Alphatec Raises Profit Outlook as Margins Expand
The spine-surgery technology company lifted its 2026 adjusted-EBITDA forecast to approximately $140 million.
Alphatec Holdings (ATEC) narrowed its second-quarter loss and expanded margins as surgical volume growth offset a slower revenue trajectory.
Revenue rose 15% from a year earlier to $213.5 million, compared with $185.5 million. That was up from $197 million in the third quarter of 2024 and essentially flat with $213 million in the fourth quarter. The GAAP net loss narrowed to $25.8 million, or 16 cents a share, from $41.1 million, or 27 cents a share, a year earlier.
Surgical revenue increased 17% to $196 million as case volume grew 20%, leaving volume growth ahead of surgical-revenue growth. The segment’s growth rate slowed from 31% in the third quarter of 2024 and 21% in the fourth quarter. Net new surgeon-user growth was 24%, slightly above the fourth quarter’s 23% and below the third quarter’s 26%.
Higher gross margins converted that volume into stronger operating performance. GAAP gross margin widened 260 basis points to 72.2%, while adjusted EBITDA rose to $36.0 million from $23.5 million and its margin expanded 420 basis points to 16.8%. Adjusted EBITDA had totaled $33 million in the fourth quarter and $26 million in the third quarter.
The GAAP operating loss narrowed to $1.9 million from $13.1 million even as operating expenses increased to $156.0 million from $142.2 million. On a non-GAAP basis, Alphatec earned $11 million, up from $9 million in the fourth quarter and $4 million in the third quarter.
Alphatec now expects approximately $140 million of adjusted EBITDA in 2025, up $6 million from its previous forecast and $10 million from its initial January outlook. Revenue guidance remains approximately $882 million, representing 15% growth, after the company earlier projected $890 million and 17% growth.
Expected surgical revenue remains approximately $805 million, while the EOS forecast has fallen to approximately $77 million from $85 million, accounting for the lower total-revenue outlook. Alphatec continues to expect at least $20 million of full-year free cash flow after reporting positive free cash flow in the quarter.
The quarter included an $11.9 million loss on debt extinguishment tied to a refinancing that the company expects will reduce annual interest expense by more than $6 million. Cash fell to $118.7 million at June 30 from $160.8 million at year-end, leaving margin gains and lower prospective interest costs to carry more of the profitability improvement.