Alphatec Spine

Company at a Glance

• Legal name: Alphatec Spine (Alphatec Holdings, Inc.)
• Headquarters: Carlsbad, California
• Industry: Medical technology focused on surgical treatment of spine disorders
• Core focus: Design, development, and advancement of approach-based spine procedures and an expanding informatics platform to support pre-, intra-, and post-operative spine care

What the Company Does

• Develops and commercializes approach-based spine procedures and an integrated ecosystem of imaging, navigation, monitoring, and robotics to improve predictability, durability, and outcomes in spine surgery.
• Builds an informatics ecosystem (IX platform) that connects imaging, planning, intraoperative guidance, and post-operative review.

Key IX components:

• EOS imaging system: full-body, calibrated 2D/3D imaging for diagnostics and surgical planning
• EOS Insight: end-to-end spine care software for alignment assessment, planning, intraoperative guidance, and post-operative review
• SafeOp Neural InformatiX System: intraoperative neuromonitoring (EMG, SSEP, MEP)
• Valence navigation and robotics platform: navigation-enabled robotic assistance
• Ongoing integration to connect IX applications across imaging, planning, and intraoperative guidance

Flagship procedural family:

• Prone TransPsoas (PTP): single-position lateral approach for spinal fusion, enabled by SafeOp neuromonitoring
• Lateral TransPsoas (LTP) and Midline ALIF approaches
• Approach-specific positioning and access systems (e.g., PTP Positioning System)
• Implants and fixation systems, including polyaxial pedicle screw-based systems, porous and 3D-printed titanium implants, expandable interbody devices, and NanoTec surface enhancements

Biologics and graft materials:

• AlphaGRAFT family (DBM, CBM, and related products)
• 3D ProFuse Osteoconductive Bioscaffold
• BioCORE Moldable Bioactive Graft
• Amniotic tissue barrier products

Other major offerings and capabilities:

• Acquired EOS Imaging and added software-enabled planning and analytics
• Acquired SafeOp for advanced neuromonitoring and nerve localization
• Acquired Valence (navigation/robotics) with ongoing integration into spine workflows

Global expansion and product adoption:

• International rollout focused on Australia, New Zealand, and Japan, including LTP and other approaches
• EOS Insight launched in 2024; 2025 enhancements include 3D pediatric modeling for AIS/deformity and AutoDensity bone density assessment

Financial and Operational Highlights (as of/for 2025)

• Revenue: $764.2 million for the year ended December 31, 2025
  • Increase of $152.6 million, or 25%, compared to $611.6 million for the year ended December 31, 2024
• Growth metrics (2025 vs. 2024):
  • Surgical volume grew 22%
  • Average revenue per surgery increased 4%
• Employees: 913 worldwide
  • 706 in the United States
  • 207 outside the United States
  • 411 based in Carlsbad, California
• Profitability and liquidity:
  • Accumulated deficit of $1.4 billion as of December 31, 2025
  • History of net losses and expectation of additional losses in the near term
  • Liquidity sources include cash and cash equivalents of $160.8 million as of December 31, 2025; accounts receivable; cash from operations; and available borrowings under a revolving credit facility
• Intellectual property:
  • U.S. patents issued: 178
  • U.S. patent applications pending: 51
  • Foreign patents issued or pending: 268
  • Trademarks: 35 registered in the U.S.; 29 registered outside the U.S.
• Recent milestones:
  • Valence navigation/robotics platform acquired in 2023
  • EOS Imaging acquisition integrated operationally and regulatorily over prior years
  • SafeOp integrated to support lateral approaches
  • EOS Insight launched in 2024; 2025 enhancements include 3D pediatric modeling and AutoDensity bone density assessment

Business Model and Market Position

• Customers and partners: spine surgeons, hospitals, healthcare systems, and payors
• Distribution: mix of exclusive independent sales agents and direct sales representatives
• Competitive landscape: competes with large medical device companies; differentiation based on approach-specific procedures, the IX platform, and surgeon education programs
• Growth strategy:
  1. Create clinical distinction through approach-based procedures and integrated technologies
  2. Compel surgeon adoption via clinician-focused education and hands-on training (ATEC Experience)
  3. Elevate distribution by expanding exclusive agents and direct sales teams and aligning EOS with field sales
• R&D and manufacturing:
  • Internal R&D combined with surgeon collaboration
  • Outsourced manufacturing to third-party suppliers; reliance on Invibio for PAEK materials in certain spacers
  • Quality controls aligned with FDA and ISO standards; ongoing regulatory compliance including 510(k) and PMA processes where applicable

International and Regulatory Context

• Global operations with an early-stage international footprint in select markets (Australia, New Zealand, Japan)
• Regulatory pathway:
  • Many U.S. products rely on 510(k) clearance; certain higher-risk products may require PMA
  • Ongoing compliance with FDA QSR, labeling, post-market surveillance, adverse event reporting, and other regulatory requirements
• Data and privacy:
  • Cybersecurity program aligned with HITRUST, SOC 2, and NIST frameworks
  • Focus on protecting patient health information and sensitive data across IX platforms and imaging software

Corporate Structure and Business Risks

• Operates as a holding company with significant subsidiary activity; relies on dividends and disclosures from subsidiaries to meet obligations
• Business is capital-intensive and subject to regulatory, reimbursement, and market dynamics that can affect revenues and profitability