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Business segment information
 9 Months Ended
Sep. 30, 2025
Segment Reporting [Abstract]  
Business segment information

10. Business segment information

The Company's operations are managed through two reporting segments: Global Spine and Global Orthopedics. These reporting segments represent the operating segments for which the President and Chief Executive Officer, who is also the Chief Operating Decision Maker ("CODM"), reviews financial information and makes resource allocation decisions among businesses. The primary metric used by the CODM in managing the Company is adjusted earnings before interest, tax, depreciation, and amortization ("adjusted EBITDA", a non-GAAP financial measure). Adjusted EBITDA represents earnings before interest income (expense), income taxes, depreciation, and amortization, and excludes the impact of share-based compensation, gains and losses related to changes in foreign exchange rates, charges related to the SeaSpine Merger and other strategic investments, restructuring costs and impairments related to M6 product lines, acquisition-related fair value adjustments, gains and/or losses on investments, litigation and investigation charges, succession charges, and refunds associated with the employee retention credit established by the Coronavirus Aid, Relief, and Economic Security Act.

Corporate activities are comprised of operating expenses not directly identifiable within the two reporting segments, such as human resources, finance, legal, and information technology functions. The Company neither discretely allocates assets, other than goodwill, to its operating segments nor evaluates the operating segments using discrete asset information.

Global Spine

The Global Spine reporting segment offers two primary product categories: (i) Bone Growth Therapies and (ii) Spinal Implants, Biologics, and Enabling Technologies.

The Bone Growth Therapies product category manufactures, distributes, sells, and provides support services for market-leading bone growth stimulation devices that enhance bone fusion. These Class III medical devices are indicated as an adjunctive, noninvasive treatment to improve fusion success rates in the cervical and lumbar spine as well as a therapeutic treatment for non-spinal, appendicular fractures, treating both fresh or nonunion fractures. These products are sold almost exclusively in the U.S., using distributors and direct sales representatives to provide our devices to healthcare providers and their patients.

Spinal Implants, Biologics, and Enabling Technologies comprises (i) a broad portfolio of spine fixation implant products used in surgical procedures of the spine, (ii) one of the most comprehensive biologics portfolios in both the demineralized bone matrix and cellular allograft market segments, and (iii) image-guided surgical solutions to facilitate degenerative, minimally invasive, and complex surgical procedures. Spinal Implants, Biologics, and Enabling Technologies products are sold through a network of distributors and sales representatives to hospitals and healthcare providers on a global basis for Spinal Implants and Enabling Technologies, and primarily within the U.S. for Biologics.

Global Orthopedics

The Global Orthopedics reporting segment offers products and solutions for the underserved limb reconstruction market that encompasses four pillars: deformity correction, limb lengthening, complex fracture management, and limb preservation. This reporting segment specializes in the design, development, and marketing of external and internal fixation orthopedic products that are coupled with enabling digital technologies to serve the complete patient treatment pathway. The Company sells these products worldwide through a global network of distributors and sales representatives to hospitals, healthcare organizations, and healthcare providers.

 

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

 

 

Three Months Ended September 30, 2025

 

Nine Months Ended September 30, 2025

 

(U.S. Dollars, in thousands)

 

Global Spine

 

 

Global Orthopedics

 

 

Total

 

Global Spine

 

 

Global Orthopedics

 

 

Total

 

Segment revenues

 

$

172,063

 

 

$

33,571

 

 

$

205,634

 

$

505,723

 

 

$

96,678

 

 

$

602,401

 

Less:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Non-GAAP Cost of sales

 

 

44,016

 

 

 

12,611

 

 

 

56,627

 

 

131,414

 

 

 

36,748

 

 

 

168,162

 

Non-GAAP Sales, general, and administrative

 

 

93,288

 

 

 

20,379

 

 

 

113,667

 

 

282,995

 

 

 

56,290

 

 

 

339,285

 

Non-GAAP Research and development

 

 

11,051

 

 

 

2,764

 

 

 

13,815

 

 

34,436

 

 

 

8,290

 

 

 

42,726

 

Other segment expenses (benefits)

 

 

2,223

 

 

 

(37

)

 

 

2,186

 

 

9,130

 

 

 

(206

)

 

 

8,924

 

Add:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Non-GAAP Depreciation, amortization, and share-based compensation expense

 

 

9,157

 

 

 

4,037

 

 

 

13,194

 

 

28,843

 

 

 

8,793

 

 

 

37,636

 

Segment Adjusted EBITDA

 

$

30,642

 

 

$

1,891

 

 

$

32,533

 

$

76,591

 

 

$

4,349

 

 

$

80,940

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reconciling items:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Corporate operating expenses

 

 

 

 

 

 

 

 

7,951

 

 

 

 

 

 

 

 

24,283

 

Interest expense, net

 

 

 

 

 

 

 

 

4,681

 

 

 

 

 

 

 

 

13,137

 

Depreciation and amortization

 

 

 

 

 

 

 

 

12,941

 

 

 

 

 

 

 

 

64,243

 

Share-based compensation expense

 

 

 

 

 

 

 

 

7,181

 

 

 

 

 

 

 

 

21,474

 

Foreign exchange impact

 

 

 

 

 

 

 

 

571

 

 

 

 

 

 

 

 

(3,224

)

SeaSpine merger-related costs

 

 

 

 

 

 

 

 

126

 

 

 

 

 

 

 

 

6,142

 

Restructuring costs and impairments related to M6 product lines

 

 

 

 

 

 

 

 

6

 

 

 

 

 

 

 

 

15,485

 

Strategic investments

 

 

 

 

 

 

 

 

227

 

 

 

 

 

 

 

 

4,094

 

Acquisition-related fair value adjustments

 

 

 

 

 

 

 

 

(427

)

 

 

 

 

 

 

 

(1,800

)

Interest and loss on investments

 

 

 

 

 

 

 

 

(10

)

 

 

 

 

 

 

 

(41

)

Litigation and investigation costs

 

 

 

 

 

 

 

 

21,548

 

 

 

 

 

 

 

 

28,619

 

Employee retention credit

 

 

 

 

 

 

 

 

—

 

 

 

 

 

 

 

 

(2,854

)

Loss before income taxes

 

 

 

 

 

 

 

$

(22,262

)

 

 

 

 

 

 

$

(88,618

)

 

 

 

 

 

Three Months Ended September 30, 2024

 

Nine Months Ended September 30, 2024

 

(U.S. Dollars, in thousands)

 

Global Spine

 

 

Global Orthopedics

 

 

Total

 

Global Spine

 

 

Global Orthopedics

 

 

Total

 

Segment Revenues

 

$

166,104

 

 

$

30,502

 

 

$

196,606

 

$

495,431

 

 

$

88,403

 

 

$

583,834

 

Less:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Non-GAAP Cost of sales

 

 

46,140

 

 

 

10,429

 

 

 

56,569

 

 

134,952

 

 

 

33,744

 

 

 

168,696

 

Non-GAAP Sales, general, and administrative

 

 

89,052

 

 

 

16,598

 

 

 

105,650

 

 

273,406

 

 

 

54,120

 

 

 

327,526

 

Non-GAAP Research and development

 

 

14,042

 

 

 

3,088

 

 

 

17,130

 

 

44,106

 

 

 

9,943

 

 

 

54,049

 

Other segment expenses (benefits)

 

 

98

 

 

 

38

 

 

 

136

 

 

(39

)

 

 

(34

)

 

 

(73

)

Add:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Non-GAAP Depreciation, amortization, and share-based compensation expense

 

 

10,024

 

 

 

2,921

 

 

 

12,945

 

 

31,367

 

 

 

11,328

 

 

 

42,695

 

Segment Adjusted EBITDA

 

$

26,796

 

 

$

3,270

 

 

$

30,066

 

$

74,373

 

 

$

1,958

 

 

$

76,331

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reconciling items:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Corporate operating expenses

 

 

 

 

 

 

 

 

10,886

 

 

 

 

 

 

 

 

32,853

 

Interest expense, net

 

 

 

 

 

 

 

 

5,210

 

 

 

 

 

 

 

 

14,711

 

Depreciation and amortization

 

 

 

 

 

 

 

 

15,173

 

 

 

 

 

 

 

 

44,067

 

Share-based compensation expense

 

 

 

 

 

 

 

 

6,531

 

 

 

 

 

 

 

 

25,290

 

Foreign exchange impact

 

 

 

 

 

 

 

 

(1,176

)

 

 

 

 

 

 

 

1,263

 

SeaSpine merger-related costs

 

 

 

 

 

 

 

 

2,616

 

 

 

 

 

 

 

 

12,992

 

Strategic investments

 

 

 

 

 

 

 

 

39

 

 

 

 

 

 

 

 

470

 

Acquisition-related fair value adjustments

 

 

 

 

 

 

 

 

5,017

 

 

 

 

 

 

 

 

15,351

 

Interest and loss on investments

 

 

 

 

 

 

 

 

3,567

 

 

 

 

 

 

 

 

5,120

 

Litigation and investigation costs

 

 

 

 

 

 

 

 

8,335

 

 

 

 

 

 

 

 

10,318

 

Succession charges

 

 

 

 

 

 

 

 

505

 

 

 

 

 

 

 

 

8,061

 

Loss before income taxes

 

 

 

 

 

 

 

$

(26,637

)

 

 

 

 

 

 

$

(94,165

)

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)

 

2025

 

 

2024

 

 

2025

 

 

2024

 

Global Spine

 

$

9,372

 

 

$

11,512

 

 

$

56,125

 

 

$

34,484

 

Global Orthopedics

 

 

2,986

 

 

 

2,964

 

 

 

6,341

 

 

 

7,363

 

Corporate

 

 

583

 

 

 

697

 

 

 

1,777

 

 

 

2,220

 

Total

 

$

12,941

 

 

$

15,173

 

 

$

64,243

 

 

$

44,067

 

 

Geographical information

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)

 

2025

 

 

2024

 

 

2025

 

 

2024

 

Global Spine

 

 

 

 

 

 

 

 

 

 

 

 

U.S.

 

$

160,143

 

 

$

158,036

 

 

$

474,696

 

 

$

469,092

 

International

 

 

11,920

 

 

 

8,068

 

 

 

31,027

 

 

 

26,339

 

Total Global Spine

 

 

172,063

 

 

 

166,104

 

 

 

505,723

 

 

 

495,431

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Global Orthopedics

 

 

 

 

 

 

 

 

 

 

 

 

U.S.

 

 

10,198

 

 

 

8,604

 

 

 

29,064

 

 

 

24,500

 

International

 

 

23,373

 

 

 

21,898

 

 

 

67,614

 

 

 

63,903

 

Total Global Orthopedics

 

 

33,571

 

 

 

30,502

 

 

 

96,678

 

 

 

88,403

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Consolidated

 

 

 

 

 

 

 

 

 

 

 

 

U.S.

 

 

170,341

 

 

 

166,640

 

 

 

503,760

 

 

 

493,592

 

International

 

 

35,293

 

 

 

29,966

 

 

 

98,641

 

 

 

90,242

 

Net sales

 

$

205,634

 

 

$

196,606

 

 

$

602,401

 

 

$

583,834

 

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)

 

2025

 

 

2024

 

 

2025

 

 

2024

 

U.S.

 

$

170,341

 

 

$

166,640

 

 

$

503,760

 

 

$

493,592

 

Italy

 

 

5,658

 

 

 

5,142

 

 

 

16,357

 

 

 

15,401

 

France

 

 

2,691

 

 

 

2,996

 

 

 

8,500

 

 

 

9,022

 

United Kingdom

 

 

3,645

 

 

 

2,937

 

 

 

9,800

 

 

 

8,191

 

Germany

 

 

2,311

 

 

 

2,165

 

 

 

6,784

 

 

 

6,663

 

Brazil

 

 

1,200

 

 

 

1,096

 

 

 

3,323

 

 

 

4,332

 

Others

 

 

19,788

 

 

 

15,630

 

 

 

53,877

 

 

 

46,633

 

Net Sales

 

$

205,634

 

 

$

196,606

 

 

$

602,401

 

 

$

583,834

 

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

(U.S. Dollars, in thousands)

 

September 30,
2025

 

 

December 31,
2024

 

 

 

(Unaudited)

 

 

 

 

U.S.

 

$

114,879

 

 

$

125,541

 

Italy

 

 

10,064

 

 

 

9,472

 

Germany

 

 

1,552

 

 

 

1,904

 

Others

 

 

3,522

 

 

 

2,887

 

Total

 

$

130,017

 

 

$

139,804