Alphatec Holdings, Inc. (ATEC) 2026 Q1 法說會逐字稿

Good afternoon, everyone, and welcome to the webcast of ATEC's first-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.

各位下午好，歡迎收看 ATEC 第一季財務業績網路直播。我們提醒各位，本次電話會議中的發言者將作出前瞻性陳述。這些陳述係基於目前的預期，並受不確定性影響，可能導致實際結果與陳述存在重大差異。相關不確定性已在公司定期向美國證券交易委員會（SEC）提交的文件中詳述。

During this call, you may hear the company refer to non-GAAP or adjusted measures. Reconciliation of these measures to US 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.

在本次電話會議中，您可能會聽到公司提及非 GAAP 或調整後的衡量指標。這些指標與美國 GAAP 的調節表可見於今日新聞稿所附的補充財務表，該等表格已識別並量化所有被排除項目，並提供管理層對於為何該資訊對投資人有用的觀點。

Sell-side analysts planning to ask a question must be registered through the dedicated analyst link included in today's materials. If you have not yet registered, please do so now to be included in the Q&A queue.

計畫提問的賣方分析師必須透過今日資料中所附的專用分析師連結完成註冊。若您尚未註冊，請立即註冊以納入問答環節的排隊序列。

Leading today's call will be the ATEC's Chairman and CEO, Pat Miles; and CFO, Todd Koning.

今日電話會議將由 ATEC 董事長兼執行長 Pat Miles，以及財務長 Todd Koning 主持。

Now, I will turn the call over to Pat Miles.

現在，我把電話會議交給 Pat Miles。

Thanks, Paige. Appreciate it. Welcome to the Q1 2026 financial results call from ATEC. There will be some forward-looking statements, so please review at your leisure.

謝謝你，Paige。感謝。歡迎參加 ATEC 2026 年第一季財務業績電話會議。會中將包含一些前瞻性陳述，請您在方便時自行查閱相關說明。

With that, let me start simple. The business is working and it's scaling. We did $192 million in Q1. This was short of our internal expectation, primarily due to a shortfall in EOS sales performance. Surgical revenue was up 17%, mostly in line with consensus.

那麼，我先從簡單的開始。業務運作良好，而且正在擴張。我們第一季營收為 1.92 億美元。這低於我們內部預期，主要原因是 EOS 銷售表現未達標。手術相關營收成長 17%，大致符合市場共識。

What matters most is what is fueling that growth. Case is up 21%, surgeon's up 23%. That's not only a utilization story, it's an adoption story. We're adding surgeons, and they're doing more with us. We have created a durable growth model.

最重要的是推動這項成長的動能。手術案例數成長 21%，外科醫師數成長 23%。這不僅是使用率的故事，也是採用率的故事。我們正在增加外科醫師，而且他們與我們合作的量也在提升。我們已建立一個具韌性的成長模型。

EOS revenue was $14 million for the quarter. As stated, this was short of our quarterly goal, and we have taken steps to bolster the team in sales, downstream marketing, and EOS support. However, the important thing we are seeing is EOS Insight is evolving into more than a product, but a platform. Growth and adoption of our EOS Insight platform is creating significant momentum. EOS has enabled us to gain access to prestigious institutions and a hunting license within those institutions, which is increasingly paying off for us. We generated $21 million of EBITDA, and yes, we used $11 million of cash, but that was a function of timing and intent. We're leaning into and investing in what's working.

本季 EOS 營收為 1,400 萬美元。如前所述，這低於我們的季度目標；我們已採取措施強化銷售、下游行銷以及 EOS 支援團隊。然而，我們看到的重要趨勢是：EOS Insight 正在演進，不再只是產品，而是一個平台。我們的 EOS Insight 平台之成長與採用正在形成顯著動能。EOS 讓我們得以進入具聲望的機構，並在這些機構內取得「狩獵執照」（hunting license），且正日益為我們帶來回報。我們產生了 2,100 萬美元 EBITDA；是的，我們使用了 1,100 萬美元現金，但那是時點與策略意圖所致。我們正加碼並投資於有效的領域。

When you step back, ATEC has become a compounding engine, more surgeons, more cases, and more platform pull-through. And we're still just at the beginning of what we know we can do.

從更宏觀的角度看，ATEC 已成為一部複利引擎：更多外科醫師、更多案例，以及更多平台帶動的拉動效應（pull-through）。而我們仍只是剛開始發揮我們所知能做到的成果。

With that, I will turn it over to Todd.

接下來，我把時間交給 Todd。

Well, thank you, Pat, and good afternoon, everyone. I'll start with the first-quarter 2026 revenue. Total revenue was $192 million, up 14% year over year, with surgical revenue of $178 million, growing 17%. Sequentially, surgical revenue declined 6%, which was more pronounced than we have historically seen, primarily due to lower revenue per procedure contribution.

謝謝你，Pat，各位下午好。我先從 2026 年第一季營收開始。總營收為 1.92 億美元，年增 14%；其中手術相關營收為 1.78 億美元，成長 17%。按季比較，手術相關營收下滑 6%，降幅較我們過往所見更為明顯，主要因每例手術的營收貢獻較低。

Our strong year-over-year growth continues to be driven by the core elements of our model, which are 21% procedural volume growth, driven by 23% growth in new surgeon users, and continued revenue per procedure expansion within our individual procedures.

我們強勁的年增成長持續由模型的核心要素所驅動：手術量成長 21%，主要來自新外科醫師使用者成長 23%，以及在各項個別手術中每例手術營收的持續擴張。

The consistent trends in net new surgeon additions and strong case volume, both above 20% again this quarter, speak to the ongoing momentum and durability in our surgical business.

本季淨新增外科醫師人數與強勁的案例量皆再次超過 20%，這些一致的趨勢顯示我們手術業務持續的動能與韌性。

Revenue per case declined approximately 3% year over year, driven primarily by mix impacts. In the US, we saw a higher mix of cervical procedures, which have a lower average revenue per case. In addition, our strong OUS performance reduced reported revenue per case by approximately 130 basis points.

每例營收年減約 3%，主要由產品組合（mix）影響所致。在美國，我們看到頸椎手術占比提高，而該類手術的平均每例營收較低。此外，我們強勁的美國以外（OUS）表現，使得報告的每例營收約降低 130 個基點。

Finally, our overall biologics attachment rate was lower than expected. Importantly and consistent with the prior periods, we are seeing strength in core individual procedural ASPs for lateral, ALIF, and cervical, which were up 2%, 4%, and 8%, respectively, year over year.

最後，我們整體生物材料（biologics）搭售率低於預期。重要的是，且與前期一致，我們看到核心個別手術的 ASP（平均銷售價格）表現強勁：側向（lateral）、ALIF 與頸椎分別年增 2%、4% 與 8%。

Turning to EOS, revenue was $14 million, down $3 million year over year, as the number of system deliveries were lower than the prior year period, resulting in lower revenue recognition for the quarter. These results were below our expectations for the quarter, and we have taken steps to address this by strengthening our sales team and downstream marketing function.

談到 EOS，營收為 1,400 萬美元，年減 300 萬美元，原因是系統交付數量低於去年同期，導致本季可認列的營收較少。這些結果低於我們對本季的預期；我們已透過強化銷售團隊與下游行銷職能來加以改善。

The installed base of global EOS units increased by 7% year over year. In the US, the EOSedge installed base, which is a prerequisite for EOS Insight, grew by 39% year over year, and the amount of EOS Insight accounts more than doubled. We continue to see strong utilization trends in these EOSedge accounts and increasing evidence of implant pull-through following EOS Insight adoption. Implant volumes at EOS Insight accounts are increasing meaningfully post go-live, reinforcing the long-term strategic and financial value of the platform.

全球 EOS 設備裝機量（installed base）年增 7%。在美國，作為 EOS Insight 先決條件的 EOSedge 裝機量年增 39%，而 EOS Insight 帳戶數量增加逾一倍。我們持續在這些 EOSedge 帳戶中看到強勁的使用率趨勢，並且在採用 EOS Insight 後，愈來愈多證據顯示植入物的拉動效應（implant pull-through）。EOS Insight 帳戶在上線（go-live）後的植入物量顯著增加，進一步強化該平台的長期策略與財務價值。

Turning to the P&L, gross margin for the quarter was 71.6%, representing over 120 basis points of improvement year over year. This expansion was driven by continued asset efficiency improvements, temporary mix benefit from lower-than-expected EOS and biologic sales, and ongoing cost improvements in operational discipline.

接著看損益表，本季毛利率為 71.6%，年增超過 120 個基點。毛利率擴張主要由持續的資產效率提升、EOS 與生物材料銷售低於預期所帶來的短期組合利多，以及營運紀律下的持續成本改善所驅動。

Non-GAAP operating expenses grew approximately 6% year over year, well below the revenue growth, reflecting continued operating leverage in the business and disciplined management of expenses. First-quarter non-GAAP R&D was $14 million, or 7% of revenue, up slightly year over year as we continue to invest in innovation and launch new procedural solutions.

非 GAAP 營業費用年增約 6%，明顯低於營收成長，反映業務持續的營運槓桿以及對費用的紀律管理。第一季非 GAAP 研發費用為 1,400 萬美元，占營收 7%，年增小幅上升，因我們持續投資創新並推出新的手術解決方案。

Non-GAAP SG&A was $118 million, which grew 6% and was 62% of revenue, improving by 420 basis points year over year, which is primarily driven by improvements in our variable selling costs and slower depreciation growth.

非 GAAP 銷售、一般及行政費用（SG&A）為 1.18 億美元，年增 6%，占營收 62%，年減（改善）420 個基點，主要由可變動銷售成本改善以及折舊成長放緩所帶動。

As a result of the continued top-line revenue growth and disciplined management of expenses, we continued to see margin expansion and profitability improvements. Adjusted EBITDA was $21 million in the first quarter, representing 11% of revenue and growing 97% year over year.

在營收持續成長與費用紀律管理的帶動下，我們持續看到利潤率擴張與獲利能力改善。第一季調整後 EBITDA 為 2,100 萬美元，占營收 11%，年增 97%。

Importantly, we delivered 45% drop-through on incremental revenue, demonstrating the scalability of the business model. Overall, we continue to see meaningful operating leverage, consistent margin expansion, and improving profitability aligned with our long-term plan.

重要的是，我們在增量營收上實現 45% 的 drop-through，展現商業模式的可擴展性。整體而言，我們持續看到顯著的營運槓桿、穩定的利潤率擴張，以及與長期計畫一致的獲利能力提升。

Turning now to the balance sheet, we ended the quarter with approximately $140 million in cash. Free cash use for the quarter was approximately $11 million at the favorable end of our expected range. Our cash flow profile continues to reflect positive operating cash flow with operating cash flow generating cash for the fourth consecutive quarter while continuing to invest in instruments and inventory to support growth.

接著看資產負債表，我們在季末持有約 1.40 億美元現金。本季自由現金使用約 1,100 萬美元，落在我們預期區間的較有利端。我們的現金流輪廓仍反映正向的營運現金流：營運現金流已連續第四季帶來現金流入，同時我們持續投資器械與存貨以支援成長。

Notably, we invested approximately $33 million in inventory and instruments this past quarter to support the demand we are seeing from our 20%-plus growth in surgeon adoption and the corresponding growth in our sales team. Our consistent profitable growth, strong cash generation, and increasingly attractive EBITDA profile, now exceeding $100 million on a trailing 12-month basis, have positioned us to mature our capital structure.

值得注意的是，為支援我們所看到的外科醫師採用率 20% 以上的成長，以及相應的銷售團隊擴張，本季我們在存貨與器械上投資約 3,300 萬美元。我們一貫的獲利性成長、強勁的現金創造能力，以及愈發具吸引力的 EBITDA 輪廓（過去 12 個月已超過 1 億美元），使我們具備條件推動資本結構走向成熟。

As a result of our strong operating performance and continued progression to a more scaled and profitable financial profile, we were able to announce today that we recently entered into a new Term Loan A and revolving credit facility led by JPMorgan and TD Cowen. This new bank facility, which replaces our previous term loan and asset-backed revolver, simplifies our capital structure. It extends maturities to 2031 and reduces interest expense by more than $6 million annually. We estimate this new facility will save the company as much as $35 million in interest over the life of the facility.

由於我們強勁的營運表現，以及持續朝向更具規模且更高獲利能力的財務結構邁進，我們今天宣布，近期已簽訂由摩根大通（JPMorgan）與 TD Cowen 主導的新 Term Loan A 與循環信用額度。這項新的銀行融資安排取代了我們先前的定期貸款與資產擔保循環信貸，並簡化了我們的資本結構。其將到期日延長至 2031 年，並使年度利息費用降低逾 600 萬美元。我們估計，該新融資在其存續期間可為公司節省高達 3,500 萬美元的利息。

At close, the new loan has a rate of SOFR plus 275 basis points. The new facility matures in May 2031. We are very pleased with the bank syndicate we partnered with in this new facility. This transaction reflects the continued maturation of the business and the continued improvement of our capital structure and credit profile.

在交割時，新貸款利率為 SOFR 加 275 個基點。新融資將於 2031 年 5 月到期。我們對於此次融資所合作的銀行聯貸團非常滿意。此交易反映了公司業務的持續成熟，以及我們資本結構與信用狀況的持續改善。

Turning to the revenue outlook, we now expect total revenue for full year 2026 of approximately $882 million, representing 15% growth year over year. This includes surgical revenue of approximately $805 million, unchanged from our prior guidance, representing 17% growth or a $118 million increase year over year. We expect surgical case volume growth in the high-teens and average revenue per case to be flat for the full year.

談到營收展望，我們目前預期 2026 全年總營收約為 8.82 億美元，年增 15%。其中包含手術營收約 8.05 億美元，與先前指引一致，年增 17%，亦即年增 1.18 億美元。我們預期全年手術案例量將以高十幾%的幅度成長，而每例平均營收全年將持平。

We now expect EOS revenue of approximately $77 million, reflecting updated expectations for our EOS business. We take guidance very seriously, and this update reflects our current outlook and a clear, realistic view of near-term performance while reinforcing our confidence in the long-term opportunity.

我們目前預期 EOS 營收約為 7,700 萬美元，反映我們對 EOS 業務的最新預期。我們非常重視財測指引，而此次更新反映我們目前的展望，並以清晰、務實的角度看待短期表現，同時強化我們對長期機會的信心。

Importantly, we are maintaining our surgical revenue guidance, reflecting continued confidence in the underlying demand and growth drivers of the business.

重要的是，我們維持手術營收指引不變，反映我們對業務基本需求與成長驅動因素的持續信心。

To recap our financial outlook, we expect revenue to grow 15% to $882 million for the full year. We continue to expect adjusted EBITDA of approximately $134 million, even with the reduced revenue expectations, which reflect the confidence we have in our profitability progression. This is a 15% margin, representing approximately 35% drop-through on the incremental revenue dollar year over year.

總結我們的財務展望，我們預期全年營收成長 15% 至 8.82 億美元。即使在營收預期下修的情況下，我們仍預期調整後 EBITDA 約為 1.34 億美元，這反映我們對獲利能力持續提升的信心。這相當於 15% 的利潤率，代表相較去年，每增加 1 美元的增量營收約有 35% 轉化為利潤（drop-through）。

For free cash flow, we continue to expect at least $20 million in free cash flow for the full year, with the second quarter expectations for free cash flow to approximate zero. We recognize that adjusting our guidance is a significant decision, and we believe that the updated guidance appropriately reflects our current outlook as we remain laser-focused on delivering the profitable sales growth implied in our 2026 guide.

就自由現金流而言，我們仍預期全年自由現金流至少 2,000 萬美元，且第二季自由現金流預期約為零。我們理解調整指引是一項重大決策，並相信更新後的指引能適切反映我們目前的展望；同時我們仍高度聚焦於交付 2026 年指引所隱含的獲利性銷售成長。

To put our first-quarter financial performance in perspective, we drove 14% overall revenue growth and 17% surgical revenue growth at an annualized scale of approximately $800 million, with strong operating leverage translating into significant profitability expansion while making material improvements to our balance sheet.

為了將第一季的財務表現置於適當脈絡，我們在約 8 億美元的年化規模下，推動整體營收成長 14%、手術營收成長 17%；強勁的營運槓桿帶來顯著的獲利擴張，同時也對資產負債表做出實質改善。

While the quarter didn't live up to our growth expectations, we are confident in our ability to continue to grow at multiples in the market, translating that into profitability and cash flow.

儘管本季未達到我們對成長的預期，我們仍有信心能持續以高於市場的倍數成長，並將其轉化為獲利與現金流。

With that, I'll turn the call back to Pat.

接下來，我把電話交回給 Pat。

Thanks, Todd. Our strategy hasn't changed because we know it works. We start with clinical distinction. If it doesn't matter in the OR, it doesn't matter. But if it makes surgery better in the OR, it matters to us greatly. This is how we have built the best procedural approaches in our industry.

謝謝，Todd。我們的策略沒有改變，因為我們知道它有效。我們從臨床差異化開始。如果在手術室（OR）裡不重要，那就不重要。但如果它能讓手術室裡的手術變得更好，對我們而言就非常重要。這就是我們如何打造出本產業最佳的手術流程方法。

Second is surgeon adoption. We don't sell products; we develop approaches that improve surgery, elevate workflows, and build trust. We know this philosophy is effective because our surgeon demand remains very high.

第二是外科醫師採用。我們不只是賣產品；我們開發能改善手術、提升工作流程並建立信任的方法。我們知道這個理念有效，因為外科醫師對我們的需求仍然非常高。

Third is the sales engine. We're continually assembling and improving upon a sales force that is disciplined, aligned and energized, and built to scale.

第三是銷售引擎。我們持續組建並精進一支紀律嚴明、目標一致且充滿動能、並可擴張規模的銷售團隊。

Put that together, and it's very straightforward; do something clinically meaningful, surgeons adopt, and we scale it. We're not focused on widgets, or as we like to say, the currency of our business. We assemble procedures from the ground up.

把這些結合起來就很直接：做出具臨床意義的事，外科醫師採用，然後我們把它規模化。我們不專注於零件（widgets），或如我們常說的「我們業務的貨幣」。我們從零開始組裝手術流程。

Everything you see here is designed to work together. That's what has driven and will continue to drive our model.

你在這裡看到的一切都是為了彼此協同運作而設計。這正是推動、並將持續推動我們模式的原因。

We don't sell one thing, be it a screw, a plate, an implant, or a rod. We offer procedural approaches that make surgery better. And better procedures over time lead to expanded indications, greater complexity, and increased revenue.

我們不是只賣單一產品，不論是螺釘、鋼板、植入物或棒材。我們提供能讓手術變得更好的手術流程方法。而更好的手術流程，隨著時間推進，會帶來適應症擴大、更高複雜度，以及更高營收。

While we call that a convoyed sales effect, it's really just a result of designing procedures the right way, leading to better patient outcomes. We start in lateral for a reason. because it is where we have the greatest collection of know-how and how we most distinguish. The surgery works. It's reproducible, efficient, and surgeons feel comfortable with it very quickly.

雖然我們把這稱為「護航式銷售效應」（convoyed sales effect），但本質上只是把手術流程以正確方式設計所帶來的結果，進而改善病患預後。我們從側方入路（lateral）開始是有原因的，因為那是我們累積最多專業知識、也最能展現差異化的領域。這個手術是有效的。它可重複、效率高，外科醫師也能很快就感到熟悉與安心。

I was in a case last Friday, an L4-5 spondy. 15 minutes in, discite was restored. In under an hour, the case was done with minimal blood loss and morbidity. That same case used to take four hours, and it was a very different experience, far less reproducible for the surgeon, far less predictable for the patient.

上週五我參與了一台病例，是 L4-5 脊椎滑脫（spondy）。15 分鐘內，椎間盤高度就恢復了。不到一小時就完成手術，失血量與併發症風險都很低。過去同樣的病例要花四個小時，而且體驗截然不同：對外科醫師而言可重複性低得多，對病患而言可預測性也低得多。

PTP has profoundly improved surgery for both surgeon and patient. That's what creates confidence. And once surgeons experience reproducible success in lateral, they don't stay with just that procedure; they expand their utility into cervical, TU lift, posterior fixation, all things across the board.

PTP 已深刻改善外科醫師與病患的手術體驗。這就是信心的來源。而一旦外科醫師在側方入路中體驗到可重複的成功，他們不會只停留在那一種手術；他們會把應用擴展到頸椎、TU lift、後路固定等各方面。

Our growth isn't dependent on just adding incremental surgeons; it's expanding indications for procedures they adopt and moving them to other approaches, which is what happens after they trust you. That's what the model is really about, and that's how it compounds.

我們的成長不僅依賴新增外科醫師；更在於擴大他們所採用手術流程的適應症，並引導他們採用其他方法——這正是建立信任之後會發生的事。這才是這個模式的核心，也是它如何產生複利效應。

EOS continues to be a big deal for us. And while installation timing was a challenge in the quarter, the EOS experience is playing out exactly as we expected.

EOS 對我們而言仍然非常重要。雖然本季安裝時程帶來挑戰，但 EOS 的發展正如我們預期地逐步展開。

First, EOSedge gets us in the door with leading institutions that were hard to impossible for us to access previously. Places like Duke, NYU, HSS, Northwestern, University of Virginia, University of Maryland, just to name a few, then EOS becomes part of the workflow, pre-surgical planning, intraoperative reconciliation, and follow-up.

首先，EOSedge 讓我們得以進入過去難以、甚至幾乎不可能接觸到的頂尖機構。例如 Duke、NYU、HSS、Northwestern、維吉尼亞大學、馬里蘭大學等，僅舉幾例；接著 EOS 便成為工作流程的一部分，涵蓋術前規劃、術中校核與術後追蹤。

Then it starts driving the case volume, insight, patient-specific rods, alignment, and over time, it builds something more valuable than any one product. It's data generation. That's the moat.

接著它開始帶動病例量、洞察（insight）、病患客製化棒材、對位（alignment），並隨著時間推進，建立出比任何單一產品更有價值的東西。那就是資料生成。這就是護城河。

We're already seeing EOS impact, about 30% revenue lift per surgeon after insight adoption. So EOS isn't just additive, it's multiplicative.

我們已經看到 EOS 的影響：在採用 Insight 之後，每位外科醫師的營收提升約 30%。因此 EOS 不只是加法，而是乘法。

What's happening with Insight right now is important. We're moving from imaging to intelligence, 3D alignment, patient-specific planning, starting to predict outcomes, not just react to them. And every case makes the system better. That's how this compounds. We are creating a true structured data advantage.

Insight 目前的進展很重要。我們正從影像走向智慧：3D 對位、病患客製化規劃，開始預測結果，而不只是對結果做出反應。而每一台手術都讓系統變得更好。這就是它如何產生複利效應。我們正在打造真正的結構化資料優勢。

At the core of this is our ability to take EOS imaging and convert it into quantitative, actionable intelligence. It's becoming smarter, more predictive, and more embedded into clinical decision-making. That's how you build clinical distinction. This is where owning the image and translating into data matters.

其核心在於我們能將 EOS 影像轉化為可量化、可執行的智慧資訊。它正變得更聰明、更具預測性，並更深度嵌入臨床決策。這就是你如何建立臨床差異化。這也是為什麼擁有影像並將其轉譯為資料如此重要。

Valence is early, but it's doing exactly what we need it to do. It fits seamlessly into the surgical workflow. It doesn't get in the way. The footprint is very small. It actually makes the case cleaner, and that's everything. If it disrupts the surgeon's workflow, it doesn't get used. We're seeing strong utility, positive surgeon feedback, and real usage. And the same pattern we've seen before. It works, surgeons trust it, it grows. That's how this is playing out.

Valence 還在早期階段，但它正好做到我們需要它做到的事。它能無縫融入手術工作流程。不會礙事。占用空間非常小。它實際上讓整個手術案例更乾淨俐落，而這就是一切。如果它會干擾外科醫師的工作流程，就不會被使用。我們看到很強的實用性、外科醫師正向回饋，以及實際使用。而且呈現出我們以前看過的同樣模式。它有效、外科醫師信任它、它就成長。這就是目前的發展方式。

Japan looks very familiar in a good way. We're leading with lateral, building early confidence, and seeing surgeons engage. I have seen it firsthand. I was in the OR a couple of weeks ago, and the surgery was methodical, predictable, and reproducible. This is the same pattern; they adopt, they do more, they expand. It's early, but it's exactly what we wanted to see.

日本的情況在好的方面看起來非常熟悉。我們以側向（lateral）為切入點，建立早期信心，並看到外科醫師投入參與。我親眼見過。我在幾週前進了手術室，手術過程有條不紊、可預期、且可重複。這是同樣的模式；他們採用、做得更多、再擴大。雖然還早，但這正是我們希望看到的。

In closing, when I think about ATEC, it's pretty straightforward. We're focused, 100% in spine. We built real leadership in lateral. We're doing the same thing in deformity with EOS, and we put the infrastructure in place to scale.

最後總結一下，當我想到 ATEC，其實很直接。我們專注，100% 聚焦脊椎。我們在側向（lateral）建立了真正的領導地位。我們也正以 EOS 在脊椎畸形（deformity）領域做同樣的事，並且已建置好可擴張的基礎設施。

Most importantly, we're growing and becoming more profitable at the same time. We've established a system and ecosystem that builds upon itself.

最重要的是，我們在成長的同時也變得更有獲利能力。我們已建立一套能自我強化、持續累積的系統與生態系。

Last point, why people are coming here, surgeons and reps, because we care about what they care about. We don't push widgets, we give them procedures and increasingly information. That improves predictability and patient outcomes. That drives surgeon interest and adoption, leading to more cases. That, in turn, attracts sales agents and builds careers. And that's why ATEC is the preferred destination in spine.

最後一點，為什麼外科醫師和業務代表會來這裡，因為我們在乎他們在乎的事。我們不推銷小玩意，我們提供的是手術流程，並且越來越多地提供資訊。這能提升可預測性與病患治療結果。這會帶動外科醫師的興趣與採用，進而帶來更多案例。反過來，這也吸引銷售代理並建立職涯。這就是為什麼 ATEC 是脊椎領域的首選目的地。

With that, we will take questions.

接下來，我們開始提問。

(Operator Instructions) Mathew Blackman, TD Cowen.

（接線員指示）TD Cowen 的 Mathew Blackman。

Good afternoon, everybody. Can you hear me okay?

各位下午好。你們聽得到我嗎？

We can hear you, yeah.

聽得到，對。

You guys hear me?

你們聽得到我嗎？

Yes, go ahead, Mathew. Thank you.

是的，請說，Mathew。謝謝。

Thank you. So I guess this is not really a fair question, but I do need to ask it in the context of the LRP 2027, you feel confident, comfortable today reaffirming that billion-dollar revenue number. Obviously, all the other pieces feel like they're in a good place. But the billion-dollar top line, particularly in the context of, I think consensus is at about 4% or 5% higher than that. Just any thoughts on that 2027 LRP number where consensus is relative to how things shook out here in the first quarter. And relative to the new guide, just the big step up that's implied to get to that 2027 number, particularly that consensus number.

謝謝。我想這其實不太公平的問題，但在 2027 年長期計畫（LRP）的脈絡下我必須問：你們今天是否仍有信心、也覺得自在地重申那個 10 億美元的營收數字。顯然其他各項看起來都在不錯的位置。但 10 億美元的營收目標，尤其是在我認為市場一致預期大約比這高 4% 到 5% 的情況下。想請教你們對 2027 年 LRP 這個數字的看法：相較於第一季的實際表現，以及相較於新的財測指引，為了達到 2027 年的數字所隱含的那個大幅躍升，特別是相對於一致預期的那個數字。

I'll leave it at that. That's my one question. Thank you.

我就問到這裡。這是我唯一的問題。謝謝。

Hello?

哈囉？

A reminder to unmute yourself locally.

提醒您在本地端解除靜音。

Matt, can you hear us?

Matt，你聽得到我們嗎？

I can hear you now.

我現在聽得到你們了。

Could you repeat your question for us, please?

可以請你把問題再重複一次給我們嗎？

Sure. My one question was actually in regards to the 2027 LRP, aside from all the margins sort of metrics withdrawal tracking above plan, the revenue target, $1 billion, more so just looking at in the context of where consensus is, which is about 4% to 5% higher than that.

當然。我唯一的問題其實是關於 2027 年 LRP：撇開所有利潤率等指標都高於計畫、進展良好不談，營收目標 10 億美元——主要是從市場一致預期的角度來看，一致預期大約比這高 4% 到 5%。

With the new guidance here for 2026, it's a pretty big incremental revenue step up to get to that number. Just your level of comfort here sitting today with that LRP revenue number for 2027. And he sent you a comment on where consensus is sitting for 2027, just given some of these puts and takes over here early here in 2026. Thank you so much.

以你們這次給出的 2026 年新指引來看，要達到那個數字需要相當大的增量營收躍升。想請教你們今天對 2027 年 LRP 營收目標的信心程度。也請你們評論一下 2027 年一致預期目前的位置，考量到 2026 年初這些利多利空因素。非常感謝。

Can you guys hear me? Anyone?

你們聽得到我嗎？有人嗎？

Hi, Mathew, I can hear you. I think we might be having some technical difficulties with the main speaker line room. Please just hold them momentarily.

嗨，Mathew，我聽得到你。我想主講者線路的會議室可能有一些技術問題。請稍等他們一下。

Okay.

好的。

They can hear you.

他們聽得到你。

Okay, can you?

好的，你呢？

You guys back?

你們回來了嗎？

Matt? All right, I'm going to get a shot here answering your question. So I think your question ultimately is, given the fact that we've adjusted our guidance to reflect our current expectations around our EOS number, I would tell you that the guide in terms of where we are on EOS and the adjustment that we've made is really to reflect some very near-term execution issues that we believe that we've addressed through adding incremental sales talent and downstream marketing resources to the organization. And so we fundamentally believe that that's going to just address the issues that we have.

Matt？好，我來嘗試回答你的問題。我想你的問題最終是：鑑於我們已調整指引以反映我們目前對 EOS 數字的預期，我會告訴你，這份指引以及我們對 EOS 所做的調整，主要是為了反映一些非常短期的執行面問題；我們相信已透過增補額外的銷售人才與下游行銷資源來加以解決。因此，我們從根本上相信這將能解決我們目前面臨的問題。

I think the guidance would suggest that as ultimately we believe that we've addressed the foundational issues that are execution related. So as we would expect to exit this year more in line with what our original guide would have assumed. And therefore, we believe that we are on track to accomplish the goals that we laid out in the context of our long-range plan.

我認為這份指引所傳達的是：我們最終相信已處理好這些與執行相關的基礎性問題。因此，我們預期在今年結束時，表現會更接近我們原先指引所假設的水準。也因此，我們相信我們正按計畫達成我們在長期計畫中所提出的目標。

Okay. I'll leave it at that. I'll get back in queue. Appreciate it.

好的。我就先到這裡。我再回到排隊序列。感謝。

Allen Gong, JPMorgan.

JPMorgan 的 Allen Gong。

Thanks for the question. Mine is kind of on the forward trajectory, and specifically the pricing per case headwind that you saw this quarter. It was good to see volumes stick back up to 20%-plus, but it sounds like that price per case headwind could be sticking around, especially as cervical and some of your faster-growing businesses sound like they're going to continue to put pressure onto that. Is that the right way to think about it going forward, that maybe for this year we should be forecasting continued revenue per case headwinds offset by volume growth?

謝謝讓我提問。我的問題比較偏向未來走勢，特別是你們本季看到的每例定價（pricing per case）逆風。很高興看到量又回到 20% 以上的成長，但聽起來每例價格的逆風可能會持續一段時間，尤其是頸椎以及你們一些成長較快的業務似乎會繼續對此造成壓力。未來應該這樣理解嗎：也許今年我們應該預測每例營收持續承壓，但由量的成長來抵消？

Yeah. Allen, I think that our guidance implies kind of high-teens volume growth with kind of flattish revenue per procedure growth or essentially no growth on the revenue per procedure.

是的。Allen，我認為我們的指引隱含的是：量大約是高十幾%的成長，而每例/每項手術的營收成長大致持平，或基本上沒有成長。

And in your commentary and your understanding, I think is correct in the sense that, as I called out in my prepared comments, our revenue per procedure growth or the score of the decline this quarter was really a function of mix, attributed to both strong cervical procedures because cervical procedures have a lower revenue per procedure contribution, as well as a strong performance in our international business, which does currently have a lower revenue per procedure profile as well.

而就你的評論與理解而言，我認為方向是對的：如同我在事先準備的發言中提到的，我們每例/每項手術的營收成長（或本季的降幅）主要是組合（mix）因素所致，來自兩個面向：其一是頸椎手術表現強勁，因為頸椎手術對每例營收的貢獻較低；其二是我們國際業務表現強勁，而國際業務目前的每例營收結構也較低。

And then the third piece is a little bit more execution related associated with our biologics attachment rate. And so again, there, we believe that we've got some upcoming product launches and improvements in our execution associated with that part of the business as well. And so as we think about how to model our revenue per procedure for the balance of the year, we're thinking about that to be flat on a year-over-year basis.

第三個因素則比較偏向執行面，與我們生物材料（biologics）的搭載率（attachment rate）相關。因此在那部分，我們也相信接下來會有一些產品上市，以及在該業務的執行面有所改善。所以，當我們思考今年剩餘期間每例/每項手術營收該如何建模時，我們的看法是：以年對年來看大致持平。

I would just add, if you look at the places where we make investments, we get a response. And if you look across lateral, it grew, ASB grew. It was reflective of exactly what we intended from the build perspective. And so to me, it's like frustrating to see the mix impact the overall, but where we're investing and where we're distinguishing ourselves, I think we're prospering.

我只想補充，如果你看看我們投資的那些地方，我們確實得到了回應。而且如果你橫向比較，lateral 成長了，ASB 也成長了。這正好反映了我們從建置角度所預期要達成的結果。所以對我來說，看到產品組合影響整體表現確實令人沮喪，但在我們投入資源、並且展現差異化的領域，我認為我們其實是在成長、在受益。

Yeah, I think that's a good point, Pat. In the context of the prepared remarks, we said, lateral grew 2% revenue per procedure, ALIF grew 4%, and ultimately, cervical grew 8%. We've made significant investments in those areas.

是的，我覺得這點說得很好，Pat。在事先準備的講稿脈絡下，我們提到 lateral 每例手術的營收成長 2%，ALIF 成長 4%，而最終 cervical 成長 8%。我們在這些領域做了相當重大的投資。

That's right.

沒錯。

Got it. And then I guess a question on your ability to like reiterate adjusted EBITDA, you know, is definitely good to see you able to kind of keep cost under control, but seems as though there are some root areas where you potentially may need to increase investment, such as what you had talked about for EOS Insight. So how should we think about balancing potential need for increased investment and driving revenue growth? How do you kind of balance those two things? What are your priorities? Thank you.

了解。接著我想問一下你們維持（重申）調整後 EBITDA 的能力；看到你們能把成本控制住確實是好事，但看起來在某些根本領域你們可能需要增加投資，例如你們提到的 EOS Insight。那我們應該如何看待在可能需要增加投資與推動營收成長之間的平衡？你們如何在這兩者之間取得平衡？你們的優先順序是什麼？謝謝。

Yeah, I think it's an interesting question. And one of the things that I feel great about is the infrastructures in place. And what's interesting is when you grow 39% year over year in EOSedge base, just the opportunity for you to exploit that base is very, very evident.

是的，我覺得這是個很有意思的問題。我覺得很棒的一點是，我們的基礎設施已經到位。而有趣的是，當 EOSedge 的裝機基礎年增 39% 時，你去開發、運用這個基礎的機會就非常、非常明顯。

What's maddening about this business is the installation elements. And what happens is, there's always a build out with regard to installation. So it makes some of the installation choppy, which the revenue record reflects the installation. And so I don't see it as an investment requirement for us to grow.

這個業務最讓人抓狂的是安裝（installation）這一塊。因為每次安裝都會伴隨一段建置期。所以安裝節奏會變得有些顛簸，而營收認列又會反映安裝進度。因此我不把它視為我們成長所需要新增的投資需求。

We're growing 30% by surgeon in accounts that have EOS. The thesis is totally intact. And that's like, to me, I'm thrilled about the reflection of the demand profile around those places where we have systems installed and we have the EOS Insight software installed.

在已經有 EOS 的客戶中，我們按外科醫師口徑成長了 30%。我們的論點（thesis）完全沒有被破壞。對我來說，我非常振奮，因為這反映出在我們已安裝系統、並且已安裝 EOS Insight 軟體的那些地方，需求輪廓非常強勁。

And so to me, this is just the quarter-by-quarter dynamics of a long-term execution. And so I'm totally thrilled about the EOS business in general, irritated by the lumpiness but don't see some new investment profile required at all.

所以對我而言，這只是長期執行過程中，季度之間的動態波動。因此我對整體 EOS 業務非常興奮；對於波動性（lumpiness）感到煩躁，但完全不認為需要任何新的投資配置。

Matt Miksic, Barclays.

Barclays 的 Matt Miksic。

Hey, can you hear me okay?

嗨，你們聽得到我嗎？

Yeah, we can hear you.

可以，我們聽得到。

Excellent. Thank you. So I understand the call can be moving a little bit slow here with the audio. And so I'll try to keep this tight and to one.

太好了。謝謝。我知道這通電話因為音訊的關係可能進行得有點慢。所以我會盡量簡短，問一個問題。

Maybe just obviously, the numbers and surgical putting in a little bit later than expected. We didn't hear or see anything in the quarter that would suggest it was kind of anything quote like wrong with time or anything tripping up companies in time. Can you maybe talk a little bit about if there was some phasing in Q1, if there was some, I don't know, territories catching up difficult comps, like regional, I don't know if there was storms. Not many companies have said much about storms, but was there anything that you'd say, you know what, there's really in a better quarter if this. Any kind of color and maybe confidence of sequential performance, either sequentially, acceleration sequentially, anything you can help us understand about the sequence from here to get to your new full-year number. And thanks so much.

也許很明顯地，這次的數字以及手術端的表現比預期晚了一點才跟上。我們在本季並沒有聽到或看到任何跡象顯示是因為某些「出了問題」或是有什麼因素在拖累公司。你們能否談談是否 Q1 有一些時點上的遞延（phasing），或是某些區域在追趕、比較基期較難，像是區域性因素；我不知道是否有風暴影響。很多公司都沒怎麼提到風暴，但你們這邊是否有任何因素會讓你們覺得：如果不是因為這些因素，本來會是更好的一季？也請提供一些補充說明，以及對於後續逐季表現的信心——不論是逐季改善、逐季加速——任何能幫助我們理解從現在到你們新的全年目標之間節奏的資訊。非常感謝。

Yeah, Matt, I'll start with just a little bit of color and then let Todd jump in.

好的，Matt，我先提供一些補充說明，然後讓 Todd 接著回答。

But I would say the most comforting part is that the momentum reflected in the business where we most distinguish continues to be profoundly robust. And so that's the part that I think we find most comforting. And clearly, the surgeon addition's up over 20%. It speaks to a business in demand. And so it was kind of a goofy quarter, I'll let Todd provide his view, but it's like we're seeing strength right out of the gate in Q2, and so it's, to me, it's a quarter-by-quarter lumpiness.

我會說，最令人安心的是：在我們最具差異化的業務領域，所反映出的動能仍然非常強勁。這是我們覺得最安心的部分。而且很明顯地，新增外科醫師數量成長超過 20%。這說明業務端的需求是存在的。所以這一季有點怪，我讓 Todd 提供他的看法；但我們在 Q2 一開始就看到強勁表現，所以對我來說，這就是逐季的波動性。

And Matt, maybe just to put a little bit more finer point on that or add to that, I think your question about like the Q1 in total, I mean, clearly there's been some -- there was some weather in kind of late January. FedEx was restrained for almost an entire week. I think the Northeast had two storms.

Matt，也許我再把重點說得更精準一些或補充一下。你問到 Q1 整體情況——很明顯地，1 月下旬確實有一些天氣因素。FedEx 幾乎有整整一週受到限制。我想東北部也遇到兩場風暴。

Now, there's weather every year, so how much of that is discrete impact here? Probably some amount, given the fact that I think there was more weather this year than historically is normal. So I think there's that consideration.

當然，每年都會有天氣因素，所以這次到底有多少是單一事件造成的影響？考量到我認為今年的天氣比歷史常態更嚴重，可能確實有一定程度的影響。所以我覺得這是一個需要納入考量的因素。

I think the question of really just, at the end of the day, where we exited March was probably a bit softer than we had expected it to end. And I think we attribute that to just some of the growth that we didn't see in our traditional posterior kind of open procedures and some bio attachment along with that.

我認為問題的核心是：我們在 3 月底的收尾表現，可能比我們原先預期稍微疲弱一些。我們把這歸因於：在我們傳統的 posterior（後路）偏 open（開放式）手術，以及與之相關的一些生物材料（bio）搭配上，沒有看到我們預期的成長。

I think to Pat's point, though, the good news is, you started to see definitely a sequential improvement in April, which ultimately gives us confidence as we grow into the second quarter and the seasonality we see from Q1 to Q2. And so I think it's important to kind of keep in context that historically, the seasonality between kind of April and March and all of that's a little bit hard to predict.

不過如 Pat 所說，好消息是你在 4 月確實開始看到逐月（sequential）的改善，這也讓我們對第二季的成長，以及我們從 Q1 到 Q2 所看到的季節性變化更有信心。因此我認為把它放在脈絡中很重要：歷史上，4 月相對 3 月以及相關的季節性，其實有點難以精準預測。

And so fundamentally, I think we believe that we're in a good spot relative to our guidance, and our guidance philosophy hasn't changed. And so, I think the other thing, just more structurally going from Q1 to Q2, you obviously have the deformity season that comes up, starts in kind of late May and into June. And so that will ultimately drive some improvement there.

所以從根本上來看，我們認為相對於我們的財測指引，我們處在一個不錯的位置，而且我們的指引哲學也沒有改變。另外，從 Q1 到 Q2 更結構性的角度來看，你會進入畸形矯正（deformity）的旺季，大約從 5 月下旬開始延續到 6 月。因此那將最終帶動一些改善。

When you think about our overall demand profile and the investment we've made in sets and inventory to support that increased demand, that's there. And again, I think we take a step back and we look at the overall volume growth and the surgeon adoption, and that is really what gives us a level of confidence that we're in the same spot relative to where we expected to be coming into the year on a full-year growth basis expectation. And so I think we ultimately hang our hat on the strong surgeon adoption and the volumetric components of the business.

當你思考我們整體的需求輪廓，以及我們為了支援需求增加而在器械組（sets）與庫存上所做的投資，這些都已經到位。再者，我們退一步看整體的手術量成長與外科醫師採用情況，這才是真正讓我們有信心的原因：就全年成長預期而言，我們仍在年初預期的位置上。所以我認為我們最終最倚重的是外科醫師採用的強勁表現，以及業務的量（volume）面向。

It's a [history] utilization.

這是一個[history]使用率。

Maybe just one, I don't know if you can still hear me, but just, you know, I noticed that surgeon adoption was up year over year. I mean, it is obviously up 22%, but it's faster than a year ago, surgeon adoption growth and anything just on the same. I'm not a question of acceleration of trends or momentum, and how much of a leading indicator is that, is the fact that it's growing faster now, what would we attribute that to? And does that tell us anything about what to expect in the coming quarters as well, the fact that that's, I guess, it's accelerating instead of growing? And thanks again for taking the question.

也許再問一個——我不知道你們是否還聽得到我——我注意到外科醫師採用率年增了。我的意思是，顯然是成長 22%，而且比一年前更快：外科醫師採用的成長速度更快。我想問的是，這是否代表趨勢或動能在加速？這在多大程度上是一個領先指標？也就是說，現在成長更快，我們應該把它歸因於什麼？另外，這是否也告訴我們接下來幾季可以期待什麼——也就是它看起來是在加速，而不只是成長？再次感謝你們回答問題。

Yeah, again, my general sense is the volume of people adopting our lateral portfolio is growing and is growing at an expedient rate. And so the frustrating part is, I think to Todd's point, is it's like, you see the growth profile, you see the price surgery with regard to the lateral contribution.

是的，再次，我的整體感受是，採用我們側向產品組合的人數正在增加，而且增長速度相當快。令人沮喪的部分是，我認為如 Todd 所說，就像你看到成長曲線，也看到與側向貢獻相關的價格手術。

And then the stuff where I think is more conventional, I would say short segment surgery that's open, that is like everybody else's, just seem flat. And so -- and then the biologic impact I think was bad. Fair adaptive can't come fast enough. And so it's one of those things where it's like, again, I think the procedural strategy has been well adopted. I think the EOS stuff is working as planned, the clearly distinguishing in lateral. But when we're not profoundly different than somebody else, we don't do profoundly better than everybody else.

然後我認為比較傳統的部分，我會說是開放式短節段手術，跟大家都差不多，看起來就是持平。所以——然後我認為生物製劑的影響是負面的。Fair adaptive 再快都不夠快。所以這就是那種情況：再說一次，我認為手術策略已被很好地採納。我認為 EOS 的部分按計畫運作，明顯在側向上形成差異化。但當我們沒有比別人顯著不同時，我們也不會比其他人顯著做得更好。

I think the only thing I'd add there, Matt, would just be the continuing growing contribution from our international business. I think that both is a surgeon adoption story as well as a revenue contributor and a growing revenue contributor as we grow through the rest of the year.

我想我唯一要補充的是，來自我們國際業務的貢獻持續成長。我認為這既是一個外科醫師採用的故事，也是營收貢獻者，而且隨著我們在今年剩餘時間的推進，它會成為越來越大的營收貢獻來源。

And the beauty of that thing is it's completely reflective of the lateral thesis that the company's been built on. And we're seeing the same type of adoption dynamics happen internationally. So to me, that's a great reflection.

而這件事的美妙之處在於，它完全反映了公司建立所依據的側向論點。我們也看到同樣類型的採用動態在國際市場發生。所以對我來說，這是一個很好的印證。

Matthew O'Brien, Piper Sandler.

Matthew O'Brien，Piper Sandler。

Good afternoon. This is Anna on for Matt. Thanks for taking our question. I wanted to ask on sort of the cadence for the rest of the year. It sounds like the majority of work has been done here in terms of realigning the sales team for EOS, new reps coming on board, some investment and additional marketing resources. So I presume it'll take some time for these new reps to ramp though. So just as we look at the cadence for the rest of the year, when would you anticipate things in the EOS franchise getting back on track for foreseeable future? Thanks.

午安。我是代替 Matt 的 Anna。感謝讓我們提問。我想問一下今年剩餘時間的節奏。聽起來在 EOS 方面，多數工作已完成，包括重新調整銷售團隊、新業務代表到位、一些投資以及額外的行銷資源。所以我推測這些新業務代表需要一些時間爬坡。因此，當我們看今年剩餘時間的節奏時，您預期 EOS 產品線何時能回到正軌並在可預見的未來維持？謝謝。

Yeah, this is Todd. I think our expectation is that begins to contribute in a more full way in the second half. And so that's really how we're thinking about it. We think the overall growth in the second quarter should be similar to our first-quarter results at about 14%. And I think our guide implies essentially 17% overall revenue growth in the second half as EOS contributes more meaningfully.

是的，我是 Todd。我認為我們的預期是，它在下半年開始以更完整的方式做出貢獻。所以我們是這樣思考的。我們認為第二季的整體成長應該會與第一季的結果相近，大約 14%。而我認為我們的指引基本上意味著，下半年整體營收成長約 17%，因為 EOS 的貢獻會更具實質性。

Just to make sure that I appreciate the question, too, it's like, the cadence of adding surgical sales rep has been totally consistent and they're coming from all players. And so what you're getting is just the consistency of the reflection of attracting more salespeople. So that's going on as it has in the same cadence and is not slowed at all. And that part I think is just continuing.

另外，為了確保我理解這個問題：新增外科銷售代表的節奏一直完全一致，而且他們來自所有競爭對手。所以你看到的就是吸引更多銷售人員的穩定反映。因此這件事一直以相同節奏在進行，完全沒有放慢。而我認為這部分會持續下去。

If anything, really the focal part of the frustration is around EOS placements. And the dynamic is, we've got to continue to improve as a capital equipment provider. But when you missed by three units or whatever, five units, like in the grand scheme of thing, what it doesn't do is impede the belief in being -- or what's going on in the field. And what's going on in the field is absolute expansion of the utility of the device once we get in place.

如果說有什麼的話，真正令人沮喪的焦點其實在 EOS 的裝機（placements）。而其動態是：作為資本設備供應商，我們必須持續改善。但當你少了三台或之類的、五台，在大局來看，它並不會阻礙對我們的信心——或不會改變前線正在發生的事情。而前線正在發生的是：一旦設備裝上線，其效用的擴張是非常明顯的。

David Saxon, Needham.

David Saxon，Needham。

Yeah, great. Good afternoon. Thanks for taking my questions. Maybe to start, I just want to clarify, Todd, the comment you just made about second quarter. You said something about 14. Can you clarify, is that $14 million for EOS for the second quarter or 14% overall growth for the second quarter?

好的，很好。午安。感謝回答我的問題。也許先釐清一下，Todd，你剛剛對第二季的評論。你提到 14。你能澄清一下，那是指第二季 EOS 的 1,400 萬美元，還是指第二季整體成長 14%？

My commentary, David, was that we would expect the overall growth to mirror first quarter's overall growth at 14%.

David，我的評論是，我們預期整體成長會與第一季的整體成長 14% 相呼應。

Okay, great. And then my one question is just on the -- a follow-up on the revenue per case assumption and the guidance. So like specifically what's embedded in that in terms of how US case mix trends over the balance of the year and biologics attachment rate, like really just trying to understand if cervical mix continues to be strong and no change to the biologics attachment rate, like kind of what's the risk to the flat revenue per case assumption? Thanks so much.

好的，了解。那我還有一個問題，是關於——針對每例手術營收（revenue per case）假設與指引的追問。具體來說，其中隱含了什麼假設：例如今年剩餘時間美國病例組合（case mix）的趨勢，以及生物製劑的搭載率（attachment rate）？我主要是想了解，如果頸椎組合持續強勁、且生物製劑搭載率沒有變化，那麼每例手術營收持平這個假設的風險大概是什麼？非常感謝。

Yeah. David, I think the idea here is that we would continue to see a relative contribution of cervical to the overall business as we've seen the strength of its growth over the last really number of quarters. That business continues to grow, and we continue to drive adoption through that procedural mix.

是的。David，我認為這裡的想法是：我們會持續看到頸椎在整體業務中的相對貢獻，與過去幾個季度其強勁成長所呈現的情況一致。該業務持續成長，而我們也會透過這樣的手術組合來持續推動採用。

We saw about 38% biologics attachment rate. We would expect that to go off a couple points. I think things that would make sense there, why we believe that is one and just a greater salesforce execution and focus on that front, as well as the fact that you enter deformity season and those deformity season cases tend to be longer, longer constructs.

我們看到生物製劑搭載率約 38%。我們預期它會下降幾個百分點。我認為這樣的判斷合理，原因之一是銷售團隊在該方面會有更好的執行與更聚焦；此外，你會進入畸形（deformity）季節，而畸形季節的病例通常時間更長、構型（construct）更長。

So one, you get just more revenue per case on average from that, plus they tend to have a higher utilization of biologics as well. And so that's more or less where we believe that the growth in -- or excuse me, that is how I constructed the revenue per procedure math for the balance of the year.

因此第一，你平均每例手術的營收會更高；再加上這類病例通常也會有更高的生物製劑使用量。所以大致上，我認為這就是我為今年剩餘時間所建立的每例手術營收——呃，應該說每次手術營收——的計算方式。

Great. Thank you.

很好。謝謝你。

Caitlin Roberts, Canaccord Genuity.

Caitlin Roberts，Canaccord Genuity。

Hi, thanks for taking the question. Maybe just to turn back to EOS, and I think you noted the weakness was execution related, if you could provide any more color on that specifically, and if any of the weakness is related to more the capital environment or appetite by facilities.

嗨，感謝讓我提問。也許回到 EOS，我想你提到疲弱是與執行相關；你能否更具體地補充一些細節？以及這些疲弱是否有一部分與資本環境或醫療機構的採購意願有關？

And then just following on from that, do any of those hurdles translate into the other capital parts of your business with Valence and navigation?

然後延伸追問，這些障礙是否也會影響你們業務中其他資本設備的部分，例如 Valence 和導航（navigation）？

Yeah, thanks for the question. I would say that the EOS thing bleeding into the Valence thing is really a non-starter. One of the challenges associated with EOS has always been the structural build-out. It's like literally you're doing construction on a room just based upon the size of the unit.

是的，謝謝你的問題。我會說，EOS 的狀況延燒到 Valence 的說法基本上不成立。EOS 一直以來的挑戰之一是結構性的建置（build-out）。就字面上來說，你是在因為設備尺寸而對一個房間進行施工。

And so what happens is, if you have more EOS unit that requires more build out, the predictability associated with the delivery becomes or the installation becomes less. And it's one of the scenes where it's like, when we said, hey, we're going to get better with regard to the sales piece, we're going to get better with regard to the downstream marketing piece, we're going to get better with regard to the support piece. The support piece really is making sure that we're aligned with regard to the timing associated with the installation. And so those things are somewhat challenging.

所以會發生的是：如果你有更多需要更多建置的 EOS 設備，那麼交付或安裝的可預測性就會降低。這也是那種情境：當我們說，嘿，我們要在銷售端做得更好、在下游行銷端做得更好、在支援端做得更好。支援端其實就是確保我們在與安裝相關的時程上保持一致。而這些事情確實有一定挑戰。

They have nothing to do with valence. And I always hate to suggest that we're a proxy for anything. With regard to understanding the capital equipment environment, it's just tough to tell. And so we're irritated over the lack of execution. We committed to a number of units. We didn't fulfill the number of units.

這些都與 Valence 無關。而且我一向不喜歡暗示我們是任何事情的代理指標。至於要理解資本設備的整體環境，確實很難判斷。所以我們對於執行不到位感到惱火。我們承諾了一定數量的設備。但我們沒有交付那個數量。

I got to tell you, the demand profile is phenomenal, and the thesis of it is great. The construction and installation is less good. And so that's kind of the way I think about the business, but I don't see it bleeding into anything else. I just see it as an execution flaw.

我得說，需求輪廓非常驚人，背後的投資論點也很棒。但在施工與安裝方面就沒那麼理想。所以我對這門生意的看法大概就是這樣，但我不認為它會蔓延影響到其他任何事情。我只把它視為執行上的瑕疵。

Tom Stephan, Stifel.

Tom Stephan，Stifel。

Great. Hey, guys, thanks for taking the questions. Wanted to ask about the 2026 surgical outlook. Hopefully, I have some of these numbers correct. I think surgical up 17% in the quarter, full-year guidance, also 17%. Coms get much more difficult.

很好。各位，謝謝讓我提問。我想問一下 2026 年手術業務的展望。希望我對其中一些數字的理解是正確的。我記得本季手術業務成長 17%，全年指引也是 17%。比較基期會變得困難得多。

You talked about March below expectations, but April came back. Business seemingly has become a little unpredictable, I feel like, in the last couple of quarters. So Todd or Pat, what gives you the confidence in maintaining the outlook for surgical when you decelled again in 1Q and with guidance implying the stacks reaccelerate? Is it April? Are there incremental drivers that can continue to support growth? Thanks.

你們提到 3 月低於預期，但 4 月又回來了。我覺得過去幾個季度業務似乎變得有點難以預測。所以 Todd 或 Pat，是什麼讓你們有信心在 1Q 再度放緩、且指引暗示後續會再加速的情況下，仍維持手術業務的展望？是因為 4 月嗎？是否有額外的驅動因素能持續支撐成長？謝謝。

Yeah, this is Pat. It's like -- I'll always provide the color, and I'll let Todd make me right or not based upon the numbers.

對，這裡是 Pat。我會先補充一些背景說明，然後讓 Todd 依據數字來判斷我說得對不對。

The thing that gives us confidence is just the demand profile around the procedures that most distinguish us and the volume of surgeons that continue to flock toward us. Like to see a historical growth rate in the volume of surgeons and then to see historically what they've done from a utilization perspective gives us a lot of confidence.

讓我們有信心的，是圍繞那些最能凸顯我們差異化的手術項目的需求輪廓，以及持續湧向我們的外科醫師數量。看到外科醫師數量的歷史成長率，再看他們在使用率方面過去的表現，讓我們非常有信心。

Looking at kind of the demographics of the types of surgery and seeing that what we were losing more is some conventional stuff, Q2/Q3 are conventional fests, if you will. It's a lot of long reconstruction stuff.

從手術類型的人口統計來看，我們流失較多的是一些傳統項目；如果你要這麼說，Q2/Q3 是傳統手術的旺季。那會有很多長節段重建類的手術。

The way that EOS is impacting our business, I would say that gives us a lot of confidence. And so as I look at just the demographics of how the revenue was reflected, I remain totally bullish. And so clearly the comps get harder, but it's one of those things where it's like when the business is coming in as you expected it from a procedural type standpoint, and you see the surgeons joining, for me, it just gives me It feels like a tailwind.

EOS 對我們業務的影響方式，我會說這也給了我們很大的信心。因此，當我看收入反映出的結構與組成時，我仍然完全看多。當然比較基期會更難，但這種情況是：當業務在手術類型的面向上如你所預期地進來、而你又看到外科醫師持續加入，對我來說就像是一股順風。

And Tom, I think your question is totally a fair one in terms of the deceleration that we've seen and how do we think about Q2 onwards in light of our Q1 performance.

Tom，我認為你提的問題非常合理：我們看到的放緩，以及在 1Q 表現的背景下，我們如何看待 Q2 之後的走勢。

And so I would point to a couple of things. One, I made the comment about March was not as good as we had expected, although April has rebounded and feel like that gives us a good platform into Q2. And so I think fundamentally, a lot of this is where do you start? And so I think the April start is a confidence builder there.

我會指出幾點。第一，我提過 3 月不如我們預期，雖然 4 月已經反彈，我覺得這為 Q2 提供了一個不錯的平台。所以我認為很多事情的根本在於你從哪裡起跑。而 4 月的起跑點在這裡確實增強了信心。

Second point I'd make is just the structural increase from Q1 to Q2 in terms of the deformity season. We've invested in incremental assets, whether that be small stature sets or -- and/or rather patient positioners. And so we know that demand is there. And so we have invested to fulfill the expectation of that demand to come. And that happens both in Q2 and NQ.

第二點是，從 Q1 到 Q2 在結構上會有提升，因為畸形矯正（deformity）旺季到來。我們已投資增加資產，不論是小體型器械組，或是（更準確地說）病患定位器。因此我們知道需求就在那裡。我們也已投資以滿足即將到來的需求預期。這會在 Q2 以及 NQ 同時發生。

I think we talked about our ability to drive increased biologics attachment rate through focused sales execution efforts. The international contribution continues to get better as we walk through the year. And I think that has been demonstrated as we've gone. And so our confidence there is high as well.

我想我們也談到，透過聚焦的銷售執行，我們有能力提升生物材料（biologics）的搭載率。隨著年度推進，國際市場的貢獻持續改善。我認為這一路走來已經得到驗證。所以我們在這方面的信心也很高。

And so I think for all those reasons, we believe that the path from Q1 to Q2 and onwards is very much intact. And then I think just if you look at the total surgeon adoption, again, I think it's just a great leading indicator. It historically has been. And I think to have sales, you've got to have customers. And the customers are growing at 20%-plus.

因此基於上述原因，我們相信從 Q1 到 Q2 以及之後的路徑非常完整。另外，如果你看外科醫師採用的總量，我認為這是一個很好的領先指標。歷史上一直如此。而且要有銷售，你必須先有客戶。而客戶數正在以 20% 以上的速度成長。

Got it. Thanks, guys.

了解。謝謝各位。

Ross Osborn, Wells Fargo.

Ross Osborn，Wells Fargo。

Hi. Thanks for taking our questions. So maybe moving on to Valence, would you discuss placements to date and what early pull-through numbers look like?

嗨。謝謝讓我們提問。那也許轉到 Valence，你們能談談截至目前的裝機/布建情況，以及早期的帶動（pull-through）數據看起來如何嗎？

Yeah, not going to speak to the specific numbers, and I think what we -- or at least how we characterized this year was one of, let's get as much experience as we can. Let's make sure the product is absolutely perfect. It is doing everything that we've expected.

對，我不會談具體數字；而且我想我們——或至少我們對今年的定位是：盡可能累積更多使用經驗。確保產品做到絕對完美。它的表現完全符合我們的預期。

And so I would tell you that -- and these are things that you won't appreciate is my presumption. Clearly not trying to be insulting, but there's an infield camera that is hugely elegant. And just the ability to have the surgeon control the elements in the room is exactly what you want.

所以我會告訴你——我推測有些細節你可能不會特別在意。我當然不是要冒犯，但它有一個術野（infield）攝影機，設計非常精巧。而且能讓外科醫師控制手術室內的各項元素，正是你想要的。

You also don't want a huge piece of capital. It's not a huge piece of capital. And so it's doing everything that we've expected. It's been utilized in PTP mostly. It's trending toward more than the numbers that we provided for the year as a target, and so we're totally bullish on it.

你也不希望是一個很龐大的資本設備。它不是很龐大的資本設備。所以它正在做到我們所期待的一切。目前主要用在 PTP。它的趨勢正朝向超過我們今年提供作為目標的數字，因此我們對它完全看多。

Super excited about just the type of clinical impact it can have and the workflow that's been initiated with its design. And so again, hugely confident, hugely bullish. The ability to integrate the best neurophysiology in class with the most elegant, seamlessly effective workflow will increase the volume of PTP users. There's no question in my mind, so it's going as planned.

我們對它可能帶來的臨床影響，以及其設計所啟動的工作流程都非常興奮。所以再次強調：信心非常高、非常看多。把同級最佳的神經生理（neurophysiology）與最精巧、無縫且高效的工作流程整合在一起，將會提高 PTP 使用者的數量。我毫不懷疑，所以一切都按計畫進行。

Thank you.

謝謝。

Keith Hinton, Freedom Capital Markets.

Keith Hinton，Freedom Capital Markets。

Hey, guys. Good afternoon. This is [Nakul] on for Keith. First of all, thank you for taking our questions. We have two questions.

嗨，各位。下午好。我是 [Nakul]，代 Keith 發言。首先，謝謝讓我們提問。我們有兩個問題。

The first one being the revenue per procedure appearing to be down approximately 4% year over year. We think that's the first case of down year over year since at least 2021 or maybe earlier. What are the drivers there and how are you thinking about revenue per procedures for the rest of 2026 and in the out years?

第一個是，每例手術收入看起來年對年下降約 4%。我們認為這至少是自 2021 年、甚至可能更早以來，第一次出現年對年下滑。背後的驅動因素是什麼？你們如何看待 2026 年剩餘期間以及更長期的每例手術收入走勢？

Yeah. So as I shared my prepared remarks, you've got about a, clearly, a mixed impact from a stronger growth in our cervical procedures. Cervical procedures carry a lower revenue per procedure profile than our overall average. And so since that led the growth, that pulled the overall average revenue per procedure down.

好的。如同我在事先準備的發言中分享的，你會看到一個——很明顯——由組合（mix）帶來的影響：我們的頸椎手術成長更強。頸椎手術的每例手術收入水準低於我們整體平均。因此，由於它領先帶動成長，就把整體平均每例手術收入拉低了。

The second is our strong performance outside the US. They also have a lower revenue per procedure profile than our overall average. And so really the two primary drivers there are mix related.

第二個因素是我們在美國以外市場的強勁表現。那些市場的每例手術收入水準也低於我們整體平均。所以主要兩個驅動因素其實都與組合有關。

And then the final driver is just lower biologics attachment rate and so that had an impact.

最後一個驅動因素就是生物材料（biologics）搭載率較低，因此也造成了影響。

I would just tell you though, as when you look at our anterior columns, so think about lateral and ALIF, laterals revenue per procedure grew 2%, ALIF's revenue per procedure grew 4%, cervicals revenue per procedure grew 8%. And so I think the revenue per procedure growth or our ability to capture the revenue opportunity in a procedure continues to expand. And that's the important piece to this. And I think that is also a fulfillment of the investment thesis that we've laid forth.

不過我想跟你說的是，當你看我們的前柱產品線時，想想側方與 ALIF：側方每例手術的營收成長了 2%，ALIF 每例手術的營收成長了 4%，頸椎每例手術的營收成長了 8%。因此我認為，每例手術營收的成長，或是我們在單一手術中掌握營收機會的能力，仍在持續擴大。而這才是其中最重要的部分。我也認為，這同時是在落實我們先前提出的投資論點。

Great. Just the last one. So in 2025, growth in surgeon users was in line with procedure growth, which seems to imply procedures for surgeon was around flat year over year. Where are you today in terms of penetration rate with active US spine surgeons?

很好。最後一個問題。所以在 2025 年，外科醫師使用者的成長與手術量成長一致，這似乎意味著每位外科醫師的手術量年對年大致持平。就目前而言，你們在美國活躍脊椎外科醫師的滲透率大概到什麼程度了？

And going forward, how should we think about the balance between increasing breadth and depth in terms of driving volume growth? Also, once again, thanks for taking your questions.

展望未來，在推動手術量成長方面，我們應該如何看待「增加廣度」與「增加深度」之間的平衡？另外，再次感謝你們回答問題。

Yeah. I mean, we obviously saw another strong quarter of surgeon adoption.

是的。我的意思是，我們顯然又看到外科醫師採用的強勁季度表現。

I think your question on utilization rates, I think if you go back to 2022, we saw utilization rates, and we've seen utilization rates grow on average about 3% a year in the US. And so clearly, on average, we're seeing greater utilization. That utilization number is obviously pulled down by the strong adoption numbers that we see. And so the averaged out at about 3%, and we continue to feel good about that.

我想你問到使用率，我認為如果你回到 2022 年，我們看到使用率，而且我們在美國看到使用率平均每年大約成長 3%。因此很明顯，平均而言我們看到更高的使用程度。而這個使用率數字，顯然會被我們看到的強勁採用人數所拉低。所以平均大約是 3%，我們也持續對此感到樂觀。

And I think going back to some of the themes of this call in terms of why we have confidence in our full-year guide on the surgical revenue piece is fundamentally related to the fact that we see strong demand for new surgeons to come here and have always seen that demand translate into procedural adoption. And so we expect to continue to see that throughout the balance of this year, which gives us kind of confidence in our overall guide.

我想回到本次電話會議的一些主題，談到為什麼我們對全年指引中手術營收那一塊有信心，根本原因在於：我們看到新外科醫師來到這裡的需求很強，而且我們一直看到這種需求會轉化為手術採用。因此我們預期在今年剩餘期間仍會持續看到這種情況，這也讓我們對整體指引更有信心。

Okay, got it. Thanks.

好的，了解。謝謝。

Sean Lee, H.C. Wainwright.

Sean Lee，H.C. Wainwright。

Hey, good afternoon, guys, and thanks for taking our questions. I just have a bit of a higher level one. So with the EOS revenue and the guidance staying at a low growth this year, I was wondering, does the strategic case of where EOS sits inside the procedure ecosystem, where -- as the platform as a door knocker as well as for a driver for surgeon pull-through, does that case still hold? And do you think it maybe makes sense to rethink some of the hardware monetization model as well?

嗨，大家下午好，謝謝你們回答我們的問題。我有一個比較高層次的問題。今年 EOS 的營收與指引都維持在低成長，我想請問：EOS 在手術生態系中的策略定位——作為平台的「敲門磚」以及帶動外科醫師拉動效應（pull-through）的驅動器——這個策略論點仍然成立嗎？另外，你們是否認為也許有必要重新思考硬體的變現模式？

Sean, it doesn't make me think -- it makes me so enthusiastic about what we're doing. Imagine from where we've come. It's Alphatec Spine getting access to the institutions like HSS, NYU, Duke, Northwestern, University of Virginia, University of Maryland. It is unbelievable the type of access that EOS has given us.

Sean，這不會讓我覺得——反而讓我對我們正在做的事情非常振奮。想像一下我們一路走來的進展。是 Alphatec Spine 得以進入像 HSS、NYU、Duke、Northwestern、University of Virginia、University of Maryland 這些機構。EOS 帶給我們的這種進入機會，真的令人難以置信。

And probably the thing that I am most kind of disappointed in myself in is enabling you guys to understand the uniqueness of this informatic tool. There is nobody in the business that has a tool that ultimately provides for a preoperative image, a plan integrated into the interoperative experience, and then evaluated postoperatively. It's all the same image. And so that provides you what's called a structured dataset. And your ability to transit a structured data set is unlike anything anybody else has, and it's all automated.

而且我可能最對自己感到有點失望的一點，是沒有讓各位更充分理解這個資訊工具的獨特性。業界沒有任何人擁有一個工具，能夠最終提供術前影像、將計畫整合進術中體驗，並在術後進行評估。全部都是同一張影像。因此它能提供所謂的結構化資料集。而你傳輸結構化資料集的能力，是任何其他人都沒有的，而且全部是自動化的。

The nemesis of spine surgery historically has been a lack of data. And so for us to have these structured dataset that automatically fuels information into a depot that we could translate to mitigate variables. We've talked in previous calls about the revision rate in spine and how mitigating variables is the route to greater predictability.

脊椎手術歷來最大的宿敵就是缺乏資料。因此，對我們而言，擁有這些結構化資料集，能自動把資訊輸送到一個資料庫（depot），讓我們可以轉化運用以降低變異。我們在先前的電話會議談過脊椎手術的翻修率（revision rate），以及降低變異是通往更高可預測性的途徑。

The fact that we've missed on a few installations and then to suggest that we're going to rethink the thesis is not even a consideration. I would tell you that I just got back from the American Academy of Neurosurgery. You know who the big players are? It's Medtronic, Globus, and ourselves. You know who the most promising player is? ATEC Spine.

我們在少數幾個安裝案上失手，然後就有人暗示我們要重新思考這個論點，這根本不在考慮範圍內。我可以告訴你，我剛從美國神經外科學會回來。你知道那裡的大玩家是誰嗎？是 Medtronic、Globus，還有我們自己。你知道最有前景的玩家是誰嗎？ATEC Spine。

And so it's one of these things for us to translate this tool. In five years, it's going to be the father-son game. And so it's any inference that there is any blinking with regard to the thesis is misdirected. And so sorry for the diatribe, but I got to tell you, it's like this has to run the size of Texas. You have a team that's committed to the size of Texas, and you miss on the construction on a few placements of EOS, and people questioning you is, a word I would choose not to use. So anyway, appreciate the question.

所以對我們來說，關鍵在於把這個工具轉化落地。五年後，這會變成父子局（father-son game）。因此，任何暗示我們在這個論點上有所動搖的推論，都是方向錯誤的。抱歉我講得有點長，但我必須告訴你，這件事必須做到「德州那麼大」。你有一個團隊以「德州那麼大」的規模投入承諾，結果只是在 EOS 的幾個布建點位施工上失手，就有人質疑你，我想到的一個詞我就不說了。總之，感謝你的提問。

Yeah. Thanks for that, and thanks again for taking your question.

是的。謝謝你的回覆，也再次感謝你們回答問題。

We have reached the end of the question-and-answer session. I will now hand the call back to Pat Miles for closing remarks.

問答環節到此結束。我現在把電話交回給 Pat Miles 作結語。

Just a quick comment. I just want to thank everybody for dialing in. I've never been more bullish and more enthusiastic with regard to the build of ATEC Spine. I'm thrilled about the volume of people coming over here from competitive companies that are supporting the effort. It's like our best days are out in front of us. The strategic thesis is such the right one. We're going to be the data source in this business. And so just want to share my enthusiasm for where we are and look forward to discussions as the year progresses because we will continue to prosper as we have for the last eight years.

簡短補充一下。我想感謝各位撥冗參與。對於 ATEC Spine 的建構，我從未像現在這樣看多、也從未像現在這樣充滿熱情。我對於有這麼多人從競爭對手公司加入我們、支持這項努力感到非常振奮。就像是，我們最好的日子還在前面。這個策略論點非常正確。我們將成為這個產業的資料來源。因此只是想分享我對我們現況的熱情，也期待隨著年度推進持續交流，因為我們會像過去八年一樣持續成長茁壯。

So anyway, thanks very much for your interest, and look forward to more.

總之，非常感謝各位的關注，期待後續有更多交流。

This concludes today's call. Thank you for attending. You may now disconnect.

今天的電話會議到此結束。感謝各位參與。您現在可以掛線。