Net Revenue

+40% (from $37,613K in Q4 2023 to $52,667K in Q4 2024)

Strong revenue growth driven by increased volume in core business segments (notably Trauma and Deformity and Scoliosis), bolstering overall sales compared to Q4 2023. This acceleration reflects both organic expansion and potential benefits from previous period momentum. " "

Gross Profit

+33% (from $26,714K to $35,565K)

Gross profit increased in line with improved net revenue, although the slightly lower growth rate compared to revenue indicates some margin pressure, likely due to evolving product mix and associated cost of goods sold dynamics relative to Q4 2023. " "

Operating Expenses

+42% (from $34,780K to $49,620K)

A sharp rise in operating expenses reflects higher investments in personnel, integration, and expanded sales and marketing efforts that were initiated in previous periods, which now intensified as the business scaled, outpacing revenue growth. " "

Operating Loss

Widened by 74% (from -$8,066K to -$14,055K)

Operating loss deterioration is mainly due to increased expenses exceeding the gross profit gains, indicating that cost escalations (personnel, integration, and other non-recurring costs) are not yet offset by the revenue expansion seen since Q4 2023. " "

Net (Loss) Income

Deepened to -$16,069K (from -$6,691K)

Net loss worsened over 2.4× primarily as a result of the expanded operating expenses and margin compression, compounded by a reduction or absence of other income items that previously helped mitigate losses in Q4 2023. " "

Geographic Revenue (U.S./International)

U.S. $42.89M (≈81% of total); International $9.77M

Geographic revenue remains heavily weighted to the U.S. (≈81%), underscoring domestic market strength, while international markets continue to contribute modestly. This distribution is consistent with prior period trends, suggesting that while domestic growth drives overall revenue, international expansion remains an ongoing focus. " "

Business Segment Revenue

Trauma and Deformity: $36.39M; Scoliosis: $15.68M; Sports Medicine/Other: $0.58M

Segment contributions show that Trauma and Deformity remains the dominant revenue driver, Scoliosis has experienced significant acceleration, and Sports Medicine/Other continues to be a minor component. These dynamics echo the historical pattern where core segments fuel growth, but with evolving emphasis that is now more pronounced in Q4 2024. " " "

Revenue

FY 2025

"$202 million to $204 million, YoY growth 36%–37% " " "

"$235 million to $242 million, YoY growth 15%–18% " " "

raised

Revenue growth

FY 2025

"36%–37% " " "

"15%–18% " " "

lowered

Gross Margin

FY 2025

"74% to 75% " "

"72% to 73% " "

lowered

Adjusted EBITDA

FY 2025

"$8 million to $9 million " "

"$15 million to $17 million " " "

raised

New Set Deployment

FY 2025

"Less than $20 million " "

"Approximately $15 million " " "

lowered

Seasonal Virus Impact Assumptions

FY 2024

"Assumes same reported RSV and flu cases as last fall " "

"no current guidance"

no current guidance

EU MDR Certification

FY 2024

"Anticipated to be finalized by mid‑2025 " "

"no current guidance"

no current guidance

Free Cash Flow

FY 2025

"no prior guidance"

"First quarter of positive free cash flow in Q4 2025 " " "

no prior guidance

Tariffs and Government Changes

FY 2025

"no prior guidance"

"Assumes no impact from tariffs; minimal effect " "

no prior guidance

OPSB Growth and Clinic Expansion

Consistently highlighted in Q1–Q3 as a rapidly growing business with aggressive territory expansion, robust product pipeline, and early clinic acquisitions driving long‐term scale " " "

Q4 emphasized rapid revenue growth, manufacturing scaling for DF2, and strategic greenfield clinic expansions with clear guidance for 2025 " " "

Steady and intensifying growth focus, with increasing operational scale and confidence in nationwide expansion " " " "

7D Technology in Scoliosis Segment

Q1 and Q3 calls noted early placements and strong surgeon feedback, with early revenue contributions and a growing installed base " " (Q2 had general positive mentions outside scoliosis)

Q4 call reinforced that 7D technology is a key revenue driver with consistent placements and strong impact on scoliosis revenue growth for future quarters "

Evolving positive sentiment with stronger and more consistent deployment, reinforcing its role as a strategic growth lever " " "

High‐Margin Product Performance (DF2, PNP Tibia, etc.)

From Q1 to Q3, high‐margin products were repeatedly praised for exceeding sales expectations and providing robust margins despite early launch challenges " " "

Q4 reiterated exceptional performance, noting DF2’s rapid demand, expanded indications, and PNP Tibia’s record sales as central to future growth " " " "

Consistently strong performance with incremental improvements in market acceptance and supply chain scaling, reinforcing its strategic importance " " " "

Trauma, Deformity, and Legacy Spine/Trauma Business Dynamics

Across Q1–Q3, this segment was characterized by strong revenue growth, successful set deployments, and a gradual shift from legacy products toward new technology launches " " "

Q4 emphasized continued robust domestic and international growth, with strategic shifts to focus on new products and reduced reliance on legacy inventory " " "

Solid and evolving dynamics with a maintained growth trajectory, while transitioning from legacy-heavy deployments to newer, higher-margin product innovations " " "

Margin and Cost Pressures Impacting Profitability

Q1–Q3 discussions pointed to declining gross margins due to product mix changes, reclassification of expenses, and rising operating costs despite some EBITDA improvements " " "

Q4 reported a slight decline in gross margin (68% vs. 71% YoY) mainly due to reclassification adjustments and strategic production changes, with optimism for stabilization at 72–73% over the coming years " " "

Ongoing margin pressures due to cost reclassifications and increased expenses, yet management remains cautiously optimistic about near‐term stability and potential margin uplift " " "

International Revenue and Market Challenges

Q1–Q3 highlighted strong international growth driven by robust performance in scoliosis and T&D, yet noted challenges from currency fluctuations, regulatory hurdles, and prior-year stocking anomalies " " "

Q4 recorded moderate 5% YoY international revenue growth with continued challenges in South America and pending EU MDR audit outcomes, despite strong non-LatAm performance " " "

Continued growth with mixed challenges; international markets remain promising but are tempered by regulatory delays and currency-related issues " " "

Seasonal and External Healthcare Factors (RSV, Flu, Medicaid Changes)

Q1–Q3 addressed seasonality and RSV/flu impacts (and even hurricanes in Q3) affecting surgery volumes with cautious outlooks on summer performance; Medicaid changes were not previously mentioned " " "

Q4 expanded the discussion by reaffirming seasonal patterns (e.g. summer and December peaks) and introduced Medicaid coverage changes as a new factor to monitor, while still acknowledging RSV/flu impacts " "

Seasonality remains a constant risk, with the added nuance of monitoring Medicaid-related changes emerging in Q4, potentially affecting future demand " "

New Product Launches and Regulatory Hurdles (Early Onset Scoliosis, EU MDR Delays)

Q1–Q3 consistently covered a robust pipeline including EOS devices (RESPONSE, eLLi, Vertiglide), PNP Tibia, DF2, and new external fixation systems; regulatory challenges were acknowledged, particularly around FDA pathways and early delays " " "

Q4 maintained focus on new launches with strong momentum in scoliosis and fusion implant systems while highlighting ongoing regulatory hurdles—specifically EU MDR certification delays expected mid-2025—and slight timing adjustments for U.S. approvals " "

Persistent pipeline strength combined with regulatory hurdles that remain a challenge; growth opportunities continue but require managing delays and compliance issues effectively " " "

Capital Expenditure Reductions on Set Deployments in Legacy Segments

Q1–Q3 repeatedly mentioned efforts to limit new set deployments to less than $20 million, reflecting a gradual shift away from legacy capital-intensive approaches " "

Q4 confirmed that set deployment remains under $20 million, with a strategic focus on reducing legacy inventory investments to drive cash flow improvements toward 2026 " "

Consistent emphasis on capital efficiency, with ongoing reductions in legacy set deployments as a strategic step toward achieving cash flow breakeven " " "