SEXTANT® system was succeeded by the second-generation

PathFinder® (Abbott Spine, Austin, TX, USA), VIPER® (DePuy Synthes Spine, Raynham, MA, USA), MANTIS® (Stryker Kalamazoo, MI, USA) SpiRIT® (Synthes, Solothum, Switzerland), and Ballista® (Biomet Spine, Broomfield, CO, USA) in 2009; and ILLICO SE® (Alphatec Spine, Carlsbad, CA, USA) in 2011

Typical third-generation systems include ES2® (Stryker)

VIPER 2 X-tab® (DePuy Synthes Spine)

CD Horizon Solera Voyager spinal system® (Medtronic)

PRECEPT® (NuVasive, San Diego, CA, USA)

RELINE® (NuVasive)

Associa Harp®/Associa Zique® (KYOCERA, Kyoto, Japan)

CREO® (Globus Medical, Audubon, PA, USA)

Saccura® (Teijin Nakashima Medical, Tokyo, Japan)

IBIS®/Pisces® (Japan Medical Dynamic Marketing, Tokyo, Japan)

Furthermore, fourth-generation PPS systems that do not require the use of conventional guidewires were introduced from 2019 onwards, including VIPER PRIMETM System® (DePuy Synthes Spine)

Voyager ATMAS® (Medtronic). To date, approximately 30 types of systems have been made available since 2022 when including product revisions