Globus Medical Inc (GMED) 2024 Q3 法說會逐字稿

Welcome to Globus Medical's third-quarter 2024 earnings call. (Operator Instructions) I will now turn the call over to Brian Kearns, Senior Vice President of Business Development and Investor Relations. Mr. Kearns, please go ahead.

歡迎參加 Globus Medical 2024 年第三季財報電話會議。（操作員指示）現在我將把電話轉給業務發展和投資者關係高級副總裁 Brian Kearns。科恩斯先生，請繼續。

Thank you, Victor, and thank you, everyone, for being with us today. Joining today's call from Globus Medical will be Dan Scavilla, President and CEO; and Keith Pfeil, Chief Operating Officer and Chief Financial Officer. This review is being made available via webcast, accessible through the Investor Relations section of the Globus Medical website at www.globusmedical.com.

謝謝維克多，也謝謝大家今天與我們在一起。參加今天 Globus Medical 電話會議的有總裁兼執行長 Dan Scavilla；以及首席營運長兼財務長 Keith Pfeil。該評論將透過網路廣播發布，可透過 Globus Medical 網站 www.globusmedical.com 的投資者關係部分存取。

Before we begin, let me remind you that some of the statements made during this review are or may be considered forward-looking statements. Our Form 10-K for the 2023 fiscal year and our subsequent filings with the Securities and Exchange Commission identify certain factors that could cause our actual results to differ materially from those projected in any forward-looking statements made today.

在我們開始之前，請允許我提醒您，本次審查期間所做的一些陳述是或可能被視為前瞻性陳述。我們 2023 財年的 10-K 表格以及隨後向美國證券交易委員會提交的文件確定了某些因素，這些因素可能導致我們的實際結果與今天做出的任何前瞻性陳述中的預測存在重大差異。

Our SEC filings, including the 10-K, are available on our website. We do not undertake to update any forward-looking statements as a result of new information or future events or developments. Our discussion today will also include certain financial measures that are not calculated in accordance with generally accepted accounting principles or GAAP. We believe these non-GAAP financial measures provide additional information pertinent to our business performance. These non-GAAP financial measures should not be considered replacements for and should be read together with the most directly comparable GAAP financial measures.

我們的 SEC 文件（包括 10-K 文件）可在我們的網站上查閱。我們不承諾根據新資訊或未來事件或發展來更新任何前瞻性陳述。我們今天的討論還將包括某些未按照公認會計原則或 GAAP 計算的財務指標。我們相信這些非公認會計準則財務指標提供了與我們的業務績效相關的更多資訊。這些非 GAAP 財務指標不應被視為替代品，而應與最直接可比較的 GAAP 財務指標一起解讀。

Reconciliations to the most directly comparable GAAP measures are available in the schedules accompanying the press release and on the Investor Relations section of the Globus Medical website. With that, I will now turn the call over to Dan Scavilla, our President and CEO.

最直接可比較的 GAAP 指標的對帳表可在新聞稿附帶的附表中以及 Globus Medical 網站的投資者關係部分找到。說完這些，我現在將電話轉給我們的總裁兼執行長 Dan Scavilla。

Thanks, Brian, and good afternoon, everyone. September 1 marked the 1-year anniversary of the Globus NuVasive merger, making this quarter the fourth consecutive combined earnings release with sales growth strong financial performance and best-in-class innovative product launches. Globus delivered an exceptional third quarter with sales of $626 million, growing 63% or $242 million. Non-GAAP EPS was a record $0.83, increasing 45% even with the 20% increase in diluted shares versus prior year. We also had a record free cash flow of $162 million in Q3.

謝謝，布萊恩，大家下午好。9 月 1 日是 Globus NuVasive 合併一周年紀念日，本季是公司連續第四次發布綜合收益報告，銷售額增長，財務業績強勁，並推出了一流的創新產品。Globus 第三季表現出色，銷售額達 6.26 億美元，成長 63%，即 2.42 億美元。非公認會計準則每股收益達到創紀錄的 0.83 美元，儘管攤薄後股價較上年同期增長了 20%，但仍增長了 45%。我們的第三季自由現金流也創下了 1.62 億美元的紀錄。

This amount is equivalent to our 2023 full year free cash flow. These results reflect our continued drive in market penetration, synergy acceleration and sustained profitable growth through financial discipline. Based on our results so far, I would like to compliment the entire Globus team for their speed and effort in completing the most successful spine merger in history.

這個金額相當於我們 2023 年全年自由現金流。這些結果反映了我們透過財務紀律繼續推動市場滲透、協同加速和持續獲利成長。根據我們迄今為止的成果，我要讚揚整個 Globus 團隊以最快的速度和努力完成了歷史上最成功的脊椎合併。

There's still a great deal of work ahead of us, but I look forward to building from this base and accelerating growth as we move into the future. In addition to our great financial performance, Globus launched four new products in Q3 across our businesses, reaching 13 product launches year-to-date and more to come this year.

我們面前還有大量的工作要做，但我期待在此基礎上再接再厲，並在未來加速發展。除了出色的財務業績外，Globus 在第三季度還在整個業務領域推出了四款新產品，今年迄今推出的產品數量已達 13 款，今年還將推出更多產品。

These results are a testament to our incredible team working tirelessly around the clock to drive integration, overcome challenges and create scalable solutions so that we can reach steady state quickly and shape the markets in which we compete, while delivering innovation to our surgeons. Focusing on the performance of our business, US Spine grew 55% in Q3 with significant gains across our product portfolio in expandables, MIS screws, biologics, lateral and cervical offerings.

這些結果證明了我們出色的團隊日以繼夜地努力工作，推動整合，克服挑戰，創造可擴展的解決方案，以便我們能夠迅速達到穩定狀態，塑造我們競爭的市場，同時為我們的外科醫生提供創新。專注於我們業務的表現，美國脊椎公司在第三季度成長了 55%，我們的可擴展產品、MIS 螺絲、生物製劑、側位產品和頸椎產品等產品組合均取得了顯著成長。

The growth is driven by several factors, including a high retention rate at all levels of our field sales team, successful distributor to direct conversions, the strength of our combined product offering, increasing product cross-selling, implant pull-through from robotic procedures and contributions from prior period competitive rep recruiting. Competitive rep recruiting remained strong in Q3 and the pipeline is solid as we enter Q4.

成長是由多種因素推動的，包括我們現場銷售團隊各個級別的高留任率、成功的分銷商到直接轉化、我們組合產品供應的實力、不​​斷增加的產品交叉銷售、機器人程序帶來的植入拉動以及前期競爭性銷售代表招募的貢獻。第三季度，競爭性銷售代表招募依然強勁，進入第四季度，通路十分穩固。

2024 is positioned to be one of the strongest competitive recruiting years as we continue to attract the most successful and tenured competitive professional reps who see the power and future we can offer them as a destination of choice for innovation and growth. As mentioned earlier, we continue to flex our innovation muscle, launching four new products from our prolific R&D pipeline in Q3.

2024 年將成為競爭最激烈的招募年之一，因為我們將繼續吸引最成功和最資深的競爭性專業代表，他們將看到我們可以為他們提供的力量和未來，成為創新和成長的首選目的地。如前所述，我們繼續展示我們的創新實力，並於第三季度從我們豐富的研發管道中推出了四款新產品。

I want to share these meaningful launches with you. The Excelsius Navigation hub pairs navigational accuracy with innovative patient safety features such as patient array shift tracking and navigation of DuraPro oscillating instruments. The Hub seamlessly integrates with Globus products and procedures, offering enhanced navigation of best-in-class instruments and implants for a complete procedural solution from the cervical spine to the sacrum.

我想與你們分享這些有意義的發布。Excelsius 導航中心將導航精度與創新的病患安全功能（如病患陣列移位追蹤和 DuraPro 振盪儀器導航）結合在一起。這款 Hub 與 Globus 產品和程式無縫集成，提供一流儀器和植入物的增強導航，從而實現從頸椎到骶骨的完整程序解決方案。

It is the only freehand navigation system on the market to offer the versatility of three distinct imaging workflows. The first is with Excelsius 3D imaging with automatic registration for optimized flexibility and efficiency. The second is preoperative CT fluoroscopy emerging, and the third is interoperative 2D fluoroscopy.

它是市場上唯一提供三種不同影像工作流程多功能性的自由導航系統。首先是採用具有自動配準功能的 Excelsius 3D 成像，以優化靈活性和效率。二是術前CT透視檢查，三是術中2D透視檢查。

Excelsius health navigated instruments are an expansive and comprehensive suite of navigated instruments that enable the navigation of a wide variety of open and minimally invasive spine procedures, including XLIF, TLIF, posterior cervical fusion, thoracolumbar fusion and SI joint fusion.

Excelsius 健康導航儀器是一套廣泛且全面的導航儀器，可導航各種開放式和微創脊椎手術，包括 XLIF、TLIF、後頸椎融合術、胸腰椎融合術和 SI 關節融合術。

They are designed for optimal camera tracking throughout the procedure and are compatible with innovative angle navigation arrays that reduce the need for interoperative camera adjustments, streamlining all workflows while maintaining backward compatibility with existing Excelsius GPS navigated instruments.

它們旨在在整個過程中實現最佳的攝影機跟踪，並與創新的角度導航陣列兼容，從而減少了操作間攝影機調整的需要，簡化了所有工作流程，同時保持與現有 Excelsius GPS 導航儀器的向後相容性。

The ACTIFY 3D Total Knee System is a contemporary total knee solution that pairs cementless reconstruction with operative efficiency and anatomic fit. Compatible with manual robotic-assisted workflows, ACTIFY 3D is engineered to combine implant endurance and a poor lattice interface for cementless fixation, addressing surgeon preferences and varying patient anatomies. ACTIFY 3D complements the Excelsius Flex robot with the TKA total knee arthroplasty application that received FDA clearance in late Q2.

ACTIFY 3D 全膝關節系統是一種現代化的全膝關節解決方案，將非骨水泥重建與手術效率和解剖貼合結合在一起。ACTIFY 3D 與手動機器人輔助工作流程相容，旨在結合植入物的耐力和較差的晶格介面進行無骨水泥固定，滿足外科醫生的偏好和不同的患者解剖結構。ACTIFY 3D 與 Excelsius Flex 機器人相輔相成，推出了 TKA 全膝關節置換術應用，該應用已於第二季末獲得 FDA 批准。

E-Flex enables consistent accurate anatomic cuts while maintaining surgeon flexibility in tactile feel. It accommodates varying surgeon preferences by offering imageless and CT-based workflows, ergonomic and unrestricted jigless resections and restore surgeon control while active tracking is engaged.

E-Flex 能夠實現一致且準確的解剖切割，同時保持外科醫師觸覺的靈活性。它透過提供無影像和基於 CT 的工作流程、符合人體工學和不受限制的無夾具切除來滿足不同外科醫生的偏好，並在進行主動追蹤時恢復外科醫生的控制。

The system features advanced registration and planning algorithms to enable streamlined and efficient procedures. The system is slated for launch in Q4. For trauma, the captivate solar headless compression screw system provides a fast and efficient solution for fracture repair, bone reconstruction, joint fusion, osteotomy and arthrodesis.

該系統具有先進的註冊和規劃演算法，可實現精簡且高效的程序。該系統預計將於第四季推出。對於創傷，Captivate Solar無頭加壓螺絲系統為骨折修復、骨重建、關節融合、截骨和關節融合提供了快速有效的解決方案。

This headless screw is capable of accommodating a wide range of patient anatomies, the intuitive graphic case design, aids efficiency and reduces space in the OR. In addition to driving growth from the 13 products we've launched so far this year, I look forward to sharing future impactful launches as we go through the rest of 2024.

這種無頭螺絲能夠適應各種各樣的患者解剖結構，直觀的圖形病例設計有助於提高效率並減少手術室的空間。除了推動今年迄今推出的 13 款產品的成長之外，我還期待在 2024 年剩餘時間分享未來具有影響力的產品發布。

This is a year of record launches for us, and this innovation is key to building long-term growth while working through near-term merger integration. We are investing significantly in comprehensive product development training to harmonize our product development processes between Autobahn, San Diego and the Filan.

這是我們創紀錄的一年，這項創新對於在完成近期合併整合的同時實現長期成長至關重要。我們正在大力投資全面的產品開發培訓，以協調 Autobahn、聖地牙哥和 Filan 之間的產品開發流程。

And this is expected to further expand our significant lead over the competition in IP generation and new product development. Enabling Technology sales were $38 million, an increase of 39% versus prior year. Q3 was the highest number of unit placements since launch, growing 50% over prior Q3, including the acceleration of our rental program, where, unlike unit sales, we recognize revenue over the rental contract life.

預計這將進一步擴大我們在 IP 生成和新產品開發方面的競爭領先優勢。使能技術銷售額為 3,800 萬美元，較上年增長 39%。第三季度是自推出以來單位安置數量最多的季度，比去年同期增長了 50％，其中包括我們租賃計劃的加速，與單位銷售不同，我們在租賃合約期限內確認收入。

Robotic procedures continued to accelerate, growing 34% versus prior year and exceeding 84,000 robotic procedures performed since launch. As mentioned earlier, the Excelsius Hub launch in Q3 is going well. as we enter the freehand navigation market, opening the largest market segment of navigation for Globus innovation and growth.

機器人手術持續加速發展，較上年增長 34%，自推出以來已執行超過 84,000 例機器人手術。如前所述，Excelsius Hub 在第三季的啟動進展順利。隨著我們進入自由導航市場，為Globus的創新和成長開闢了最大的導航市場領域。

The combination of the E3D imaging system with the iHub navigation platform, gives Globus the most comprehensive and sophisticated navigation offering available. We also plan to advance navigation further in the near future with our XR augmented reality headset designed to work with the Excelsius Hub.

E3D 成像系統與 iHub 導航平台的結合，為 Globus 提供了最全面、最先進的導航產品。我們還計劃在不久的將來透過與 Excelsius Hub 配合使用的 XR 擴增實境耳機進一步推進導航技術。

We expect to gain FDA clearance of the headset in Q4. The DuraPro and Vocera Power Tool systems launched in Q1, continue to differentiate our power tool offerings and pair seamlessly with our enabling tech portfolio. The unique ability of DuraPro Oscillating Drill to add extra safety around soft tissue structures, including neurovascular anatomy while allowing for easy removal of bone, help surgeons work safely and efficiently.

我們預計該耳機將在第四季獲得 FDA 批准。DuraPro 和 Vocera 電動工具系統於第一季推出，繼續使我們的電動工具產品與眾不同，並與我們的支援技術組合無縫配對。DuraPro 振盪鑽的獨特功能在於為軟組織結構（包括神經血管解剖結構）增加額外的安全性，同時可以輕鬆去除骨骼，幫助外科醫生安全高效地工作。

Market interest remains high for our state-of-the-art Excelsius 3D imaging system with most surgeons immediately recognizing and appreciating the stark differentiation over existing systems and seeing the value of combining E3D with the Excelsius GPS or hub. We're delivering on our promise to create a launch our enabling tech ecosystem, an ecosystem that is designed and built from the ground up to communicate together seamlessly.

市場對我們最先進的 Excelsius 3D 成像系統的興趣仍然很高，大多數外科醫生立即認識到並欣賞與現有系統的鮮明差異，並看到了將 E3D 與 Excelsius GPS 或集線器相結合的價值。我們正在履行我們的承諾，推出我們的支援性技術生態系統，這個生態系統是從頭開始設計和建構的，以實現無縫溝通。

Investment in this area remains strong as we enhance our ecosystem offering and bring about more functionality in our imaging, navigation and robotic current and future portfolio. Our international spinal implant business delivered record sales in Q3, growing 86% on a constant currency basis compared to prior year with high double-digit growth in most markets and strong dollar contribution driven by Japan, Germany, the UK, Italy, Brazil and Colombia.

隨著我們增強生態系統產品並為我們當前和未來的成像、導航和機器人產品組合帶來更多功能，對該領域的投資仍然強勁。我們的國際脊椎植入物業務在第三季度實現了創紀錄的銷售額，按固定匯率計算比上年增長 86%，大多數市場都實現了兩位數的高增長，日本、德國、英國、義大利、巴西和哥倫比亞的美元貢獻強勁。

We have yet to fully harness the power of the combined Globus NuVasive product offerings internationally and feel this will be a significant tailwind moving forward in 2025 and beyond. The combined trauma and NSO business delivered 99% growth for Q3, driven by the continued powerful performance and market penetration of our base trauma business, combined with the fast uptake of the NuVasive specialty orthopedic growth now. The combination of these two businesses is one of the strengths of our merger, offering a broad range of products and market-changing innovation.

我們尚未充分利用 Globus NuVasive 產品的國際影響力，我們認為這將成為 2025 年及以後發展的重要推動力。綜合創傷和 NSO 業務在第三季度實現了 99% 的成長，這得益於我們基礎創傷業務持續強勁的表現和市場滲透，以及目前 NuVasive 專業骨科業務的快速成長。這兩家企業的結合是我們合併的優勢之一，能夠提供廣泛的產品和改變市場的創新。

Integration is progressing well as we continue to cross-train our field, implement common global systems, expand our investment in sets and bring new products to market. There's been a great deal of progress from our teams, and we're fortunate to have such strong leaders throughout the world.

隨著我們繼續進行領域交叉培訓、實施全球通用系統、擴大對設備的投資以及將新產品推向市場，整合進展順利。我們的團隊取得了巨大的進步，我們很榮幸在世界各地擁有如此強大的領導者。

You can see from this quarter's financials, synergies have been identified and actions have begun to realize benefits, focusing on out-of-pocket spending and prioritizing investments to match future growth plans. In-house organizational structures have been implemented and we're working towards reaching steady state by year-end.

從本季度的財務狀況可以看出，已經確定了協同效應，並且採取的行動已開始產生效益，重點關注自付費用並優先考慮投資以符合未來的成長計劃。內部組織結構已經實施，我們正在努力在年底前達到穩定狀態。

I believe the potential for Globus has never been greater. It's up to us to harness our resources and shape the future of our markets. We have at our fingertips, everything we need to realize this. I want to thank the worldwide Globus team for your dedication and support, delivering an incredible quarter and furthering the pathway to becoming the preeminent musculoskeletal technology company in the world.

我相信 Globus 的潛力從未如此巨大。我們必須充分利用我們的資源並塑造我們市場的未來。我們已經擁有實現這一目標所需的一切。我要感謝全球 Globus 團隊的奉獻和支持，帶來了令人難以置信的季度業績，並進一步邁向成為全球卓越的肌肉骨骼技術公司的道路。

I will now turn the call over to Keith.

現在我將電話轉給 Keith。

Thanks, Dan, and good afternoon, everyone. During our third quarter, we passed the 1-year mark since the closing of the NuVasive merger. Much work has been done thus far in becoming the most successful spine integration at the 1-year mark. Much work remains, we are hard at work to continue in this vein. I'm extremely pleased with the outstanding results of our third quarter.

謝謝，丹，大家下午好。在第三季度，我們與 NuVasive 合併已經結束一周年。迄今為止，我們已經做了大量工作，以實現一年內最成功的脊椎整合。還有很多工作要做，我們正在努力繼續這樣做。我對我們第三季的出色業績感到非常高興。

As I look at sales performance, profitability, the balance sheet, cash flow and cash generation, I see Q3 as a fundamentally complete quarter. All facets of the business performed, and the outcomes are clearly visible in our third quarter results. Revenue for the third quarter was $625.7 million, growing 63.1% as reported. Day adjusted sales growth was 60.8%, with one more selling day in the US versus Q3 of 2023.

當我查看銷售業績、獲利能力、資產負債表、現金流量和現金產生情況時，我認為第三季是一個基本上完整的季度。業務的各個方面均有表現，其成果在我們的第三季業績中清晰可見。據報道，第三季營收為 6.257 億美元，成長 63.1%。日調整後銷售額成長率為 60.8%，與 2023 年第三季相比，美國的銷售日增加了一天。

Our Q3 GAAP net income was $51.8 million, resulting in $0.38 of fully diluted earnings per share. This compares to GAAP net income of $1 million and $0.01 of fully diluted earnings per share in the prior year quarter. Q3 '24 non-GAAP net income was $114 million, growing 73.9% versus the prior year quarter resulting in $0.83 of fully diluted earnings per share. Third quarter non-GAAP earnings per share grew 45% despite a 20% increase in diluted shares as a result of the merger. Our third-quarter adjusted EBITDA was 31% and free cash flow was a record $161.7 million.

我們第三季的 GAAP 淨收入為 5,180 萬美元，每股攤薄收益為 0.38 美元。相比之下，去年同期的 GAAP 淨收入為 100 萬美元，每股攤薄收益為 0.01 美元。24 年第三季非公認會計準則淨收入為 1.14 億美元，較去年同期成長 73.9%，每股完全攤薄收益為 0.83 美元。儘管合併導致稀釋股增加 20%，但第三季非 GAAP 每股盈餘仍成長 45%。我們第三季的調整後 EBITDA 為 31%，自由現金流達到創紀錄的 1.617 億美元。

Musculoskeletal revenue in the third quarter was $587.4 million, growing 65% as compared to the prior year quarter, driven mainly by the contributions from the NuVasive merger. On a pro forma basis, assuming NuVasive was in our prior period results, musculoskeletal revenue grew 5.4% compared to Q3 of 2023. Growth was again led this quarter by US Spine and our International Spine businesses.

第三季的肌肉骨骼收入為 5.874 億美元，比去年同期成長 65%，主要得益於 NuVasive 合併帶來的貢獻。從預測基礎來看，假設 NuVasive 符合我們前期業績，那麼與 2023 年第三季相比，肌肉骨骼收入成長了 5.4%。本季的成長再次由美國脊椎業務和國際脊椎業務所引領。

Our Q3 enabling technologies revenue was $38.3 million, growing 38.5% versus the prior year quarter. Growth was driven by increased sales within the US market across our EGPS and E3D products. In addition, we also sold and shipped our first EHub units during the quarter. Overall, the third quarter represented a record for total Excelsius units placed in a quarter.

我們第三季的支援技術收入為 3,830 萬美元，比去年同期成長 38.5%。成長的動力來自於我們 EGPS 和 E3D 產品在美國市場的銷售成長。此外，我們還在本季度銷售並運送了第一批 EHub 單元。總體而言，第三季 Excelsius 單位總數創下了單季的最高紀錄。

Looking ahead to our fourth quarter, the capital market remains healthy, and we are well positioned with a strong pipeline and seek to close the year strong. US revenue in the third quarter was $495.8 million, growing 60.3% as reported compared to the prior year quarter. Looking at the quarter on a pro forma basis, US revenue grew 7.3%, driven predominantly by US Spine and Enabling Technologies.

展望第四季度，資本市場依然健康，我們憑藉強大的產品線做好了充分準備，力爭以強勁勢頭結束這一年。第三季美國營收為 4.958 億美元，較去年同期成長 60.3%。從預測基礎來看，本季美國營收成長 7.3%，主要得益於美國脊椎技術和支援技術。

Looking back on the past year since the merger closed, I call attention to the fact that our US business has grown on a pro forma basis in each of the four quarters, led predominantly by our US Spine and Enabling Technologies businesses. International revenue during the third quarter was $129.9 million, growing 74.8% as reported compared to the prior year quarter. On a pro forma basis, international revenue grew 5.1%, driven by strong implant growth primarily in our EMEA countries, partially offset by lower capital sales.

回顧合併完成以來的過去一年，我注意到，我們的美國業務在四個季度中都實現了預計增長，主要由我們的美國脊椎業務和支援技術業務帶動。第三季國際營收為 1.299 億美元，較去年同期成長 74.8%。從預測基礎來看，國際收入成長了 5.1%，這主要得益於我們在歐洲、中東和非洲 (EMEA) 國家/地區植入物的強勁增長，但資本銷售額的下降部分抵消了這一增長。

Q3 GAAP gross profit was 53% compared to 62.2% in the prior year quarter, which is inclusive of product-related intangible amortization for both periods presented. The decline in GAAP gross profit is primarily the result of step-up amortization from the NuVasive merger, which will end during our fiscal fourth quarter.

第三季 GAAP 毛利為 53%，去年同期為 62.2%，其中包含兩個期間的產品相關無形資產攤銷。GAAP 毛利的下降主要是由於 NuVasive 合併帶來的逐步攤銷，合併將於我們財政年度第四季度結束。

Excluding the impacts of step-up amortization, non-GAAP gross profit was 66.5% compared to 69.7% in the prior year quarter. The decline in gross profit rate was driven primarily by the inclusion of NuVasive in our consolidated results as well as a higher mix of capital sales in the quarter. We expect the full year adjusted gross profit rate to be in the range of 67% to 68% for the full year 2024.

排除逐步攤銷的影響，非公認會計準則毛利為 66.5%，去年同期為 69.7%。毛利率下降主要是由於我們合併業績中納入了 NuVasive，以及本季資本銷售組合增加。我們預計 2024 年全年調整後毛利率將在 67% 至 68% 之間。

Looking ahead, we expect to work back towards the goal of a mid-70s adjusted gross profit margin as we complete the integration and realize all the synergies across manufacturing, operations and vendor management. Research and development expenses in the third quarter were $35.4 million or 5.7% of sales compared to $29.3 million or 7.6% of sales in the prior year quarter.

展望未來，隨著我們完成整合並實現製造、營運和供應商管理之間的所有協同效應，我們預計調整後毛利率將重新回到 70 年代中期的目標。第三季研發費用為 3,540 萬美元，佔銷售額的 5.7%，而去年同期為 2,930 萬美元，佔銷售額的 7.6%。

The increase in spending is the inclusion of NuVasive in our consolidated results, partially offset by synergy actions taken. Consistent with our previous expectations, we still expect R&D expenses to be in the range of 6.5% to 7% for the full year 2024. SG&A expenses for the third quarter were $240.7 million or 38.5% of sales compared to $156.2 million or 40.7% of sales in the third quarter of the prior year.

支出的增加是由於我們將 NuVasive 納入了我們的合併業績，但部分被所採取的協同行動所抵消。與我們先前的預期一致，我們仍預計 2024 年全年研發費用將在 6.5% 至 7% 之間。第三季的銷售、一般及行政費用為 2.407 億美元，佔銷售額的 38.5%，去年同期為 1.562 億美元，佔銷售額的 40.7%。

Consistent with prior quarters, the increase in total SG&A dollars is directly the result of the NuVasive merger, partially offset by cost actions taken and fixed cost leverage on spending. Consistent with our comments last quarter, we still expect full year SG&A expenses to improve 1 to 2 percentage points over the full year 2023 SG&A expense as a percentage of sales.

與前幾季一致，銷售、一般及行政支出總額的增加直接歸因於 NuVasive 合併，但被採取的成本行動和固定成本支出槓桿部分抵銷。與我們上個季度的評論一致，我們仍然預計全年銷售、一般及行政開支佔銷售額的百分比將比 2023 年全年銷售、一般及行政開支提高 1 至 2 個百分點。

Net interest expense in the third quarter of 2024 was $0.8 million compared to net interest income of $7.8 million in the prior year quarter. The resulting $8.6 million pretax unfavorable impact is driven by the use of cash to A, fund the NuVasive line of credit pay down at merger close; B, fund share repurchases related to our buyback plan; and C, interest expense from the senior convertible note, which is assumed from NuVasive at merger close. The GAAP tax rate for the third quarter was 9.1% and compared to 60.7% in the prior year quarter.

2024 年第三季的淨利息支出為 80 萬美元，而去年同期的淨利息收入為 780 萬美元。由此產生的 860 萬美元的稅前不利影響是由於使用現金來 A、在合併結束時為 NuVasive 信用額度償還提供資金； B、與我們的回購計畫相關的基金份額回購； C，優先可轉換票據的利息費用，該費用在合併結束時由 NuVasive 承擔。第三季的 GAAP 稅率為 9.1%，去年同期為 60.7%。

The prior year rate was impacted by the low level of GAAP pretax income in the prior year quarter as well as a non-recurring benefit in the current year quarter related to a reserve reversal, which favorably impacted the rate by approximately 11%. Our non-GAAP tax rate for the quarter was 29.1% and does not include this nonrecurring benefit. We expect our full year non-GAAP tax rate to be in the range of 24% to 25% for the full year 2024.

去年同期的利率受到去年同期 GAAP 稅前收入較低以及本季與準備金逆轉相關的非經常性收益的影響，這對利率產生了約 11% 的有利影響。我們本季的非公認會計準則稅率為 29.1%，不包括此項非經常性福利。我們預計 2024 年全年非 GAAP 稅率將在 24% 至 25% 之間。

Shifting to cash flow. Our third quarter results were stellar, with both record operating cash and free cash flow. Operating cash flow was $203.7 million and free cash flow was $161.7 million. As Dan mentioned earlier, our Q3 '24 free cash flow was essentially our entire cash flow for fiscal 2023 and which is $165.2 million.

轉向現金流。我們第三季的業績非常出色，營運現金和自由現金流均創下歷史新高。營運現金流為 2.037 億美元，自由現金流為 1.617 億美元。正如丹之前提到的，我們 24 年第三季的自由現金流基本上是我們 2023 財年的全部現金流，為 1.652 億美元。

The drivers of the improved cash flow are twofold. One, we are seeing the cash benefit of synergy capture roll through our P&L as our cash earnings continue to improve; and two, we are unwinding the impacts of the system go-live to accounts receivable, which I commented on during our first quarter call. Specifically, our US systems go live in Q1 temporarily impacted accounts receivable, which resulted in a higher working capital investment.

現金流改善的驅動因素有兩個。一是，隨著現金收益的不斷改善，我們看到綜效帶來的現金收益正透過我們的損益表滾滾而來；二是我們正在消除系統上線對應收帳款的影響，我在第一季電話會議上對此進行了評論。具體來說，我們第一季上線的美國系統暫時影響了應收帳款，從而導致營運資金投資增加。

As expected, we are seeing this issue improve and expected to drive working capital improvements through the fourth quarter and into early 2025. Our record free cash flow was also achieved in a quarter where capital expenditures were approximately 6.7% of sales, showing evidence of our investment in the business, namely spine sets during the quarter. Our expectation is that full year 2024 CapEx will be in the range of 4.5% to 5.5% of sales. I began my remarks today commenting that I viewed our third quarter results as a fundamentally complete quarter.

正如預期的那樣，我們看到這個問題正在改善，並預計將推動第四季至 2025 年初營運資本的改善。我們的創紀錄自由現金流也是在資本支出約佔銷售額 6.7% 的季度實現的，這證明了我們在本季度對業務（即脊椎套件）的投資。我們預計 2024 年全年資本支出將佔銷售額的 4.5% 至 5.5% 之間。我今天的發言一開始就表示，我認為我們的第三季業績是一個基本上完整的季度。

A key driver of that statement was based on our cash flow for the quarter. To further highlight now that we have a full four quarters behind us since the merger, we are starting to see the financial vision we envisioned for the merged Globus company become more of a reality. In these trailing four quarters, operating cash flow was $415 million and free cash flow was $293.8 million.

該聲明的一個關鍵驅動因素是我們本季的現金流。進一步強調的是，自合併以來我們已經過去了整整四個季度，我們開始看到我們為合併後的 Globus 公司設想的財務願景變得更加現實。在過去四個季度中，營運現金流為 4.15 億美元，自由現金流為 2.938 億美元。

Our capital allocation priorities remain unchanged. Our long-term vision is to maintain strong financial discipline with little to no debt, invest in organic and inorganic opportunities while providing a return to shareholders through share repurchases.

我們的資本配置重點維持不變。我們的長期願景是保持嚴格的財務紀律，減少或不增加債務，投資有機和無機機會，同時透過股票回購為股東提供回報。

Share repurchases have and will remain an integral part of our approach moving forward. I remind everyone that since the merger closed, we spent a total of $310.3 million on share repurchases. Shifting over to debt and looking ahead to early 2025, it is our intent to use existing cash reserves to repay the $450 million senior convertible notes, which are due to mature in March of 2025.

股票回購已經並將繼續是我們未來策略的重要組成部分。我提醒大家，自合併完成以來，我們共花費 3.103 億美元用於股票回購。轉向債務並展望 2025 年初，我們打算使用現有現金儲備償還將於 2025 年 3 月到期的 4.5 億美元優先可轉換票據。

Now I'd like to spend a few minutes discussing our integration progress and synergy capture. Looking back on the decisions made and actions taken thus far in 2024, we are heavily focused on our US operations, namely territory realignments, remuneration of cost redundancies, facility consolidations, system integrations and contract renegotiations.

現在我想花幾分鐘討論一下我們的整合進度和協同效應。回顧 2024 年迄今所做的決定和採取的行動，我們將重點放在美國業務，即區域調整、成本冗餘補償、設施整合、系統整合和合約重新談判。

Year two efforts will focus on further refinement of our international systems and its footprint the implementation of additional warehouse efficiencies and, most importantly, product insourcing efforts. We've begun ordering the machinery and equipment that will drive our in-sourcing initiatives that will encompass both of our manufacturing facilities in Pennsylvania and Ohio.

第二年的努力將集中在進一步完善我們的國際系統及其足跡，實施額外的倉庫效率，以及最重要的是產品內部採購工作。我們已經開始訂購機械和設備，以推動我們的內部採購計劃，該計劃將涵蓋我們位於賓夕法尼亞州和俄亥俄州的製造工廠。

As we execute this, we will seek to expand our manufacturing know-how with new and expanded capabilities, all while fostering a sense of teamwork and collaboration as we bring together the knowledge and approaches of both legacy organizations. As it relates to synergy capture, we previously communicated our expectation of $170 million of synergies over three years with the ability to realize 40% or $68 million in year one, 40% or an incremental $6 million in year two and 20% or an incremental $34 million in year three.

在執行這一目標的過程中，我們將尋求透過新的和擴展的能力來擴展我們的製造技術，同時在匯集兩個傳統組織的知識和方法時培養團隊合作意識。至於綜效，我們之前曾表達過對三年內 1.7 億美元協同效應的預期，其中第一年可以實現 40% 或 6800 萬美元，第二年可以實現 40% 或增量 600 萬美元，第三年可以實現 20% 或增量 3400 萬美元。

While we expect and remain committed to achieving the $170 million in savings over three years, we are updating the time phasing of these savings. We now expect to realize 55% or approximately $94 million in year one, 30% or $51 million in year two and 15% or $25 million by the end of the third year.

我們預期並將繼續致力於在三年內實現 1.7 億美元的節約，但我們正在更新這些節約的時間表。我們現在預計第一年將實現 55% 或約 9,400 萬美元，第二年實現 30% 或 5,100 萬美元，第三年末實現 15% 或 2,500 萬美元。

This timing improvement in savings ties back to our Globus culture of moving with a sense of urgency as our employees are relentlessly changing patients' lives. We'll provide additional updates to our projections when necessary as we move ahead. Based upon our Q3 performance and outlook for the remainder of the year, we are again increasing our previously provided guidance.

這種節省成本的及時性改善與我們的 Globus 文化息息相關，即在我們的員工不懈地改變患者生活的同時，我們也懷著緊迫感採取行動。隨著工作的推進，我們將在必要時對我們的預測提供更多更新。根據我們第三季的業績以及今年剩餘時間的展望，我們再次上調了先前提供的預期。

We now expect 2024 net sales to be in the range of $2.49 billion to $2.5 billion. Our revised net sales guidance implies 3.9% to 4.3% growth over 2023 pro forma revenues of $2.396 billion. We are delivering sales growth in a year of extensive integration.

我們現在預計 2024 年淨銷售額將在 24.9 億美元至 25 億美元之間。我們修訂後的淨銷售額預期意味著 2023 年預計收入 23.96 億美元將成長 3.9% 至 4.3%。我們在廣泛整合的一年裡實現了銷售成長。

Before I provide a revised fully diluted non-GAAP EPS guidance, I'd like to call attention to a change we made during the quarter related to our non-GAAP reporting where we will no longer adjust for the impact of the acquisition of in-process research and development. This change in reporting will unfavorably impact our previously provided 2024 non-GAAP EPS guidance by $0.09 as a result of our Q1 '24 IP R&D acquisition.

在我提供修訂後的完全稀釋非 GAAP 每股盈餘指引之前，我想提請大家注意我們在本季度對非 GAAP 報告所做的一項變更，我們將不再根據收購在研研發的影響進行調整。由於我們 24 年第一季的 IP 研發收購，這項報告變更將對我們先前提供的 2024 年非 GAAP EPS 指引產生不利影響，影響幅度為 0.09 美元。

Given this change, as well as our expectations on business performance. Our revised fully diluted non-GAAP EPS is now expected to be in the range of $2.90 to $3 per fully diluted share. Our revised guidance range assumes a $0.19 increase to operational performance, partially offset by the $0.09 impact due to no longer adjusting for the acquisition of IP R&D as previously stated.

鑑於此變化，以及我們對業務表現的預期。我們修正後的完全稀釋非 GAAP 每股盈餘預計在每股 2.90 美元至 3 美元之間。我們修訂後的指導範圍假設營運績效增加 0.19 美元，但部分被不再根據先前所述的 IP 研發收購進行調整而產生的 0.09 美元的影響所抵消。

Overall, this change reflects our views of enhanced profitability driven by improving business performance while more closely aligning our non-GAAP reporting with the most comparable GAAP measure. Our Q3 performance reflected the underlying strength of our business.

總體而言，這項變更反映了我們對透過提高業務績效來提高獲利能力的看法，同時使我們的非 GAAP 報告與最具可比性的 GAAP 指標更加緊密地結合起來。我們的第三季業績反映了我們業務的潛在實力。

We achieved meaningful sales growth, drove enhanced profitability and generated record free cash flow, all while still investing in our business. I'm extremely pleased with our results and remain excited for what's to come. Closing out on my comments, I'd like to once again thank our employees for their commitment and dedication.

我們實現了有意義的銷售成長，提高了獲利能力並創造了創紀錄的自由現金流，同時仍在對業務進行投資。我對我們的成績非常滿意，並且對未來充滿期待。最後，我想再次感謝我們的員工的承諾和奉獻。

In the state of change, we've continued to deliver innovation and new products to our partners based on our culture of maintaining operational excellence and a focused, disciplined approach to cost, thus ensuring we have the right product at the right price and on time.

在變化的狀態下，我們始終本著保持卓越營運和專注、嚴謹的成本控制方法的文化，持續為合作夥伴提供創新和新產品，從而確保我們能夠按時以合適的價格提供合適的產品。

We will now open the call for questions.

我們現在開始提問。

(Operator Instructions)

（操作員指令）

Matt Miksic, Barclays.

巴克萊銀行的馬特‧米克西克 (Matt Miksic)。

Hey. Good evening and congrats on a really strong quarter, guys. So one quick sort of question on margins and then a follow-up on robots, if I could. So margins, obviously, EBITDA margins popped up nicely. You mentioned some of the things that were driving that sort of acceleration into the low 30s. Could you maybe highlight the large moving pieces that sort of -- that got you there faster, certainly faster than we were expecting and the Street was expecting? And then I mentioned I have one quick follow-up.

嘿。晚上好，大家好，恭喜你們取得如此強勁的季度業績。因此，如果可以的話，我先快速問一下利潤率，然後再問機器人的問題。因此利潤率，顯然，EBITDA 利潤率會良好上升。您提到了一些導致這種加速達到 30% 以下的因素。您能否強調一下那些讓您更快實現這一目標的重大舉措，肯定比我們和華爾街預期的還要快？然後我提到我有一個快速的後續問題。

Sure. So Matt, I'll take the first part of that question -- actually, I'll take the first part of what you stated. Really, when you look back on the year, we aggressively went after eliminating cost redundancies as well as facility consolidation like I commented on in the quarter.

當然。所以馬特，我將回答這個問題的第一部分——實際上，我將回答你陳述的第一部分。確實，當你回顧這一年時，我們積極地消除成本冗餘以及進行設施整合，就像我在本季度所評論的那樣。

As we got into the year, we identified more and more places where we felt that there was opportunity for savings and really as we really looked at the year come together, the key focus for us is driving cash savings. I'm not super interested in driving or finding ways to generate noncash savings we really took a look at four-wall spending and said, what do we need to do to really drive improved profitability. It's really about it.

隨著新年的到來，我們發現越來越多的地方有節約資金的機會，而當我們真正回顧這一年時，我們發現，我們的重點是推動現金節約。我對推動或尋找產生非現金儲蓄的方法並不是特別感興趣，我們真正研究了四面牆的支出，並說，我們需要做些什麼才能真正提高獲利能力。這確實是這樣的。

Okay. Well, I'm sure there'll be follow-ups on that. But on robots, one of the things I think we've asked about since the beginning and since the merger was announced is behind this mission of doubling the field force and selling your robot across the broader field force. What has the progress been like on the NuVasive side? reps getting into -- getting you into accounts and kind of what's the look forward on that?

好的。嗯，我確信會有後續事件。但關於機器人，我認為我們從一開始就問過的事情之一，以及自從宣布合併以來，就是這項使命的背後原因，即增加現場力量，並在更廣泛的現場力量中銷售機器人。NuVasive 方面進展如何？銷售代表進入－讓您進入帳戶，對此有什麼期待？

Hey, Matt. I'll take that one. So it's been progressing well. It's really been several fold. The first one is we have been training our reps on the system itself. So we've been bringing our team in, making them experts, getting them comfortable with that so that they understand how to perform this.

嘿，馬特。我要那個。因此，一切進展順利。確實已經增加了好幾倍。第一個是我們一直在對我們的代表進行系統性本身的訓練。因此，我們一直招募我們的團隊，讓他們成為專家，讓他們感到舒適，以便他們了解如何執行此操作。

And I've seen dozens and dozens of teams from the former NuVasive team in our labs running through that. At the same time, our product development team has been working to take the great NuVasive products like Reline or Modulus and get those on to the software that's been done. We're actually working now to -- and we're waiting for approvals of that to come through to go.

我看到我們實驗室裡前 NuVasive 團隊的數十個團隊正在進行這項工作。同時，我們的產品開發團隊一直致力於將 Reline 或 Modulus 等優秀的 NuVasive 產品融入已完成的軟體中。事實上，我們現在正在努力——我們正在等待相關批准。

It's really the combination of those two that will allow us to make that more functional. In addition to that, we've already been obviously seeding through conversations with surgeons bringing them in for VIPs, having conversations with that. I'll tell you I'm pleased where it is the real thing we need to do is get the approvals to use those NUVA products out on our system. But I think that's really what 2025 is going to be for us.

正是這兩者的結合才使我們能夠使其更具功能性。除此之外，我們顯然已經透過與外科醫生的對話來播下種子，將他們帶入 VIP 人群，並與他們進行對話。我很高興地告訴你們，我們真正需要做的是獲得在我們的系統上使用那些 NUVA 產品的批准。但我認為這確實就是 2025 年我們要做的事。

Vik Chopra, Wells Fargo.

喬普拉 (Vik Chopra)，富國銀行。

Hi. Congrats on the quarter. This is Dino on for Vik. I just wanted to ask about if you have an update on the FDA warning letter that recently came out. what update can you provide on it? And what are the next steps? Do you expect it to be resolved soon? And what, if any, is the commercial impact?

你好。恭喜本季取得佳績。這是 Dino 代替 Vik 上場。我只是想問一下，您是否有關於最近發布的 FDA 警告信的最新消息。您能提供什麼最新消息？下一步是什麼？您預計這個問題很快就會解決嗎？如果有的話，其商業影響是什麼？

Thanks, Dino. I'll take that as well. So just again, to remind everybody, that warning letter was really about our internal processes of how we handle complaints. It was not directed towards the actual robot nor did it imply any issues with a robot or with patient safety. It was about how we handle complaints.

謝謝，迪諾。我也會接受這個。因此，再次提醒大家，那封警告信其實是關於我們處理投訴的內部流程的。它不是針對實際的機器人，也沒有暗示機器人或病人安全的任何問題。這是關於我們如何處理投訴。

And it was really about the array of criteria we selected when we're analyzing plates. The FDA would like us to do more, in which case we did. We went back to the very first complaint and went through every single one of them, realized that our outcome would not change with all the additional criteria. We've agreed to put that going forward. We've submitted that out to the FDA.

這實際上與我們在分析板塊時選擇的一系列標準有關。FDA 希望我們做更多的事情，事實上我們也確實這麼做了。我們回顧了最開始的投訴，並逐一進行了檢查，發現我們的結果不會因為所有附加標準而改變。我們已同意繼續推進此事。我們已將其提交給 FDA。

We've had a few back and forth for clarification. And now we're in the phase of just proving it out as an effective approach. And we're willing, and we're excited to actually have them come back in for reinspection to get this behind us. Morning letters in the past from other companies tend to last in the year or excess of a year. So we're seeing if we can close that down and do that faster than that normal curve.

我們已多次一再澄清此事。現在我們正處於證明它是一種有效方法的階段。我們願意並且很高興讓他們回來重新檢查，以解決這個問題。過去其他公司發出的早晨信件通常會持續一年或一年以上。因此，我們正在觀察是否可以將其關閉，並且比正常曲線更快完成。

As far as sales, there's no doubt there's probably been a few customers that were worried about this. We've gone out, had direct conversations with them. We've assured them in several different ways that it's not a product-related issue. And while there's some impact, I wouldn't quantify it, and I don't feel that it's been significant to date.

就銷售而言，毫無疑問可能會有一些客戶對此感到擔憂。我們已經出去並與他們直接交談。我們已透過多種方式向他們保證這不是產品相關的問題。雖然確實存在一些影響，但我無法量化它，而且我覺得到目前為止它還不是很顯著。

Got it. That's helpful. And then one follow-up on the capital equipment environment. Just what's your view on the capital equipment environment heading into Q4? And how are you feeling about 2025 after two of your competitors recently received FDA approval for their spine robots.

知道了。這很有幫助。然後對資本設備環境進行追蹤。您對第四季的資本設備環境有何看法？您的兩個競爭對手的脊椎機器人最近獲得了 FDA 批准，您對 2025 年有何感想？

This is Keith. I'll take that. I think about going into Q4, we feel good about where the capital environment is. Our pipeline remains strong. There's a lot of inbound interest. There's lots of quotes getting turned around. As I think about going into 2025, competition is coming. We knew competition would be coming at some point. And at this point, we're leaning in and we're really focusing on selling our robot, which we still feel is best-in-class technology.

這是基斯。我接受。我認為進入第四季度，我們對資本環境感到滿意。我們的通路依然強勁。有很多人對此感興趣。很多引言都被顛倒了。當我想到即將進入 2025 年時，競爭即將到來。我們知道競爭終究會出現。此時，我們正全力以赴，真正專注於銷售我們的機器人，我們仍然認為這是一流的技術。

And if you remember, one of the premises of the merger was to actually double our total available market and introduce this to more surgeons through the NuVasive side. that is and will remain our focus. We will willingly compete head-to-head with any competition in any account, but our main focus is going to be taking advantage of the surgeons we're active with to place those units through next year.

如果您還記得的話，合併的前提之一是實際上使我們的總可用市場翻一番，並透過 NuVasive 將其介紹給更多的外科醫生。這仍然是我們的重點。我們願意與任何帳戶上的任何競爭對手進行正面競爭，但我們的主要重點是利用我們活躍的外科醫生來安排這些單位到明年。

Matt Taylor, Jefferies.

傑富瑞的馬特泰勒 (Matt Taylor)。

Hi, guys. This is Young Li in for Matt. I guess to start, one on reps, spending a little bit more than a year since the deal closed. Can you level set us on how many reps might have guarantees that are expiring? Is it a material number or revenue impacted? It sounds like you're seeing [separate] (inaudible) I guess, are you also maybe seeing some competitive responses from the other companies on your reps?

嗨，大家好。這是取代 Matt 的 Young Li。我想先談談銷售代表，自交易結束以來已經過了一年多的時間。您能否告訴我們有多少代表的保證可能即將到期？這是否對重要數字或收入產生了影響？聽起來你看到了[單獨的]（聽不清楚）我想，你是否也看到了其他公司對你的代表的一些競爭反應？

Thanks, Young Li. I'll take that as well. There was a word in the street falsely spread that the majority of our people are on contracts. I'm not sure why someone would come up with that. it's simply untrue. It shows that people are disconnected with the industry. We have historically had a few people who are on contracts and to date, even combined as one that still remains very low for us.

謝謝，Young Li。我也會接受這個。有謠言說，我們的大多數人都是簽訂合約的。我不確定為什麼有人會想到這個。這完全不是事實。這表明人們與該行業脫節了。我們歷史上曾經有過一些簽約的人，但到目前為止，即使加起來，對我們來說這個數字仍然很低。

It is not a significant impact by any stretch with that. And like regular business, we aggressively go after competitive recruits and our competition goes after competitive recruits. We're not seeing anything unusual with that related to this merger at that point.

無論如何，這不會造成重大影響。和常規業務一樣，我們積極招募有競爭力的新員工，我們的競爭對手也會積極招募有競爭力的新員工。目前我們還沒有發現與此合併有關的任何異常情況。

But I do want to stress the word on the street is simply incorrect. We do not have the majority of folks own guarantees at all it's a very manageable number. It has been managed that way. We expect our people to perform with the best-in-class portfolio. And unlike other companies, we don't have to guarantee them to do that. The products and the innovation allow them to self-sustain.

但我確實想強調的是，街頭巷尾的傳言完全是錯的。我們根本沒有大多數人自己的擔保，這是一個非常可控的數字。事情就是這樣管理的。我們期望我們的員工能夠表現出一流的業績。與其他公司不同的是，我們不必保證他們一定會這樣做。這些產品和創新使他們能夠自我維持。

All right. Great. Thanks for the information there. I guess one to follow up on really strong growth OUS, you increased investments in the useful US business. I wanted to hear a little bit about your thoughts on the international spine business profitability. There's a lot of opportunities and tailwinds on the revenue side, but I can US EBITDA back up versus the US.

好的。偉大的。感謝那裡的資訊。我想，為了跟進 OUS 真正強勁的成長，您增加了對有用的美國業務的投資。我想聽聽您對國際脊椎業務獲利能力的看法。收入方面有很多機會和順風，但我可以將美國的 EBITDA 與美國進行比較。

This is Keith. I'll take that question. I mean, absolutely. I mean international profitability is going to vary country to country. But couple of things you got to think about is we're operating in places where pricing may be favorable and you're driving volume growth of the same products that we're making here in the US.

這是基斯。我來回答這個問題。我絕對表示如此。我的意思是，國際獲利能力因國家而異。但是你要考慮的幾件事是，我們在定價可能有利的地方開展業務，並且你們正在推動我們在美國生產的相同產品的銷售成長。

So as you incrementally add more product internationally, can drop more variable profit to the bottom line just by the nature of what you're selling. So absolutely, there's an ability to create more of an enhanced profitability internationally as we move forward, which can have a compounding effect on the larger business.

因此，隨著您在國際上逐步增加更多產品，僅根據您銷售產品的性質，就會有更多的可變利潤降至底線。因此，隨著我們不斷前進，我們絕對有能力在國際上創造更多的獲利能力，這可能會對更大的業務產生複合效應。

That's great. Thanks so much for the color. And looking forward to seeing you guys at (inaudible)

那太棒了。非常感謝這個顏色。期待在（聽不清楚）

Shagun Singh, RBC Capital Markets.

加拿大皇家銀行資本市場 (RBC Capital Markets) 的 Shagun Singh。

Great. Thanks for taking the questions and congratulations on a really strong quarter. I guess just two for me. The first on the recon robotic launch, you did call out what the features are going to be. Can you maybe elaborate on what do you think is going to be most differentiated? What's your commercial strategy and how we should think about the impact in 2025.

偉大的。感謝您回答這些問題，並祝賀您本季業績表現強勁。我想對我來說只有兩個。第一次在偵察機器人發射時，你確實提到了它的特徵。您能否詳細說明一下您認為最顯著的差異是什麼？您的商業策略是什麼，我們應該如何看待 2025 年的影響。

And then I guess for my second question, on capital allocation, you had previously called out a focus on complementary M&A. It seems like you still have more work to do on NuVasive, but the big chunk is behind you. So can you just elaborate on your appetite and preference for deal size, et cetera? Thank you for taking the questions.

我想對於我的第二個問題，關於資本配置，您之前曾提到要關注互補併購。看起來您在 NuVasive 上還有許多工作要做，但是大部分工作已經完成了。那麼您能詳細說明一下您對交易規模的興趣和偏好等等嗎？感謝您回答這些問題。

Thanks, Shagun. I'll take the first part of it. I think what we're excited about with the robot is it's obviously newly designed, built from scratch. I feel like the movement of its arm itself is really a benefit of what we do. I think the accuracy of what we can come up with using all latest technology is really good as well.

謝謝，Shagun。我將選取第一部分。我認為我們對這個機器人感到興奮的原因是它顯然是全新設計的、從頭開始建造的。我覺得它的手臂本身的運動確實是我們所做事情的一個好處。我認為我們利用所有最新技術得出的結果的準確性也非常好。

I think ultimately, it can be many different things where we want to get into. The big thing I like about this is the multiple workflows, whether you want to do CT or image lists with that. The fact that it can instantly go, you don't need to send something away for planning of it to get it organized. So there's a lot of flow and efficiency. There's a lot of flexibility that I think put in the hands of the surgeon coupled with the newness and latest technology built from the ground up, I think, can be meaningful and impactful.

我認為最終我們可以涉足很多不同領域。我最喜歡它的一點是它的多種工作流程，無論您是想使用它來處理 CT 還是影像清單。事實上，它可以立即運行，您不需要將某物送去進行規劃和組織。因此流動性很大，效率很高。我認為，外科醫生擁有很大的靈活性，再加上從頭開始建立的全新最新技術，我認為這是有意義和影響力的。

And Shagun, this is Keith. I'll take the second part. As it relates to capital allocation and driving M&A, really go back to our mission. We're a musculoskeletal company looking to improve the lives of patients with musculoskeletal disorders. So as you think about that in our products, we want to fill out the bag of what is not in our product portfolio yet.

沙岡，這是基斯。我將選擇第二部分。由於它與資本配置和推動併購有關，所以我們確實要回到我們的使命。我們是一家肌肉骨骼公司，致力於改善肌肉骨骼疾病患者的生活。因此，當您考慮我們的產品時，我們希望填補我們產品組合中尚未填補的部分。

And as I think about kind of what we would look at, you could look at shoulders, you can look at enhancing our joint portfolio. There's lots of places to look, but it's also looking at complementary pieces of technology that could really help develop something or bring something in the market quicker.

當我思考我們要看什麼時，你可以看看肩膀，你可以看看增強我們的聯合投資組合。有很多地方需要關注，但同時也在尋找能夠真正幫助開發某些東西或更快地將某些東西推向市場的互補技術。

I wouldn't comment on a specific size or scale at this point. as we work through the integration and NuVasive acquisition, we want to make sure we get all of this right, there's still more work to do. I think that as time passes, we'll see what opportunities are out there. And really move based on what we see as a fit for us as we move forward.

目前我不會對特定的尺寸或規模發表評論。在我們完成整合和 NuVasive 收購的過程中，我們希望確保所有工作都正確完成，但仍有更多工作要做。我認為隨著時間的推移，我們會看到哪些機會存在。並根據我們認為適合自己的情況，真正採取下一步行動。

Thank you.

謝謝。

Matthew O'Brien, Piper Sandler.

馬修·奧布萊恩、派珀·桑德勒。

Hey. This is Joe on for Matt. Congrats on the great quarter. I really wanted to ask about the guidance update. You've seen in Q3, and I hate to ask if this bluntly, but you beat the Street by a bit over $20 million raised by $15 million. I think it implies Q4 revenue is growing in the 2% to 3% range. Is that the right way to think about things? And any color on how that's broken out between musculoskeletal and enabling technologies.

嘿。這是喬，取代馬特。恭喜本季取得如此出色的成績。我真的很想問一下有關指導更新的問題。您已經在第三季度看到了這一點，我不想直截了當地問這個問題，但您比華爾街多籌集了 2000 多萬美元，比華爾街籌集了 1500 萬美元。我認為這意味著第四季度的營收將成長 2% 到 3%。這是正確的思考方式嗎？以及如何在肌肉骨骼和支持技術之間實現突破。

Sure. So this is Keith. I'll take the question. I mean, really, when we provide guidance, we're providing guidance on the full year Obviously, we had a strong quarter, but we're still maintaining appropriate conservatism going into Q4 in saying that though, we remain extremely positive about the progress it's made and where it's going.

當然。這就是基斯。我來回答這個問題。我的意思是，實際上，當我們提供指導時，我們提供的是全年指導，顯然，我們有一個強勁的季度，但我們仍然保持適當的保守態度進入第四季度，但我們對它所取得的進展和未來發展仍然非常樂觀。

We don't provide breakouts between enabling tech and musculoskeletal. I would really just fall back on the comments that I had on the call. our musculoskeletal business really has grown this year led by US Spine and International Spine and our enabling tech business looking into Q4, the pipeline remains strong, and we remain positive about it.

我們不提供支持技術與肌肉骨骼之間的突破。我實際上只是回顧一下我在電話中所發表的評論。今年，在 US Spine 和 International Spine 的帶動下，我們的肌肉骨骼業務以及我們的支援技術業務確實實現了成長。

That's helpful. And in that context and then relatedly, I know you've described the new and improved Globus is at a high single, low double grower into the future. Just curious to get your take, and I understand it will probably be light, but any color on next year? I think the Street says 7%. But just any way to help or adjust between this year and next. Thank you so much.

這很有幫助。在這樣的背景下，與此相關的是，我知道您已經描述了新改進的 Globus 未來將處於高單產、低雙產的狀態。只是好奇想知道您的看法，我知道它可能很淡，但是明年有什麼顏色嗎？我認為華爾街的預測是 7%。但只是任何能在今年和明年之間提供幫助或調整的方法。太感謝了。

Thanks for that second part or the second question. I mean, at this point, we're not looking too much into 2025 or providing color at this point. We're coming out of this year. We've managed to work through bringing the businesses together. And we remain positive. And really, we stick by what we said. We still think Globus could be a mid- to high digit -- a mid- to high single-digit grower.

感謝您回答第二部分或第二個問題。我的意思是，目前為止，我們還沒有太多展望 2025 年，也沒有提供太多具體資訊。我們即將走出今年。我們已成功將各家企業整合在一起。我們依然保持樂觀。而事實上，我們信守了自己的承諾。我們仍然認為 Globus 的成長率可能達到中高位數——中高個位數的成長。

I think one of the indications for that as well is as we keep talking about our strong competitive recruiting activity and our strong product launches that we're putting out to build the platform for future growth.

我認為其中一個跡象就是我們一直在談論我們強有力的競爭性招募活動和強大的產品發布，我們正在推出這些產品來建立未來成長的平台。

Thank you.

謝謝。

David Saxon, Needham & Company.

大衛‧薩克森 (David Saxon)，Needham & Company。

Great. Daniel and Keith, congrats on the quarter and thanks for taking my questions. I wanted to follow up on the guidance question. It is kind of low single digits sequential growth. I think in a normal year, we're closer to high single digits. So I mean I heard you say kind of appropriate conservatism that's baked into the guide.

偉大的。丹尼爾和基思，祝賀本季取得佳績，感謝你們回答我的問題。我想跟進指導問題。這是一種低個位數的連續成長。我認為在正常年份，我們的數字更接近個位數。所以我的意思是，我聽到你說過指南中已經包含了適當的保守主義。

But I just want to be clear, are you seeing anything in the market that kind of would be a risk in your view? And then, I guess, second to that is I thought guidance assumed around $150 million of dissynergies this year. Is that still the case in any way to kind of gauge where we are with dissynergies? And then I'll have a quick follow-up.

但我只是想明確一點，您是否認為市場上有任何可能構成風險的東西？其次，我認為指導意見假設今年的不協同效應約為 1.5 億美元。我們是否仍然可以用這種方式來衡量我們目前的不協同狀況？然後我會快速跟進。

Sure. So as it relates to guidance, as I think about the year, we're extremely positive with where we are and how we finished. The $150 million dis-synergy, you'll note that I did not reference it in my prepared remarks. I think that as time passes, we feel more and more confident is there the risk of having synergies in the future? Sure, there could be risks.

當然。因此，就指導而言，當我回顧這一年時，我們對目前的狀況和結束感到非常樂觀。1.5 億美元的不協同效應，您會注意到，我在準備好的發言中沒有提到它。我認為隨著時間的推移，我們會越來越有信心，未來是否有產生綜效的風險？當然，可能會有風險。

But at the same time, at what point does it become part of just running your business. We remain appropriately conservative, like I said earlier. But going into Q4 and into 2025 will remain positive. If I think about anything specifically that we looked at, we did see a little bit of an impact related to some of the hurricanes and some shortages related to IV bags. That's really the only main thing that I would call out as I go into my Q4 and get into it deeper.

但同時，什麼時候它才會成為你經營業務的一部分呢？正如我之前所說，我們保持適當保守。但進入第四季和 2025 年仍將保持積極勢頭。如果我思考我們具體研究過的事情，我們確實看到了一些與颶風和靜脈注射袋短缺有關的影響。當我進入 Q4 並深入探討它時，這確實是我要強調的唯一主要事項。

Okay. Super helpful. Thanks for that. And then just on the trauma portfolio, I heard the combined NSO in Trauma was like 99%. I think trauma historically has kind of been in the 40% to 50%. Is that still the case? And any way you can give us a sense for the size of that portfolio in terms of revenue contribution? Thanks so much.

好的。超有幫助。謝謝。然後僅在創傷組合中，我聽說創傷領域的綜合 NSO 約為 99%。我認為從歷史上看，創傷的比例大概在 40% 到 50% 之間。現在還是這樣嗎？您能不能向我們介紹一下該投資組合在營收貢獻的規模？非常感謝。

Yeah, we don't actually break that out right now with where that is. Both have great uptake. They're both growing well, super high double digits with it. But we're really not in a position to split them out or actually lay out what the dollar impact is right now.

是的，我們現在還不能確切知道它在哪裡。兩者都有很高的接受度。他們都成長得很好，身高都達到了兩位數。但我們目前還無法真正將它們分開或真正說明其對美元的影響。

Steve Lichtman, Oppenheimer.

奧本海默的史蒂夫·利希特曼。

Thank you. Good evening, guys. Congratulations. Dan, one of the drivers you mentioned up top for this quarter was a successful distributor to direct conversions. Can you talk about what the impact is of those conversions and where you are in that process?

謝謝。大家晚上好。恭喜。丹，您在本季度提到的驅動因素之一是分銷商與直接分銷商的成功轉化。您能談談這些轉變的影響以及您在過程中所處的位置嗎？

Yeah, Steve, glad to. So we started out with Globus years ago. doing those conversions and coming into a more direct exclusive sales force. We obviously did the same with several of the former NUVA distributors bringing them in.

是的，史蒂夫，很高興。因此我們幾年前就開始與 Globus 合作。進行這些轉換並形成更直接的獨家銷售團隊。顯然，我們也對幾家前 NUVA 經銷商採取了同樣的措施。

And what that is, it just allows us to invest better in those markets, hire people, push through, get the right amount of reps, share that risk with the former distributor so we can get more rapid growth out of that type of approach, that's really the benefit.

這就是說，它使我們能夠更好地在這些市場上投資、僱用人才、推動發展、獲得適當數量的銷售代表、與前分銷商分擔風險，這樣我們就可以透過這種方法獲得更快的成長，這才是真正的好處。

There is some more out there that have not converted or chose not to convert, which is fine. But where we do have that opportunity, we're taking advantage, again, more to use the power and cash of Globus to create further growth and faster impacts into those areas.

還有一些人尚未轉變或選擇不轉變，這很好。但在我們確實有這樣的機會的地方，我們會再次利用更多的優勢，利用 Globus 的力量和現金來進一步促進這些領域的成長並產生更快的影響。

So would you say, Dan, that you're kind of toward the end of that process, is that right?

那麼，丹，您是否會說您已經接近這個過程的尾聲了，對嗎？

I don't know if I'd say towards the end of that process. We're year-end. We've done several. I would say there's probably several more. I don't want to reveal numbers or locations yet. And I think it's really several things. We want to make sure that people get comfortable with us, we get through the startups. We'll continue to work with it.

我不知道我是否會說這個過程已經結束了。我們已經年底了。我們已經做了好幾個了。我想說可能還有很多。我暫時還不想透露數字或地點。我認為這實際上有幾件事。我們希望確保人們對我們感到滿意，並順利度過新創階段。我們將繼續致力於此。

We're not going to mandate it but it's clear for anyone who has gone through that. And it's a very big benefit to them when we start using these approaches. And I think the goal, Steve, is to remain focused on that. Just for the sake of controlling our sales force in a better way and really accelerating how we can invest in there.

我們不會強制要求這樣做，但任何經歷過的人都會清楚這一點。當我們開始使用這些方法時，他們受益匪淺。史蒂夫，我認為目標就是繼續專注於此。只是為了更好地控制我們的銷售團隊並真正加速我們在那裡的投資。

Okay. Got it. And then on Orthopedics, your focus initially is in total primary as where, of course, is most synergistic with robotics. As you approach accounts, whether hospital or ASC, how are you looking to overcome, not having as full a bag as the major players? Do you see a need to sort of rapidly advance products like Unicondylar or others. How are you thinking about that?

好的。知道了。然後在骨科方面，你的重點最初是主要的，當然，它與機器人技術最具協同作用。當您接觸帳戶時，無論是醫院還是 ASC，您希望如何克服沒有像主要參與者那樣擁有充足資金的困境？您是否認為有必要快速推進 Unicondylar 或其他產品？您對此有何看法？

Yes. No, great question. Everything that we need is in progress. Nothing is ever fast enough for me, just the nature of what it is. But the Unicondylar's developed and honestly, ready to go, we're really far down the path is what I think is a fabulous revision knee.

是的。不，這個問題問得好。我們所需要的一切都正在進行中。對我來說沒有什麼是夠快的，這就是它的本質。但單髁已經開發完畢，說實話，已經準備就緒，我們已經走了很遠，我認為這是一個非常棒的膝蓋修復手術。

Everything related to hip is really either approved or in play and we're moving the robot further along in the hip development itself. Like anything, it's a journey. I would tell you we're going to be in a stronger spot this time next year. But I think when surgeons understand that and see where we're investing in how they're willing to come along with us. And so again, I think the real start of this is going to be in 2025.

與髖關節相關的一切實際上要么已獲批准，要么正在實施中，我們正在推動機器人在髖關節開發方面取得進一步進展。就像任何事情一樣，這是一趟旅程。我想告訴你們，明年這個時候我們的地位將會更加強大。但我認為，當外科醫生理解這一點，並了解我們的投資方向時，他們就會願意與我們合作。所以，我認為這一進程真正開始是在 2025 年。

And like spine, it will be a slow journey as we go and make inroads unlike what we do with robots, which was a big bang. I think this is going to be one of those steady climbs that we get out there. But I really do think '25 will become the meaningful year of impact there.

就像脊椎一樣，這將是一個緩慢的過程，我們需要不斷取得進展，而不像機器人那樣是一個大爆炸。我認為這將是我們取得的穩定攀登之一。但我確實認為 25 年將成為具有深遠影響的一年。

Thanks, Daniel.

謝謝，丹尼爾。

Matthew Blackman, Stifel.

馬修布萊克曼，Stifel。

Hi. Good afternoon, everybody and thanks for taking my question. Just one. And look, I appreciate you're not going to want to talk too much about 2025. But can you maybe just help us to think through maybe in the broadest sense, the most important puts and takes on the top and bottom-line next year.

你好。大家下午好，感謝您回答我的問題。只有一個。而且，我很欣賞你不想談論太多 2025 年的事情。但您能否幫助我們從最廣泛的意義上思考明年營收和利潤最重要的影響。

Anything you'd call out tonight as we think through our 2025 numbers. And I'm just reflecting on this quarter's performance, you're back to market levels of growth, you posted 31% plus EBITDA margins, and there's still incremental cost synergies next year.

當我們思考 2025 年的數字時，您今晚會提出任何建議。我只是在回顧本季的表現，你們已經回到了市場成長水平，你們的 EBITDA 利潤率超過了 31%，而且明年還會有增量成本綜效。

And then I look at consensus at something like $333 million or something in that neighborhood. Just given this quarter's results, that number feels low, but would love to hear what you guys think. And at the least, the thought process I just laid out is sound and I'm not missing anything. Thanks.

然後我看了看大家對 3.33 億美元左右的共識。從本季的結果來看，這個數字似乎很低，但我很想聽聽大家的想法。而且至少，我剛才闡述的思考過程是合理的，我沒有遺漏任何東西。謝謝。

So thanks for the question. I think qualitatively, stepping back and looking at the business, year two, what do you think or what do you expect could happen? You would expect more cross-selling to occur as the team further integrates in the US and international. You would expect to see greater cross-selling of the robots.

感謝您的提問。我認為從品質上講，退一步來看看業務，第二年，您認為或預期會發生什麼？隨著團隊在美國和國際上的進一步融合，您可以預期會出現更多的交叉銷售。您將會看到更多的機器人交叉銷售。

There was a question earlier that I believe Dan commented on, that there's a lot of inbound interest from legacy NuVasive customers related to EPS we're continuing to come out with more and more technology products. So that all points to a positive when you think about the top line.

我相信 Dan 之前已經評論過一個問題，那就是許多傳統的 NuVasive 客戶對 EPS 感興趣，我們將繼續推出越來越多的技術產品。因此，當你考慮營收時，所有一切都指向積極的一面。

As you move to the bottom line, you're going to annualize some of the synergy capture that you generated this year. plus you're going to drive some slight improvements, I think, early on operationally. But really, as I think about the synergy capture from in-sourcing.

當你轉向底線時，你將把今年產生的部分協同效應年度化。另外，我認為，你會在早期的營運中推動一些輕微的改進。但實際上，當我思考從內部採購中獲得的協同效應時。

That benefit is really the back half of '25 and into 2026. Again, when you get into year two, the focus really is again on managing your four-wall spending. So what is four-wall spending? It's looking at things like consulting spend and outside spend. How do you identify ways either reduce that spend or find ways to bring it in-house, that's really going back to the strategy of Globus, and we're going to continue to focus on that in year two.

這項福利實際上將持續到 2025 年後半期到 2026 年。同樣，當你進入第二年時，重點實際上又重新集中在管理家庭開支。那麼，什麼是四牆消費呢？它關注的是諮詢支出和外部支出等事項。您如何找到減少支出或將其帶入公司內部的方法，這實際上要回歸到 Globus 的策略，我們將在第二年繼續關注這一點。

Thank you.

謝謝。

Ryan Zimmerman, BTIG.

瑞安·齊默爾曼（Ryan Zimmerman），BTIG。

Hey. Good evening. I'll echo everyone's sentiment. We came out of NAS in probably what I would argue as one of the best spine markets we've seen in years, just judging by some of the feedback and commentary from management teams. And I'm wondering, Dan, if you can give your thoughts about just the durability of that, what you see as kind of the spine market and what's driving that? And also maybe kind of your thoughts on how it can continue.

嘿。晚安.我會回應大家的感受。根據管理團隊的一些回饋和評論來判斷，我們從 NAS 獲得的可能是多年來見過的最好的脊椎市場之一。我想知道，丹，您能否談談對其持久性的看法，您認為脊椎市場是什麼樣的，以及推動其發展的因素是什麼？也許您還可以談談您對如何繼續下去的想法。

Thanks, Ryan. It does seem to be a strong year this year. And I would tell you that it seems to be above historical growth, the normal growth. I don't think any of us could ever say it's pent-up demand from COVID or anything like that, like we went through in the past. That said, I think when you run your historics on this kind of data, the market does tend to be about a 3% to 3.5% growth.

謝謝，瑞安。今年似乎確實是強勁的一年。我想告訴你，它似乎高於歷史成長，即正常成長。我認為我們任何人都不會說這是由新冠疫情引起的被壓抑的需求或類似的東西，就像我們過去經歷過的那樣。話雖如此，我認為當你根據此類數據運行歷史數據時，市場確實會呈現 3% 到 3.5% 左右的成長。

And I think I'll still set my sights there to say probably over the long term, this will be somewhere between a 3% to 4% growth. While I think changing demographics can be some of the lift, I think some of the incumbent people having jobs therefore, having insurance to do it can be part of a lift.

我認為我仍然會將目光鎖定在那裡，可能從長期來看，成長率會介於 3% 到 4% 之間。雖然我認為人口結構的變化可以帶來一些好處，但我認為一些在職人員有工作，因此有保險可以成為好處的一部分。

I don't know if we're looking towards a future where you've got 5% to 7% growth in the spine market. I think it's going to just get back down to my guess, and it is an absolute guess just based on history. Somewhere between the three to four a normalized state and just progress that way.

我不知道我們是否期望未來脊椎市場能達到 5% 至 7% 的成長率。我認為它又會回到我的猜測，而且這絕對是一個基於歷史的猜測。三到四之間的某個時間點，會達到正常狀態，然後就一直這樣發展。

That's fair. And then if I could ask Keith, a couple of conceptual questions as I think about the future for year two of the merger, Keith, you talked about just some of those in-house manufacturing dynamics. It doesn't sound like you want to put numbers out there.

這很公平。然後，如果我可以問基斯 (Keith) 幾個概念性問題，當我考慮合併後第二年的未來時，基斯 (Keith)，您只談到了一些內部製造動態。聽起來你不想把數字放在那裡。

I imagine you have some ideas, but maybe you could help give us some guardrails around some of that in-house manufacturing initiatives for next year as it relates to kind of what you could or couldn't do from a margin perspective?

我想您有一些想法，但也許您可以幫助我們為明年的一些內部製造計劃提供一些指導，因為這與從利潤角度您可以做什麼或不能做什麼有關？

And the second part of my question is more on the R&D side, which is you're moving into these markets like [large joint] recon, you talked about R&D at 6.5% to 7%. But I would imagine you have to maybe step up conceptually R&D to develop more products as we think about 2025 and beyond. And so am I thinking about that correctly as well? Any color on those two would be appreciated.

我的問題的第二部分更多是關於研發方面，也就是你們正在進入像[大型聯合]偵察這樣的市場，你談到研發佔比為 6.5% 到 7%。但我想，當我們考慮 2025 年及以後時，你可能必須加強概念研發以開發更多產品。那我的想法也是正確的嗎？如果能將這兩種顏色結合起來，將會非常受歡迎。

Ryan, let me jump in, we'll kind of start with the back part of that first. Keep in mind that we always spend I consider heavily in R&D. And so everything that we need is currently in the margins we have and then the percents we have. There's nothing we're waiting to do. And it's not like we're at a milestone before we start.

瑞安，讓我先開始吧，我們先從後面的部分開始。請記住，我們總是在研發上投入大量資金。因此，我們所需要的一切都在我們目前擁有的利潤和百分比中。我們沒有等著做什麼。這並不意味著我們在開始之前就已經達到了里程碑。

And so just keep in mind that the R&D spending you have encompasses everything that we're putting out a thing that we want to do, and we talk about. I don't think it's a step up. We'll take the opportunity to discover new things and go in new areas, and we'll certainly increase spending there.

所以請記住，你們的研發支出涵蓋了我們正在推出的、我們想要做的和我們談論的一切。我不認為這是一種進步。我們將藉此機會探索新事物、進入新領域，而且我們肯定會增加這些方面的支出。

I think as Keith has always said, maybe looking around 7% of sales will be a great target to go to. But I don't feel like we have a portfolio that's been untouched, I feel like everything is moving. So I just want to answer that one first and I'll kind of turn over the first part of your question, Keith.

我認為，正如 Keith 一直所說的那樣，也許 7% 左右的銷售額是一個很好的目標。但我覺得我們的投資組合並非未受影響，我覺得一切都在改變。所以我只想先回答這個問題，然後我會轉述你問題的第一部分，基斯。

Yeah. So if you think about in-sourcing and what's planned, I mean, obviously, we've got to get all the machinery and equipment into each of the locations and get the machines program to run. But at the end of the day, the goal is really to really drive a lower cost per unit.

是的。因此，如果你考慮內部採購和計劃，我的意思是，顯然，我們必須將所有機械設備運送到每個地點並運行機器程序。但歸根結底，我們的目標實際上是降低單位成本。

And as you drive a lower cost per unit for what you're in-sourcing you're also going to get fixed cost leverages across both locations. As we do this also, the goal here is to cross-pollinate both of the manufacturing facilities that they can make both Globus and legacy NuVasive product.

而且，當您降低內部採購的單位成本時，您還將獲得兩個地點的固定成本槓桿。我們這樣做的目的是使兩個製造工廠相互協作，以便它們能夠同時生產 Globus 和傳統的 NuVasive 產品。

That helps lower our risk, but it also allows us to become more efficient with how we plan both existing products and then new product development. Over time, that creates a flywheel effect to drive some of your fixed cost savings.

這有助於降低我們的風險，同時也使我們能夠更有效地規劃現有產品和新產品的開發。隨著時間的推移，這將產生飛輪效應，推動部分固定成本的節省。

I would also say, Ryan, you've got to burn through the existing inventory that's on the shelf and then go work that through. And so we'll look to see what that impact is next year. but recognize it's more of a long-term play than a splash.

我還要說，瑞安，你必須先消耗貨架上的現有庫存，然後再去解決。因此我們將觀察明年會產生什麼影響。但要體認到，這是一個長期舉措，而非一時之舉。

And that really ties back, Ryan, to what I said earlier on a previous question, is that any gross profit improvement really is going to be smaller in 2025, but it's in the back half of the year. As we get into the year, I would expect to see that benefit first coming through in cash because your working capital investment is going to change because of your in-sourcing the inventory.

瑞安，這與我之前在回答上一個問題時所說的內容確實相關，即 2025 年的任何毛利成長實際上都會較小，但這是在下半年。隨著我們進入新的一年，我預計會看到這種收益首先以現金形式反映出來，因為您的營運資本投資將因您採購庫存而改變。

Congrats again, guys. Very stellar quarter. Thank you.

再次恭喜你們。非常出色的季度。謝謝。

(Operator Instructions)

（操作員指令）

Craig Bijou, Bank of America Securities.

克雷格‧比喬 (Craig Bijou)，美國銀行證券。

Good afternoon, guys, and congrats on the quarter. I wanted to start when you did the NUVA deal, you looked at it on -- really, with the synergies on a three-year period. And just taking your Q4 guidance, that 2% to 3% and then your aspirational goal to get to the mid- to high single digits.

大家下午好，恭喜本季取得佳績。我想從您達成 NUVA 交易時開始考慮這個問題——實際上，是從三年期的協同效應來看的。並且只採用您第四季度的指導方針，即 2% 到 3%，然後您的目標是達到中高個位數。

So I guess I kind of wanted to ask you if you need -- like if it's a three-year period to get to that aspirational goal or with some of the cross-selling synergies that you expect to come through soon. can that happen faster? I think investors are just trying to get a sense for where -- what can that acceleration look like? Or when can we see you guys reach that mid- to high single-digit growth?

所以我想我有點想問你是否需要——例如是否需要三年的時間來實現這個理想目標，或者透過一些你期望很快實現的交叉銷售協同效應。這樣能更快發生嗎？我認為投資人只是想了解這種加速會是什麼樣子？或者我們什麼時候可以看到你們達到中高個位數的成長？

Thanks, Craig, for the question. This is Keith. I mean as I think about going into next year, we should start to be able to see the growth rates accelerating. I don't want to give too much color yet on 2025, but it is our expectation that as we get into next year, it really ties back to some of the things I had said earlier that you would expect more cross-selling to occur, both across musculoskeletal enabling tech, you should start to realize that next year.

謝謝 Craig 提出這個問題。這是基斯。我的意思是，當我想到明年時，我們應該能夠開始看到成長率加速。我現在還不想對 2025 年做出過多的描述，但我們預計，隨著我們進入明年，它確實會回到我之前所說的一些事情上，即您會期望發生更多的交叉銷售，無論是在肌肉骨骼支持技術領域，您都應該在明年開始意識到這一點。

Yeah. And Craig, one of the things I'd add to that, and that's what we're pulling out in our commentary is we're putting in place all of the pieces to achieve that, whether it's the manufacturing and expanding the investment in sets everything that we've been calling out the launching of products, the retention of the sales force, the competitive recruiting.

是的。克雷格，我想補充的一點，也是我們在評論中提到的，我們正在把所有要素落實到位，以實現這一目標，無論是製造、擴大投資，還是我們一直呼籲的產品推出、銷售隊伍的保留、有競爭力的招聘。

We're really putting all the building blocks in place here to deliver that. We're not in a position to commit yet because just to be honest, we haven't run through 2025 yet. We haven't had a chance to get it approved internally. It's -- as you know, something we'll release as we get into January as normal.

我們確實正在竭盡全力實現這一目標。我們尚未做出承諾，因為說實話，我們還沒有運行到 2025 年。我們還沒有機會獲得內部批准。如您所知，我們會像往常一樣在 1 月發布一些內容。

But we feel confident with everything that we're doing, and we feel like we're in a really strong spot to deliver what we've committed to here. And of course, like anything, we'll strive to beat that and accelerate where we can.

但我們對所做的一切充滿信心，我們覺得我們處於一個非常有利的位置，可以兌現我們所承諾的事情。當然，就像任何事情一樣，我們會努力克服這一點，並盡我們所能加速發展。

Got it. Okay. That's helpful. And if I could just ask on the power tools I know just launched this year, it's probably not a huge dollar revenue contribution. But I did want to see if there's -- if you'd be willing to provide anything on kind of the size or the ramp for growth of the power tools specifically? And then one just clarification of where you book those revenues.

知道了。好的。這很有幫助。如果我可以問一下我所知道的今年剛推出的電動工具，它可能不會帶來巨大的收入貢獻。但我確實想看看是否有——您是否願意提供有關電動工具的規模或增長坡道的具體資訊？然後只需澄清一下您從哪裡預訂這些收入。

I'll handle that first part. We're really pleased with the launch. We think that the potential and the interest that we see with the surgeons, whether it be through the feedback we're getting when they are being used in the operating room is very positive. The pull-through that we're seeing of disposables and its usage is, again, a very good leading indicator that these things are being well adapted. Keep in mind that this is one part of a procedural solution.

我會處理第一部分。我們對這次發布感到非常高興。我們認為，無論是透過在手術室中使用它們時獲得的回饋，外科醫生看到的潛力和興趣都是非常積極的。我們看到的一次性用品及其使用的拉動再次是一個很好的領先指標，表明這些東西正在得到很好的適應。請記住，這是程式解決方案的一部分。

And so while we look to them as a stand-alone, not truly, it's really about how well they can go freehand with our navigation of or how they work with the Excelsius robot, et cetera, right? So it's all part of the entire program that goes. The application that we see longer term within trauma and joints as well very promising. So you're right.

因此，雖然我們將它們視為獨立的，但並非真正獨立的，這真正關乎它們如何能夠自由地跟隨我們的導航或如何與 Excelsius 機器人協作等等，對嗎？所以這都是整個計劃的一部分。我們看到其在創傷和關節領域的長期應用也非常有前景。所以你是對的。

We're not going to really call it out, but I would tell you that what we see is this can be a significant growth driver as we thought it would be in the upcoming years, and it's doing well for this year. And it is a component of musculoskeletal.

我們不會真的說出這一點，但我要告訴你，我們看到的是，這可能會成為一個重要的成長動力，正如我們所料，它將在未來幾年成為現實，而且今年它的表現很好。它是肌肉骨骼的組成部分。

Got it. Thanks, guys.

知道了。謝謝大家。

Caitlin Cronin, Canaccord.

凱特琳‧克羅寧 (Caitlin Cronin)，Canaccord。

Hi. Thanks for taking my questions. Congrats on the third quarter. Just starting with the ortho robot, maybe a reminder of what the value prop here over competitor systems, i.e., the price point, footprint, et cetera?

你好。感謝您回答我的問題。恭喜第三季。剛從矯正機器人開始，或許會提醒這裡相對於競爭系統的價值主張，即價格點、佔地面積等等？

Thanks. I'll take that. I would say that footprint is certainly one of them to be considered, especially as you work in ASCs. We've looked at this, and we're really pleased with how we've designed it to go in there. One of the things Caitlin, I had mentioned earlier is I think that just the fact that it's a newer robot that we've really built within the last year or two using some of the newest componentry, the ability to have smooth and articulating movements that I think are really good.

謝謝。我接受。我想說，足跡肯定是需要考慮的因素之一，特別是當您在 ASC 中工作時。我們已經研究過這個問題，並且對於我們的設計感到非常滿意。我之前提到過的凱特琳的一件事是，我認為事實上它是一個較新的機器人，是我們在過去一兩年內使用一些最新的組件製造的，它能夠實現流暢和清晰的動作，我認為這真的很好。

The fact that you can do a registration with or without CT, how you want to operate this. We don't need preplanning to be sent away. It's something that a surgeon can decide to do either the day before or right in the OR. So we'll build more on that and get through that. We're still working how to put that out with our Q4 launch. But all in all, I think the main components of that I've just laid out, we just probably have a lot more polish than what I just laid out for you.

事實上，您可以使用或不使用 CT 進行註冊，您可以自行決定如何操作。我們不需要預先計劃被送走。外科醫生可以決定在手術前一天或在手術室裡進行手術。因此，我們將在此基礎上進一步努力，並實現這一目標。我們仍在努力如何在第四季推出該功能。但總而言之，我認為我剛才列出的主要內容可能比我剛才為您列出的內容更加完善。

Awesome. And then just with the free hand NAV, who has been the early customers? And where do you see uptake of this technology over time? Is it more in a hospital, outpatient or ASCs.

驚人的。那麼，就自由手 NAV 而言，誰是早期客戶？隨著時間的推移，您認為這項技術將在哪裡應用？它更多是在醫院、門診還是 ASC 中？

Yeah, it's a great question. I'm going to say the answer is all of the above with that. Really pleased with the ones we've put together so far. The procedures that have occurred have really been strong. There's a lot of excitement out in the field and also with our surgeon and with these given that it is currently the largest section of navigation entering into that actually opens a brand-new field for us.

是的，這是一個很好的問題。我想說答案是以上所有。我們對目前為止組裝完成的作品非常滿意。已經發生的程式確實非常強大。這個領域以及我們的外科醫生都感到非常興奮，因為它是目前導航領域中最大的領域，實際上為我們開闢了一個全新的領域。

While we think the long-term play will be robotics, we obviously recognize there's always going to be multiple avenues for surgeons to treat patients. And so we want to just offer that as best we can, whether it be robotic or free hand. But I would tell you, again, with the activity we've seen so far late in the third quarter, I think that this can be meaningful for us as we set our eyes on what to do and grow and achieve some of our goals in 2025 and beyond.

雖然我們認為長期發展方向是機器人技術，但我們顯然認識到外科醫生總是有多種途徑來治療患者。因此，我們希望盡力提供最好的服務，無論是機器人還是自由手。但我想再次告訴你，根據我們在第三季末迄今為止看到的活動，我認為這對我們來說很有意義，因為我們正在著眼於在 2025 年及以後做什麼、發展什麼並實現我們的一些目標。

Thanks very much.

非常感謝。

(Operator Instructions)

（操作員指令）

Richard Newitter, Truist Securities.

Truist Securities 的 Richard Newitter。

Hi, guys. Thanks for taking the question. Congrats on the quarter. The first question I had, Dan, I think you had said that you expect meaningful contribution from the ortho-robotic initiatives in 2025 or something to that tune I thought you had kind of suggested that would probably be a little bit more of a gradual ramp into the out years. I guess is that a change in expectation, did I hear that right?

嗨，大家好。感謝您回答這個問題。恭喜本季取得佳績。我的第一個問題是，丹，我想你曾說過，你期待 2025 年的矯形機器人計劃能做出有意義的貢獻，或者類似這樣的計劃，我認為你曾暗示，在未來幾年裡，這一進程可能會更加漸進。我猜這是期望的改變，我聽得對嗎？

Yeah. No, you heard the right words, Rich, and I'll articulate. Thanks for calling it out. Given the fact that it has not been contributing much to us at all, this is one of the pathways for to become a growth engine. So keep in mind that obviously, the ortho market has doubled that of the spine, one would say $20 million versus $10 million with that and us piecing together all of the implants and getting them designed and ready to go now with the robot at our fingertips, I'm thinking that it can add to our dollars.

是的。不，你聽對了話，里奇，我會清楚地說出來。謝謝你的提醒。考慮到它對我們沒有太大的貢獻，這是成為成長引擎的途徑之一。所以請記住，顯然正畸市場規模是脊椎市場的兩倍，有人會說是 2,000 萬美元對 1,000 萬美元，而我們將所有的植入物拼湊在一起，並進行設計並準備好現在使用我們指尖上的機器人，我想這可以增加我們的收入。

I don't think it will become the growth driver of Globus as we come out with next year's forecast. But I'm saying that it can actually get out from the R&D side or lower contribution into something that will mean a bit more for us in the company and set the stage for '25, '26 and onward. But again, not a main growth driver of '25, but I would want to see the change in its revenue contribution to the company. really starting in 2025 with all of those components in play.

正如我們明年的預測，我認為它不會成為 Globus 的成長動力。但我想說，它實際上可以從研發方面抽身而出，或者將貢獻降低到對我們公司更有意義的事情上，為25年、26年及以後奠定基礎。但雖然這不是25年的主要成長動力，但我希望看到其對公司收入貢獻的變化。從 2025 年開始，所有這些組件都將發揮作用。

Okay. That's helpful clarification. And this question is kind of another angle to 2025. So directionally, if I think about the -- if you were going to deliver overage relative to kind of where the Street is sitting, it's about 7% pro forma growth for '25 on the top line, about 31% or about 100 basis point margin improvement, where do you think you -- or already to have more confidence that you could -- you have more cushion or more ability to achieve overage relative to those estimates. I'm just trying to get a sense, is it on the top line? Or is it maybe some of the visibility you have on the cost savings? I would love to just hear your kind of thoughts on that.

好的。這是很有幫助的澄清。這個問題是從另一個角度來看 2025 年的。因此從方向上看，如果我考慮——如果您要實現相對於華爾街目前水平的超額目標，即25年的營收預計增長約7%，利潤率提高約31%或約100個基點，您認為您——或者已經更有信心——您有更多的緩衝或更有能力實現相對於這些估計的超額目標。我只是想了解一下，它是在第一行嗎？或者這可能是您對成本節省的一些了解？我很想聽聽你對此的看法。

Rich, this is Keith. I'll take that question. As I think about it, the place that I would look really would be COGS, cost of goods sold, do you have the ability to take out more spending or turn the inventory quicker in-house to drive greater profitability in the '25. That would be the place. I think that -- I think we continue to look at spending outside of COGS or outside of the gross profit caption. But I think if it was going to accelerate anywhere to drive more profitability, it would be in the core product cost.

里奇，這是基斯。我來回答這個問題。當我考慮這個問題時，我真正要考慮的是 COGS，即銷售成本，你是否有能力削減更多支出或在內部更快地週轉庫存，以便在 25 年實現更高的盈利能力。那就是那個地方。我認為——我認為我們會繼續關注銷貨成本或毛利項目以外的支出。但我認為，如果要加速任何地方以提高獲利能力，那就是核心產品成本。

Thank you.

謝謝。

And with no further questions in the queue, that concludes the Globus Medical earnings call. Thank you for participating. You may now disconnect. Everyone, have a great day.

好了，沒有其他問題了，Globus Medical 的財報電話會議到此結束。感謝您的參與。您現在可以斷開連線。祝大家有個愉快的一天。