponsorship of the ISMISS congress. Co-development relationships with marquee KOL surgeons (Drs. Morgenstern, Choi, Lim, Schubert) drive the innovation pipeline, while an extensive peer-reviewed clinical literature archive and Erasmus MC research partnership provide evidence-based validation. Revenue is generated from hardware sales (endoscopes, instruments, and disposables), training and education services, and post-sale service and repair. Pricing is not publicly disclosed; sales are conducted through direct representative engagement. The company has remained privately held and organically funded with a small (1–10) employee base since founding, with no disclosed venture or institutional capital, and operates globally across Europe, North America, and select Asia-Pacific markets.

Name

Hoogland Spine

Legal name

Hoogland Spine Products GmbH

Website

https://max-more.com

Company type

Private

Founded year

2006

Operating status

Operating

Headcount range

1–10 employees

Short description

Hoogland Spine Products GmbH (MaxMoreSpine) is a German medical device company that designs, manufactures, and distributes endoscopic instrumentation for minimally invasive spine surgery, serving neurosurgeons, orthopedic spine surgeons, pain physicians, hospitals, and distributors across Europe, North America, and select Asia-Pacific markets.

Ownership category

akta.pro rank

Product category

Minimally Invasive Spine Surgery Medical Devices

NAICS

Surgical and Medical Instrument Manufacturing (339112), Electromedical and Electrotherapeutic Apparatus Manufacturing (334510), Surgical Appliance and Supplies Manufacturing (339113)

SIC

Surgical & Medical Instruments & Apparatus (3841), Orthopedic, Prosthetic & Surgical Appliances & Supplies (3842), Electromedical & Electrotherapeutic Apparatus (3845)

akta.pro primary industry

Endoscopic Therapeutic & Access Devices (Trocars, dilators, biopsy/ablation tools) (HLAHADAN)

akta.pro secondary industries

Open & Minimally Invasive Surgical Instruments (Handheld, Laparoscopic, MIS) (HLAHADAA), Spine Implants & Motion Preservation (Fusion/Disc/Interspinous) (HLAHAEAC), Pain Management (Spine & Musculoskeletal) (HLAKALAM)

Keywords

• Endoscopic spine surgery
• Minimally invasive surgery
• Spinal medical devices
• Surgical instrumentation
• Spine endoscopy systems

Headquarters

HQ city

Frankfurt

HQ country

Germany

HQ region

Europe

Offices3 records

Markets served

GTM type

B2B

Offering type

Hardware or Manufacturing

Cost components

Personnel, Operations, Technology or R&D, Supply Chain, Marketing or Sales, Infrastructure

Revenue model

1. Medical Device Sales: Sale of endoscopic spine surgery systems, instruments, and disposables to hospitals, surgical centers, and healthcare professionals. Products include PTED systems, PSLD systems, BESS systems, MAXDISC, MINI, MaxFusion, and J@blation systems. Includes starter kits with endoscopes and comprehensive instrument trays
2. Training and Education Services: Workshops and conferences for physicians and medical assistants on endoscopic spine surgery techniques. Cadaveric workshops and basic endoscopic spine workshops conducted at training centers. Supports continued education programs at hospitals
3. Service and Repair: Service and repair operations for medical devices. RMA (Return Merchandise Authorization) process available for both US and German customers

Go-to-market motion3 records

Distribution channels4 records

Marketing channels7 records

Core offering

MaxMoreSpine designs, manufactures, and distributes endoscopic spine surgery systems and instruments used by neurosurgeons, orthopedic spine surgeons, and pain physicians for minimally invasive treatment of lumbar and cervical spinal conditions. The portfolio includes PTED, PSLD, BESS, MAXDISC, MINI, MaxFusion, and J@blation systems, plus the PTED Access System with patented manual bone drills. All products are manufactured in Germany and carry both CE and FDA certifications.

Product overview

Hoogland Spine Products (MaxMoreSpine) offers a comprehensive portfolio of endoscopic spine surgery systems designed for minimally invasive treatment of various spinal conditions. The product line centers on PTED (Percutaneous Transforaminal Endoscopic Discectomy), PSLD (Percutaneous Stenoscopic Lumbar Decompression), and biportal endoscopic approaches, supplemented by specialized systems for intradiscal treatment (MAXDISC), cervical procedures (MINI), and facet joint ablation (J@blation). The MaxFusion system extends the portfolio into interbody fusion. All systems are designed for use with real-time endoscopic visualization, feature modular instrument trays, and are engineered for compatibility with major endoscope brands (STORZ, OLYMPUS, WOLF, ACMI) through included adapters.

Differentiator

Problem solved

Functional benefit

Brands

• MaxFusion: Endoscopic / Percutaneous Transforaminal Lumbar Interbody Fusion System (Endoscopic TLIF) developed in cooperation with Dr. Morgenstern
• J@blation
• BESS

Products and services

• PTED Endoscopic System Percutaneous Transforaminal Endoscopic Discectomy system for treating lumbar and thoracic herniations and stenosis (extraforaminal, foraminal, and lateral recess) using the transforaminal approach with patented manual bone drills. Designed for spine surgeons treating herniated discs, especially L5-S1.
• PSLD Endoscopic System Percutaneous Stenoscopic Lumbar Decompression system for interlaminar lumbar stenosis, central and bilateral lateral recess decompression, and lumbar disc herniation using the posterior interlaminar approach. Developed in cooperation with Dr. Kangtaek Lim and Dr. Gun Choi.
• MAXDISC Endoscopic System Intradiscal endoscopic system for contained lumbar spine herniations using a 2.1mm endoscope. Combines nucleus discectomy, nucleus ablation with bipolar RF probe, annulus modulation, and disc abrasion for treatment of discogenic back and leg pain. Includes abrasion device for disc regeneration.
• MINI Endoscopic System Minimally invasive anterior cervical solution using a 2.1mm endoscope through a 5mm incision for cervical herniations and stenosis treatment. Features proprietary threaded cannulas and obturators for controlled manual insertion without surgical mallet, protecting spinal cord and vascular structures. Developed with Dr. Gun Choi.
• Biportal Endoscopic System (BESS)
• MaxFusion by Dr. Morgenstern Endoscopic/Percutaneous Transforaminal Lumbar Interbody Fusion System (Endoscopic TLIF) using the Trans-Kambin approach. Enables fusion through a 10mm skin incision without facet joint resection using an expandable cage for disc height restoration and progressive blunt-tipped manual reamers. Developed by Dr. Christian Morgenstern.
• J@blation System Joint ablation system using high-frequency radiofrequency (HF/RF) energy for targeted thermal therapy of facet joint-related spine disorders. Three-effect therapy personalized by patient BMI with automated therapy time control, using the MaxMoreSpine Tom Endo Stick Endoscope for direct visualization.
• PTED Access System Access system for PTED procedures enabling safe transforaminal endoscopic surgery. Includes Tom Shidi needles and patented manual bone drills for incremental foramen widening without irritating neurological structures.
• Endoscopic Spine Surgery Training Workshops Cadaveric and basic endoscopic spine workshops conducted at hospitals and specialized training centers worldwide, including Bangkok, Thailand. Designed for physicians and medical assistants to familiarize them with the latest endoscopic treatment methods.
• Service and Repair Service and repair operations for MaxMoreSpine medical devices with a Return Merchandise Authorization (RMA) process available for both US and German customers.

Quantifiable outcome

• Many patients walk same day and return home within 24 hours after endoscopic spine surgery
• +3 more outcomes

Named customers4 records

Segments4 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration4 records

Feature9 records

Partnerships

Seven partnerships are on record, tiered core, flagship and minor.

• Erasmus MC: University Medical Center RotterdamcoreStrategic or Co-development Partner · 1 April 2026Clinical research partnership where Erasmus MC conducted a thesis study on full-endoscopic lumbar disk surgery. The research was performed under Pravesh Shankar Gadjradj and funded by the Netherlands Organization for Health Research and Development (ZonMw). All hospitals involved used the MaxMoreSpine PTED Endoscopic System.
• International Society for Minimal Intervention in Spinal Surgery (ISMISS)flagshipStrategic or Co-development Partner · 1 October 2025MaxMoreSpine is the main sponsor of ISMISS, the oldest and most respected meeting in minimally invasive spine surgery. The 40th anniversary congress was held in Zurich, Switzerland. Company participates with renowned speakers and users from all continents, showcasing innovations in stem cell applications, less invasive fusion procedures, and new endoscopic approaches.
• Dr. Christian MorgensterncoreStrategic or Co-development PartnerCo-development of the MaxFusion Endoscopic/Percutaneous Transforaminal Lumbar Interbody Fusion System. Dr. Morgenstern developed the next-generation Endoscopic TLIF approach using the Trans-Kambin method for safe, precise access to disc space.
• Dr. Gun ChoicoreStrategic or Co-development PartnerDevelopment partner for the MINI Endoscopic System (anterior cervical approach) and leading ongoing development of the Biportal Endoscopic System (BESS) in close cooperation with MaxMoreSpine.
• Dr. Kangtaek LimcoreStrategic or Co-development PartnerCo-development partner for the PSLD Endoscopic System (Percutaneous Stenoscopic Lumbar Decompression) using the posterior interlaminar approach.
• Dr. Vinod Muniswamy (Centerpoint Health)minorStrategic or Co-development PartnerHealthcare provider who performed first procedures utilizing the MaxMoreSpine endoscopic system at Centerpoint Health in Georgetown, KY (May 2026).
• Dr. Elsa González (Juaneda Hospitales)minorStrategic or Co-development PartnerNeurosurgeon at Juaneda Hospitales in Spain who performed a globally pioneering biportal endoscopic cervical tumor excision surgery using the MaxMoreSpine BESS System.

Scale indicators3 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• Medtronic plc: Largest medical device conglomerate with a substantial spine surgery division (post-Mazor Robotics acquisition) offering navigation, robotic-assisted, and minimally invasive spine solutions. The dominant scale player whose strategic moves shape category economics for specialists like MaxMoreSpine.
• Globus Medical: Large publicly traded spine medical device company offering MIS, endoscopic, navigation, and robotic spine solutions. Represents the strategic threat of a well-capitalized incumbent expanding its endoscopic portfolio, potentially pressuring specialist players like MaxMoreSpine.
• Aesculap (B. Braun): Division of B. Braun focused on surgical instruments, including a spine portfolio with endoscopic and MIS solutions. A German peer with deep surgical instrument expertise and global distribution that overlaps with MaxMoreSpine's hospital customer base.
• Stryker Corporation: Global medical device company with a spine division offering MIS and navigation products. As one of the largest orthopedic and spine players, Stryker represents a significant competitive threat if it expands its endoscopic spine offering or pursues tuck-in acquisitions in the category.
• Karl Storz SE & Co. KG: Global leader in endoscopy with extensive spine visualization offerings. Listed as a compatibility partner for MaxMoreSpine (STORZ adapters), Karl Storz is the dominant incumbent in OR endoscopy and could leverage its installed base to compete more aggressively in endoscopic spine.
• NuVasive: Major spine medical device company with a broad MIS spine portfolio. While historically focused on tubular retractor and lateral approaches, NuVasive has expanded into endoscopic techniques, competing indirectly with MaxMoreSpine's PTED and interlaminar offerings.
• Richard Wolf Medical Instruments: Large German manufacturer of endoscopic instruments and systems across urology, gynecology, orthopedics, and spine. A broad incumbent that provides endoscopic visualization platforms compatible with spine workflows, competing with MaxMoreSpine on visualization optics in the OR.
• Olympus Medical: Major endoscopy platform provider whose visualization systems are compatible with MaxMoreSpine instruments (OLYMPUS adapters included). Olympus's scale and OR relationships position it as a potential competitor or channel partner depending on strategic direction in spine.

Direct peers

• Elliquence: US-based company specializing in minimally invasive spine surgery technologies including endoscopic systems and radiofrequency-based tissue management. Directly comparable to MaxMoreSpine in its combined endoscopic and RF ablation (J@blation-equivalent) portfolio targeting degenerative spine conditions.
• joimax: German-based endoscopic spine surgery specialist offering TESSYS (transforaminal), iLESSYS (interlaminar), and CESSYS (cervical) systems. The closest direct competitor to MaxMoreSpine, competing head-to-head in PTED-equivalent and biportal endoscopic spine markets across Europe and the US.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks5 records

Key highlights7 records

Customer concentration

• YouTubeyoutube.com/channel/UCrP7zEVa-0u-pXZV6GL_Y6Q
• Facebookfacebook.com/maxmorespine
• LinkedInlinkedin.com/company/hoogland-spine-products-gmbh
• Instagraminstagram.com/maxmorespine

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles2 records

Subsidiaries1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Hoogland Spine