Financial Performance & Growth - ATEC experienced a sector-leading revenue Compound Annual Growth Rate (CAGR) of approximately 40% over 5 years, driven by market share expansion[4] - Total revenue for 2023 reached $482 million, representing a 37% year-over-year increase[7] - Surgical revenue in 2023 was $423 million, a 39% increase year-over-year[7] - EOS revenue for 2023 amounted to $59 million, reflecting a 24% year-over-year growth[7] - The company projects 2024 revenue to be $595 million, indicating a 24% growth[8] Market Position & Strategy - ATEC is focused on an $8 billion spine market[4] - The company's strategy involves meeting unmet needs in spine surgery through clinical distinction[19] - ATEC is a 100% spine-focused company, differentiating it from larger, less focused competitors[17, 20] - ATEC aims to achieve cash flow break-even in 2025, supporting self-funded future growth[4] Innovation & Technology - ATEC is integrating unprecedented information into spine care with enabling technology[19] - The company is advancing deformity treatment with procedural sophistication[19] - ATEC is developing the EOS Catalyst, expected in mid-2024, to automate alignment reports and surgical planning[72, 73]

Financial Performance & Guidance - Preliminary Q3 2023 surgical revenue is expected to be between $103.3 million and $103.9 million, representing a year-over-year (YoY) increase of 31% to 32%[4] - Preliminary Q3 2023 EOS revenue is expected to be between $14.3 million and $14.5 million, a YoY increase of 27% to 29%[4] - Total revenue for Q3 2023 is projected to be between $117.7 million and $118.5 million, reflecting a YoY growth of 31% to 32%[4] - Full-year 2023 surgical revenue guidance has been updated to $414 million, a 33% YoY increase[5] - Full-year 2023 EOS revenue guidance remains at $58 million, a 21% YoY increase[5] - Total revenue guidance for FY2023 has been increased by $10 million to $472 million, representing a 32% YoY increase[5] Strategic Focus & Innovation - ATEC is uniquely 100% spine focused, driving innovation from the operating room, not the board room[7, 9, 10] - ATEC aims to improve precision, predictability, and durability in spine surgery, addressing the 25-30% of surgeries that require revision[11, 12] - ATEC's innovation addresses the goals of spine surgery: decompression, stabilization, and alignment, strongly correlated to successful clinical outcomes[19, 25] - ATEC is positioning to capitalize on industry disruptions, adding 30 sales professionals from disrupted companies[32] Technology & Solutions - EOS imaging objectively answers essential clinical questions, providing full-body, standing, functional global alignment assessment with less radiation[52, 65] - The Catalyst system, expected to launch in 2024, will provide automated alignment reports, surgical planning, and patient-specific rods[68] - ATEC's lateral approach, including PTP (Prone Transpsoas) and LTP (Lateral Transpsoas), aims to address the hurdles of first-generation lateral surgery, with LTP designed for single-position surgery for L3 to S1[98, 122] - Valence, ATEC's navigation and robotics platform, is designed to be practical, economical, and ASC (Ambulatory Surgery Center) suitable[151]

Company Performance - Alphatec reported a quarterly loss of $0.23 per share, which was worse than the Zacks Consensus Estimate of a loss of $0.12, representing an earnings surprise of -91.67% [1] - The company posted revenues of $169.18 million for the quarter ended March 2025, surpassing the Zacks Consensus Estimate by 0.23%, and showing an increase from $138.48 million year-over-year [2] - Over the last four quarters, Alphatec has not been able to surpass consensus EPS estimates, although it has topped consensus revenue estimates four times [2] Stock Outlook - Alphatec shares have increased by approximately 19.6% since the beginning of the year, contrasting with the S&P 500's decline of -5.3% [3] - The current consensus EPS estimate for the upcoming quarter is -$0.06 on revenues of $179.11 million, and for the current fiscal year, it is -$0.25 on revenues of $733.31 million [7] Industry Context - The Medical - Instruments industry, to which Alphatec belongs, is currently ranked in the top 23% of over 250 Zacks industries, indicating a favorable outlook compared to the bottom 50% [8] - Empirical research suggests a strong correlation between near-term stock movements and trends in earnings estimate revisions, which can impact Alphatec's stock performance [5]

Financial Data and Key Metrics Changes - The company reported a revenue growth of 22% year-over-year, reaching $169 million, with surgical revenue growing by 24% to $152 million [4][9] - Adjusted EBITDA for the first quarter was $11 million, marking a 6% margin and an improvement of over 800 basis points compared to the previous year [13][14] - Non-GAAP gross margin was 70%, down 50 basis points year-over-year but up 70 basis points sequentially [11] Business Line Data and Key Metrics Changes - Surgical revenue grew by 24% year-over-year, driven by a 17% increase in procedural volume and an 18% increase in the number of surgeons utilizing ATEC procedures [6][10] - EOS revenue increased by 8% year-over-year, with a record order volume leading to a 28% year-over-year increase in the order book [11][12] Market Data and Key Metrics Changes - Established territories saw a revenue growth of 23%, indicating strong surgeon and territory penetration [6] - Same store sales from sales agents in territories for over a year grew by 23% year-over-year, reflecting significant growth in established markets [12][84] Company Strategy and Development Direction - The company is focused on creating clinical distinction through innovative procedural solutions that improve patient outcomes [24][25] - ATEC aims to expand its sales force and enhance operational efficiency to drive growth and profitability [6][23] - The strategy includes leveraging informatics to reduce surgical variables and improve predictability in spine surgery [26][28] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in achieving cash flow positivity for the full year 2025, with expectations of continued strong revenue growth [19][17] - The company anticipates a revenue outlook of approximately $734 million for 2025, with surgical revenue growth of 21% [19][21] - Management noted that the spine market remains resilient despite economic uncertainties, with high demand for their products [106][107] Other Important Information - The company successfully refinanced its 2026 convertible note, extending maturity and maintaining a low coupon rate [17] - The first quarter cash burn was at the low end of the expected range, indicating improved cash management [15][16] Q&A Session Summary Question: Market size and competitive dynamics for the new Corpectomy system - Management indicated that they are the only company offering this procedure in the prone position, which provides unique advantages [41][42] Question: Tariff exposure in 2025 - The company expects low single-digit million impacts on cost of goods sold due to tariffs, primarily affecting EOS equipment [54][55] Question: Update on robot launch plan - The robot is in the alpha phase, with plans for an end-of-year launch, and integration with navigation systems is underway [60][61] Question: Cash outlay trends - The company achieved a cash use of $15 million in Q1, with expectations for positive cash flow in subsequent quarters [65][66] Question: Salesforce productivity and opportunities - Same store sales grew by 23%, indicating strong performance from established sales agents [83][84] Question: EOS placements and portfolio pull-through - Most EOS placements are in new accounts, with a focus on expanding into complex procedures [88][90] Question: Overall volumes and ASC growth - The market is healthy, with surgical volumes growing significantly, and ASCs are expected to evolve over time [93][94] Question: International market expansion - The company remains bullish on international markets, particularly Australia and New Zealand, while maintaining a focused approach [110]

Revenue and Sales - Revenue from products and services increased by $30.7 million, or 22%, to $169.2 million for the three months ended March 31, 2025, compared to $138.5 million in the same period in 2024[126]. Costs and Expenses - Cost of sales rose by $12.1 million, or 29%, to $53.2 million for the three months ended March 31, 2025, primarily due to increased product volume and stock-based compensation[128]. - Total operating expenses increased by $19.6 million, or 14%, to $160.3 million for the three months ended March 31, 2025, compared to $140.7 million in the same period in 2024[129]. - Research and development expenses decreased by $1.4 million, or 8%, to $16.6 million for the three months ended March 31, 2025, primarily due to a decrease in stock-based compensation[129]. - Litigation-related expenses surged by $7.8 million, or 176%, to $12.2 million for the three months ended March 31, 2025, mainly due to a litigation settlement[131]. Interest and Debt - Interest expense increased by $2.5 million, or 47%, to $7.8 million for the three months ended March 31, 2025, attributed to additional borrowing on the Braidwell Term Loan[135]. - Loss on debt extinguishment increased by $17.6 million, or 100%, during the three months ended March 31, 2025, related to the redemption of 80% of the 2026 Notes[136]. - Gain on derivative liability increased by $17.4 million, or 100%, during the three months ended March 31, 2025, due to changes in the valuation of the derivative liability associated with the 2030 Notes[137]. Other Income and Tax - Other income increased by $0.2 million, or 186%, to $0.3 million for the three months ended March 31, 2025, primarily due to fluctuations in foreign currency rates[138]. - The income tax benefit for the three months ended March 31, 2025, was $64, a slight decrease from $69 in the same period in 2024, related to the recognition of tax benefits in several jurisdictions[139]. Cash Flow and Liquidity - Cash and cash equivalents increased to $153.2 million as of March 31, 2025, from $138.8 million at December 31, 2024, indicating improved liquidity[144]. - Operating activities used cash of $5.0 million for the three months ended March 31, 2025, primarily due to inventory purchases to support business growth[146]. - Investing activities used cash of $11.6 million for the same period, mainly for the purchase of surgical instruments[147]. - Financing activities provided cash of $30.8 million, primarily from proceeds of the 2030 Notes, offset by the repurchase of 80% of the 2026 Notes[148]. Debt Obligations - As of March 31, 2025, the company had $200.0 million outstanding under the Braidwell Term Loan, maturing on January 6, 2028, with an interest rate of Term SOFR plus 5.75%[149]. - The company had $405.0 million outstanding under the 2030 Notes, accruing interest at 0.75%, with a maturity date of March 2030[152]. - The remaining minimum purchase commitment under an inventory purchase agreement was $8.0 million as of March 31, 2025[154]. Future Outlook - The company anticipates future capital requirements will depend on revenue growth rates and the timing of new product introductions[144]. - The company is exposed to foreign currency exchange risk as its international business expands[142]. - The company has no material financial exposure to any single customer or country outside the U.S. that would significantly hinder liquidity[143].

Financial Data and Key Metrics Changes - The company reported a revenue of $169 million for Q1 2025, representing a 22% increase compared to the prior year [8][12] - Adjusted EBITDA for the quarter was $11 million, equating to a 6% margin, which is an improvement of over 800 basis points year over year [12][20] - Non-GAAP gross margin was 70%, down 50 basis points year over year but up 70 basis points sequentially [10][11] - Free cash use was $15 million, reflecting a $55 million improvement compared to Q1 2024 [14][15] Business Line Data and Key Metrics Changes - Surgical revenue was $152 million, growing 24% year over year, while EOS revenue was $17 million, up 8% [8][10] - Procedural volume growth was 17%, driven by an 18% increase in the number of surgeons utilizing ATEC procedures [9][10] - Average revenue per procedure grew by 6%, indicating effective capture of procedural revenue opportunities [9] Market Data and Key Metrics Changes - Same store sales grew 23% year over year, demonstrating significant growth in established markets [10][11] - The company experienced record order growth for EOS, with a 28% year over year increase in the order book [10] Company Strategy and Development Direction - The company is focused on creating clinical distinction through innovative procedural solutions that improve patient outcomes [22][24] - ATEC aims to minimize surgical variables through technology, expanding its sales force and enhancing field operations [24][26] - The strategy includes a strong commitment to informatics and automated alignment planning to improve surgical predictability [26][36] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in achieving cash flow positivity for the full year 2025, with expectations of continued strong revenue growth [15][18] - The company anticipates revenue growth of 20% for the full year 2025, with surgical revenue growth of 21% [18][20] - Management noted that the current economic environment has not negatively impacted demand, with a robust backlog of procedures [100][101] Other Important Information - The company successfully refinanced its 2026 convertible note, extending maturity and maintaining a low coupon rate [15] - The company is committed to maintaining disciplined cost management while investing in growth drivers [11][12] Q&A Session Summary Question: Market size and competitive dynamics for the new Corpectomy system - Management indicated that they are the only company offering this procedure in the prone position, which provides unique advantages [39][40] Question: Tariff exposure in 2025 - The company expects low single-digit million impacts on cost of goods sold due to tariffs, primarily affecting EOS equipment [50][51] Question: Update on robot launch plan - The robot is in the alpha phase, with plans for an end-of-year launch, and integration with navigation systems is ongoing [55][92] Question: Trends in cash outlay and cash use - The company achieved cash use at the low end of the expected range and anticipates positive cash flow in the latter half of 2025 [61][63] Question: Competitive dynamics in the spine market - Management noted that the company is positioned as the largest pure play spine company, with a strong focus on improving the ecosystem for spine surgery [66][69] Question: Salesforce productivity and performance - The company reported a 23% growth in same store sales, indicating effective performance from newly recruited sales representatives [78][79] Question: EOS placements and portfolio pull-through - Most EOS placements are in new accounts, with significant growth expected in complex procedures [84][86] Question: Overall market volumes and ASC growth - The market is healthy, with good volume trends, and the company sees potential for growth in Ambulatory Surgery Centers (ASCs) over time [88][90] Question: International market expansion - The company remains bullish on international markets like Australia and Japan, focusing on profitable growth without a large infrastructure [105][107]

Financial Performance - Surgical revenue reached $152 million, a 24% increase[5] - Total revenue was $169 million, representing a 22% growth[5] - Adjusted EBITDA was $11 million, an increase of $14 million year-over-year[8] - Adjusted EBITDA as a percentage of sales improved by 840 basis points to 6%[8] - The company reduced Q1 free cash use by $55 million year-over-year[11] Outlook - The company anticipates surgical revenue of $658 million, a 21% increase for 2025[16] - EOS revenue is projected to be $76 million, a 13% increase for 2025[16] - Total revenue for 2025 is expected to be $734 million, a 20% increase[16] - The company is on track to deliver positive free cash flow for the full year 2025[3] Balance Sheet - Cash reserves stand at $153 million[11] - Available borrowing capacity is $60 million, resulting in total cash and available cash of $213 million[11]

Exhibit 99.1 ATEC Reports First Quarter 2025 Financial Results And Raises Full-Year Guidance Surgical revenue grew 24%; total revenue grew 22% Full-year revenue and profitability guidance increased Successfully refinanced convertible debt to 2030 maturity CARLSBAD, Calif., May 1, 2025 – Alphatec Holdings, Inc. (Nasdaq: ATEC), a provider of innovative solutions dedicated to revolutionizing the approach to spine surgery, today announced financial results for the quarter ended March 31, 2025, and recent corpor ...

Group 1 - The focus has shifted towards offshore drilling, supply industry, and shipping, including tankers, containers, and dry bulk [1] - The fuel cell industry is being monitored as it is still in its early stages of development [1] Group 2 - The individual has extensive experience in auditing with PricewaterhouseCoopers before transitioning to day trading nearly 20 years ago [2] - Successfully navigated significant market events such as the dotcom bubble, the aftermath of the World Trade Center attacks, and the subprime crisis [2]

Financial Data and Key Metrics Changes - Total revenue for Q4 2024 was $177 million, representing a 28% increase year-over-year and a 17% sequential increase [13] - Full year 2024 total revenue reached $612 million, up 27% compared to the prior year [24] - Adjusted EBITDA for Q4 was $21 million, equating to a 12% margin, with over 1,000 basis points of improvement year-over-year [20] - Non-GAAP gross margin was 70%, flat compared to the previous year [16] - Free cash flow generated in Q4 was $9 million, marking the first cash flow since the transformation [23] Business Line Data and Key Metrics Changes - Surgical revenue for Q4 was $157 million, up 28% year-over-year, with procedural volume growth of 19% and average revenue per procedure growth of 7% [13][14] - EOS revenue for Q4 was $20 million, up 32% year-over-year, driven by robust demand and record order volume [15] - Surgical revenue for the full year was $545 million, a 29% increase compared to 2023 [24] Market Data and Key Metrics Changes - The company holds an 8% market share in the spine market, indicating significant growth potential [6] - Surgeon adoption grew by 19% on a five-year CAGR, with procedural volume growth at 25% [7] Company Strategy and Development Direction - The company aims to revolutionize spine surgery by improving procedural durability and predictability through informatics [40][41] - The focus is on leveraging unique technologies and clinical distinctions to capture market share in a disrupted environment [56][58] - Plans for 2025 include a revenue growth target of approximately $732 million, with surgical revenue growth of 21% [28] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the company's ability to deliver on financial commitments and translate revenue growth into profit and cash flow [21][34] - The company is optimistic about the growth potential in Japan, having conducted its first surgeries there [11][125] - Management highlighted the importance of operational discipline and efficiency improvements in driving profitability [19][78] Other Important Information - The company is positioned as the largest pure-play spine company, focusing exclusively on spine-related products and technologies [45] - The introduction of EOS Insight software is expected to enhance growth and adoption rates [102][106] Q&A Session Summary Question: Assurance on spending in 2025 amidst industry disruption - Management indicated that previous investments have been made and there are no plans for outsized expenses that could undermine financial goals [50] Question: Potential benefits from a competitor's sale of its spinal implants business - Management sees disruption as an opportunity and believes their informatics platform positions them favorably to attract talent from competitors [56][58] Question: International plans for 2025, particularly in Japan - Management emphasized a disciplined approach to entering the Japanese market, focusing on long-term growth rather than immediate gains [62] Question: Growth potential of PTP and LTP offerings - Management believes they are in the early stages of growth for PTP and LTP, with significant market opportunities ahead [70][72] Question: Efficiencies targeted in SG&A - Management discussed deliberate organizational reductions and improved operational efficiency, which are expected to continue benefiting the bottom line in 2025 [76][78] Question: Strategy for share capture and regional field team upgrades - Management noted ongoing improvements in sales force effectiveness and the need for further expansion in underrepresented geographies [83][86] Question: Competitive positioning with upcoming robotic technology - Management views robotics as part of a broader solution to surgical challenges, emphasizing the importance of systemic variables in surgical outcomes [91][92] Question: Opportunities in pediatric surgery - Management acknowledged being underpenetrated in pediatric surgery but sees potential for growth leveraging existing EOS technology [100][118] Question: Growth expectations for EOS - Management anticipates continued growth for EOS, with expectations for increased adoption and monetization through implant pull-through [102][106]