ZOEZEN Robotics Files IPO Prospectus: Driving Transformation in China's Minimally Invasive Spinal Surgery with Core Technological Advancements

As China’s population ages at an accelerating pace, the risk of osteoporosis, arthritis, and other musculoskeletal disorders continues to rise, driving increased demand for orthopedic surgeries. According to Life Science Intelligence, there were 9.66 million orthopedic procedures performed in China in 2018, making it the third most common type of surgical intervention. Among these, spinal surgeries accounted for 2.065 million cases, with over 10 million patients awaiting surgery, indicating substantial unmet demand.

However, minimally invasive spinal surgery is not only technically challenging and associated with a high risk profile, but also demands extremely high surgical precision. The preparation of the pedicle channel and decompression procedures are critical steps in spinal surgery. In conventional procedures, surgeons perform blind operations using handheld bone-cutting tools, relying solely on their tactile feedback and experience, as they cannot directly visualize the nerves within the spinal canal. Given the close proximity of major nerves and blood vessels to the spine, even minor errors can lead to severe complications such as nerve injury. Clinical research data indicate that the incidence of nerve injury due to improper manipulation in the thoracolumbar segment exceeds 6.25%.

Nowadays,Surgical safety and standardization have become the primary concerns of patients. In this context, the advantages offered by surgical robots—such as minimally invasive procedures, high flexibility, three-dimensional high-definition imaging, tremor filtration, short learning curves, reduced radiation exposure, digitalization, and intelligence—are precisely suited to address this critical issue.

Orthopedic surgical robots not only assist physicians in preoperative intelligent planning, intraoperative precise positioning, and stable instrument holding based on patients’ 3D bone models, thereby effectively enhancing access to high-quality surgical care, but also help shorten the learning curve for surgeons and reduce procedural difficulty by replicating expert experience, thus helping to address the uneven distribution of medical resources in China. In terms of improved accuracy and reduced complications, radiation exposure time, and physician training duration, spinal surgical robots undoubtedly offer greater advantages over freehand pedicle screw placement and puncture techniques.

In the face of the rise of the surgical robot industry, national policies have shown a supportive attitude.From the State Council’s issuance of the “Made in China 2025” plan in 2015, which prioritized the development of high-performance diagnostic and therapeutic equipment such as medical robots, to Beijing’s inclusion of “robot-assisted orthopedic surgery” as an adjunctive procedure in its medical insurance reimbursement list in 2021, policy support has been continuously strengthened. Meanwhile, ten ministries and commissions, including the Ministry of Industry and Information Technology, have called for concerted efforts to tackle key technological challenges in intelligent surgical robots, accelerating breakthroughs in critical areas such as image registration, high-precision positioning, intelligent human–machine interaction, and multi-degree-of-freedom precise control. These sustained policy initiatives aim to boost investment in this sector and facilitate the expansion of both supply and demand within the industry.

According to Frost & Sullivan data, the global orthopedic surgical robot industry is maintaining rapid growth, with the market expected to reach $4.69 billion by 2026. Among these, spinal surgery robots have long-term market potential.In recent years, some domestic companies have emerged, with ZOEZEN (hereinafter referred to as "ZOEZEN") being one of them.

In the field of minimally invasive spinal surgery robots, ZOEZEN boasts profound academic expertise and extensive industrialization experience.

ZOEZEN is a national high-tech enterprise specializing in intelligent surgical navigation, positioning, and operative robots, dedicated to providing comprehensive digital solutions for spinal surgery. Its core team originates from the Medical Robotics Laboratory at Beihang University, having led or participated in multiple national-level research projects, achieved numerous “firsts” in China’s surgical robotics field, and earned two Second-Class Prizes of the National Science and Technology Progress Award.

The company’s product portfolio primarily focuses on specialized surgical robots, including the pioneering image-guided spinal robot based on direct visualization and the innovatively developed autonomous laminectomy decompression robot. ZOEZEN has developed multiple original surgical robotic systems tailored to clinical applications, creating a series of digital, intelligent, and minimally invasive orthopedic solutions. The company has established a branch of the “Engineering Research Center for Precision Medicine in Bones and Joints” under the Ministry of Education, as well as a “Medical Orthopedic Robotics Laboratory.”

ZOEZEN possesses a domestically original digital intelligent navigation system and a full-stack technical platform for surgical robots. Addressing the demand for precise, minimally invasive orthopedic diagnosis and treatment, and leveraging its core technological advantages, the company has focused its R&D efforts on the spine—the lifeline of human health—establishing three product lines: a spinal surgery navigation and positioning system, disposable kits for minimally invasive spinal surgery instruments, and an autonomous robotic system for spinal laminectomy decompression.

Among these, ZOEZEN’s independently developed digital full-stack surgical robot platform and 5G-enabled telemedicine capabilities provide comprehensive assistance throughout the entire surgical workflow, meeting the needs for precise and safe surgical positioning as well as localized autonomous surgical operations. While building a matrix of spinal robotic devices and software systems to address the diverse clinical requirements of medical institutions at all levels, ZOEZEN also offers solutions based on its globally pioneering intuitive image-guided localization technology and various modular product combinations to accommodate a broader range of indications.

It is reported that the Zuohang 300, developed by ZOEZEN Robotics, received NMPA Class III certification in 2022, with more products expected to be launched.

Primary hospitals (Grade II Class A and above, excluding Grade III Class A) perform approximately 50% of spinal surgery cases. However, these institutions currently lack adequate clinical surgical capabilities. Furthermore, the average training period for interventional physicians alone is one year, which fails to meet the rapidly growing patient demand. Given that each medical malpractice incident results in significant losses, there is an urgent need for primary hospitals to enhance their surgical capabilities.

According to statistics, China has 12,000 county-level hospitals, accounting for 47% of the total number of hospitals nationwide. These large-scale county-level hospitals serve 70% of the county-dwelling population, covering primary healthcare access for 900 million people in China. The significant increase in orthopedic demand has led to a slight rise in the number of orthopedic hospitals. However, high-quality medical resources are concentrated in major central cities, while many patients in urgent need of treatment reside in county-level areas with weaker diagnostic and therapeutic capabilities. The imbalance between supply and demand in the industry, as well as the unequal distribution of resource allocation, remains prominent.

Surgical robots help lower the learning curve for physicians in areas such as preoperative planning and surgical navigation, enabling more doctors to master complex procedures and enhancing the consistency of medical services. However, currently available surgical robot systems on the market often come with exorbitant price tags in the tens of millions, far exceeding the purchasing capacity of primary-care hospitals, which has led to slow market adoption.

To address this pain point, ZOEZEN targets the domestic primary healthcare market with the goal of developing affordable intelligent medical products for all primary hospitals. Its products are designed to be highly adaptable, reduce hospital burdens, and remain compatible with existing orthopedic surgical equipment across hospitals at all levels.After five years of research and development, ZOEZEN has finally launched a robotic system designed for minimally invasive spinal surgery in primary care hospitals. With its performance and cost advantages, ZOEZEN is poised to accelerate the adoption and utilization of spinal minimally invasive surgical robots in grassroots medical institutions. Empowered by ZOEZEN’s digital orthopedic surgical solutions, primary care physicians’ cognitive (“brain”) and visual (“eye”) capabilities are significantly enhanced, markedly shortening the learning curve for mastering complex surgical procedures and further stimulating growth in the grassroots orthopedic market.

In terms of equipment and software, ZOEZEN has established a robust portfolio of spinal robotic devices and software systems, capable of meeting the diverse product needs of healthcare institutions. Meanwhile, ZOEZEN also offers various modular product combinations based on intuitive image-guided localization technology, along with customized services, to address a broader range of clinical indications.

Moreover, ZOEZEN leverages 5G technology to achieve seamless interoperability between hospital information systems and its robotic software platforms, thereby establishing a remote digital intelligent orthopedic diagnosis and treatment system for trauma care centers. This integrated telemedicine platform combines remote consultation, monitoring, diagnosis, and treatment, enabling specialists’ expertise to extend via communication networks to remote areas and deliver expert-level medical services to patients. Notably, this project was selected as one of the Ministry of Industry and Information Technology’s 2021 pilot projects for “5G + Healthcare” applications.

In the future, orthopedic surgical robots have become a key innovation to alleviate the current shortage of medical resources, thanks to their advantages of minimal invasiveness, high precision, reduced learning curve for surgeons, and standardized surgical procedures. They have also emerged as a hot spot for capital investment in recent years, ensuring rapid growth in the surgical robot market. Leveraging its unique intuitive image localization technology, intraoperative status perception technology, and the team’s extensive experience, ZOEZEN is poised to continue leading innovation in the field of minimally invasive spinal surgical robots.