Alphatec Holdings, Inc. is a medical technology firm dedicated to engineering and advancing solutions for the surgical management of spinal conditions. Its ...
Alphatec Holdings, Inc. is a spine-focused medical technology company whose roots date to 1990, when Alphatec Manufacturing was founded by Shunshiro “Roy” Yoshimi. The company has evolved from a contract manufacturing operation into an integrated developer and marketer of technologies intended to improve the treatment of degenerative disease, deformity, trauma, ...Alphatec Holdings, Inc. is a spine-focused medical technology company whose roots date to 1990, when Alphatec Manufacturing was founded by Shunshiro “Roy” Yoshimi. The company has evolved from a contract manufacturing operation into an integrated developer and marketer of technologies intended to improve the treatment of degenerative disease, deformity, trauma, and other spinal conditions. Its corporate headquarters are in Carlsbad, California, and its common stock trades on the Nasdaq Global Select Market under the symbol ATEC. Patrick S. Miles has served as chairman and chief executive officer since October 2017.
The company’s business is organized around products and technologies used throughout the spine-surgery workflow. Its implant portfolio includes interbody devices such as IdentiTi Porous Ti, Transcend Lateral, and Battalion Posterior implants. These products are designed to support fusion procedures and may be used with different surgical approaches. Alphatec also offers fixation systems, including Invictus, SingleStep, Modular Fixation, OsseoScrew, Arsenal, and cervical platforms such as OCT, Trestle Luxe, and Insignia. Additional products include Aspida anterior lumbar plating and the AMP Anti-Migration Plate.
Alphatec’s access and positioning offerings include the Sigma transforaminal lumbar interbody fusion access system, Sigma PTP Access and Patient Positioning System, and Squadron lateral retractor. These products are intended to help surgeons obtain access to the spine, position patients, and manage the surgical corridor. Its Alpha InformatiX platform includes the SafeOp Neural InformatiX System, which is designed to provide neural monitoring and information intended to help reduce the risk of nerve injury during surgery. The company also offers biologics, including structural allografts, demineralized bone matrices, osteoconductive materials, cellular bone matrices, and amniotic tissue barriers. EOS imaging products extend the portfolio into low-dose, full-body imaging and related surgical planning applications.
The company’s commercial model combines its own sales force with independent distributors, primarily in the United States. Medical-device economics are influenced by surgeon adoption, hospital purchasing decisions, reimbursement, regulatory requirements, clinical evidence, inventory management, and sales-force expenses. A typical product bill of materials can include titanium or porous titanium implants, polymer components, instruments, packaging, sterilization, and specialized electronic or imaging hardware, depending on the product category. Alphatec does not publicly disclose a single standardized BOM or unit-cost structure for its entire portfolio because products vary substantially.
The supplied financial snapshot indicates strong gross margins but continuing profitability and cash-flow pressures, including negative trailing net income, negative free cash flow, substantial leverage, and significant research, development, and selling costs. These metrics reflect the investment required to commercialize new technologies, build surgeon adoption, support clinical education, and maintain a broad product platform. With approximately 913 employees, Alphatec’s strategic objective is to expand its differentiated spine ecosystem, increase procedure adoption, improve patient outcomes, and establish further market leadership through organic innovation and integrated surgical solutions.
YoYYoY means Year-over-Year. It compares the latest annual value with the previous annual value to show long-term trend strength.
QoQQoQ means Quarter-over-Quarter. It compares the latest quarter with the immediately previous quarter to show short-term momentum changes.
RevenueThe total money that came through the front door from selling things, before paying a single bill. Think of it as the grand total of every credit card swipe from customers. (YoY compares this year to last year's performance, while QoQ compares the current three months to the previous three).
$764.2M
+25.0%
+11.1%
Net IncomeThe absolute bottom line. If the company paid every single supplier, employee, banker, and tax collector, this is the actual money left in their pocket at the end of the day.
$-143.4M
+11.6%
+24.0%
Gross MarginThe basic markup. If they sell a $100 pair of sneakers, this percentage tells you how much of that price tag is profit right after paying for the rubber and shoelaces, but before paying for things like store rent or TV commercials.
+69.6%
+0.3%
+18.2%
Operating MarginThe 'day job' efficiency score. Out of every dollar a customer spends, this shows how many cents the company keeps after making the product AND paying for all the everyday corporate overhead (like salaries, marketing, and keeping the lights on).
-10.7%
+51.7%
+92.2%
Net MarginThe final take-home percentage. When you strip away every conceivable cost, tax, and interest payment, this is the exact number of cents the company truly gets to keep from every dollar in sales.
-18.8%
+29.2%
+31.6%
Free Cash FlowThe holy grail of corporate cash. It's the spendable, physical money left over after the business pays for its daily operations AND buys the big, expensive upgrades (like new factories or servers) it needs to survive. This is the 'free' money they can use to pay dividends or buy back stock.
$2.8M
+102.0%
+105.4%
FCF MarginThe ultimate cash conversion rate. It shows how good the company is at turning regular sales directly into cold, hard, spendable cash. A high percentage means the business is an absolute cash-printing machine.
+0.4%
+101.6%
+104.8%
Debt / EquityThe financial risk gauge. It compares how much of the company's empire was built using borrowed money (loans) versus the owners' own money (shareholders). A high number means they are heavily leveraged and playing a riskier game; a low number means they are playing it safe.
1720.7%
-73.4%
-251.5%
Current RatioThe 12-month survival check. It simply compares the cash they have right now (plus things they can quickly turn into cash) against the immediate bills they absolutely must pay this year. A score above 1 means they have enough in the wallet to cover the upcoming bills without panicking.
2.06x
-24.6%
-0.6%
Total AssetsThe absolute size of the company's empire. It bundles together absolutely everything of value they own—from the cash in the register and the inventory in the warehouse, to the software patents in the vault and the factories on the ground.
Operator: Good afternoon, everyone, and welcome to the webcast of ATEC's Second Quarter Financial Results. We would like to remind everyone that participants on the call will make forward-looking statements. These statements are based on current expectations and are subject to uncertainties that could cause actual results to differ materially. These uncertainties are detailed in documents filed regularly with the SEC. During this call, you may hear the company refer to non-GAAP or adjusted measures. Reconciliations of these measures to U.S. GAAP can be found in the supplemental financial tables included in today's press release, which identify and quantify all excluded items and provide management's view of why this information is useful to investors. Leading today's call will be ATEC's Chairman and CEO, Pat Miles; and CFO, Todd Koning. Now I'll turn the call over to Pat Miles.
Patrick Miles: Thank you much. Appreciate it. Welcome to our Q2 2026 financial results call. There will be some forward-looking statements, so please review at your leisure. This quarter reflects a solid performance in both growth and profitability. We did $214 million in Q2, up 15%, with surgical up 17%, cases were up about 20%, and surgeons about 24%. Those are the leading indicators that affirm that this is both a utilization story and an adoption story. We're adding surgeons. They are doing more with us. The business is working and we are scaling. The quarter also showed strong leverage. We generated $36 million of adjusted EBITDA, up $15 million sequentially at a 17% margin, while producing positive cash flow. When you step back, this is exactly the compounding engine we've been building. More surgeons, more cases, more platform pull-through, and now it's dropping to the bottom line, creating profitable growth. EOS came in at $17 million for the quarter. Fundamentally, EOS affords us access, and as importantly, accelerated hardware usage from EOS Insight when it goes live. I'll come back to that later. Todd's going to take you through the numbers, and then I'll walk you through the catalysts that give us more enthusiasm today than ever before. We are just getting started. Over to you, Todd.
J. Koning: Thank you, Pat. The second quarter results reflect the continued strength and consistency of the company we are building. We delivered strong revenue growth, significant profitability expansion, and positive free cash flow, extending our track record of converting top-line performance into meaningful financial results through disciplined execution and scale. We've been very deliberate in how we allocate resources, invest in growth initiatives, improve asset efficiency, and leverage our infrastructure as the business grows. That discipline continues to translate revenue growth into expanding EBITDA margins and cash generation. Consistent with recent quarters, we continue to see robust surgeon adoption and procedural volume growth, clear indicators of long-term demand …
