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Business segment information (Tables)

9 Months Ended

Sep. 30, 2024

Segment Reporting [Abstract]

Summary of EBITDA by Reporting Segment

The following table presents adjusted EBITDA, the primary metric used in managing the Company, by reporting segment:

		Three Months Ended September 30,								Nine Months Ended September 30,
(Unaudited, U.S. Dollars, in thousands)		2024				2023				2024				2023
Adjusted EBITDA by reporting segment
Global Spine		$	26,795			$	22,593			$	74,373			$	58,832
Global Orthopedics			3,271				477				1,958				386
Adjusted EBITDA		$	30,066			$	23,070			$	76,331			$	59,218
Reconciling items:
Corporate operating expenses		$	10,886			$	9,549			$	32,853			$	32,574
Interest expense, net			5,210				1,576				14,711				4,131
Depreciation and amortization			15,173				13,097				44,067				39,094
Share-based compensation expense			6,531				6,274				25,290				32,540
Foreign exchange impact			(1,176	)			1,909				1,263				1,057
SeaSpine merger-related costs			2,616				5,416				12,992				34,362
Strategic investments			39				484				470				1,454
Acquisition-related fair value adjustments			5,017				7,122				15,351				26,907
Interest and loss on investments			3,567				429				5,120				429
Litigation and investigation costs			8,335				3,851				10,318				5,611
Succession charges			505				(92	)			8,061				170
Medical device regulation			—				1,840				—				7,519
Loss before income taxes		$	(26,637	)		$	(28,385	)		$	(94,165	)		$	(126,630	)

Schedule of Depreciation and Amortization by Reporting Segment

The following table presents depreciation and amortization by reporting segment:

		Three Months Ended September 30,								Nine Months Ended September 30,
(Unaudited, U.S. Dollars, in thousands)		2024				2023				2024				2023
Global Spine		$	11,512			$	10,255			$	34,484			$	30,222
Global Orthopedics			2,964				1,823				7,363				5,171
Corporate			697				1,019				2,220				3,701
Total		$	15,173			$	13,097			$	44,067			$	39,094

Summary of Net Sales by Geographic Destination

The table below presents net sales by geographic destination for each reporting segment and for the consolidated Company:

		Three Months Ended September 30,								Nine Months Ended September 30,
(Unaudited, U.S. Dollars, in thousands)		2024				2023				2024				2023
Global Spine
U.S.		$	158,036			$	145,764			$	469,092			$	432,581
International			8,068				8,588				26,339				28,953
Total Global Spine			166,104				154,352				495,431				461,534
Global Orthopedics
U.S.			8,604				7,482				24,500				21,341
International			21,898				22,172				63,903				63,351
Total Global Orthopedics			30,502				29,654				88,403				84,692
Consolidated
U.S.			166,640				153,246				493,592				453,922
International			29,966				30,760				90,242				92,304
Net sales		$	196,606			$	184,006			$	583,834			$	546,226

The following data includes net sales by geographic area:

		Three Months Ended September 30,								Nine Months Ended September 30,
(Unaudited, U.S. Dollars, in thousands)		2024				2023				2024				2023
U.S.		$	166,640			$	153,246			$	493,592			$	453,922
Italy			5,142				4,552				15,401				14,669
France			2,996				2,934				9,022				8,205
United Kingdom			2,937				2,932				8,191				8,252
Germany			2,165				3,268				6,663				8,627
Brazil			1,096				1,842				4,332				4,607
Others			15,630				15,232				46,633				47,944
Net Sales		$	196,606			$	184,006			$	583,834			$	546,226

Summary of Property, Plant and Equipment of Reporting Segments by Geographic Area

The following data includes property, plant, and equipment by geographic area:

(U.S. Dollars, in thousands)		September 30, 2024				December 31, 2023
		(Unaudited)
U.S.		$	131,653			$	142,727
Italy			9,636				10,187
Germany			2,197				3,030
Others			3,199				3,116
Total		$	146,685			$	159,060

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Tabular disclosure of long-lived assets, excluding financial instruments, long-term customer relationships of a financial institution, mortgage rights, deferred policy acquisition costs, and deferred tax assets, by geographic areas located in the entity's country of domicile and foreign countries in which the entity holds assets.

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