NuVasive Inc (NUVA) 2022 Q4 法說會逐字稿

Good day, ladies and gentlemen, and welcome to the NuVasive Fourth Quarter and Full Year 2022 Earnings Conference Call. I would now like to introduce your host for today's call, Ms. Juliet Cunningham, Vice President of Investor Relations at NuVasive. Please go ahead, Ms. Cunningham.

女士們先生們，美好的一天，歡迎來到 NuVasive 第四季度和 2022 年全年收益電話會議。現在我想介紹一下今天電話會議的主持人，NuVasive 投資者關係副總裁 Juliet Cunningham 女士。請繼續，坎寧安女士。

Thank you. Good afternoon, everyone. Joining me today are Chris Barry, Chief Executive Officer; and Matt Harbaugh, Chief Financial Officer. Chris will provide an overview of NuVasive's fourth quarter and full year 2022 business results and trends as well as innovation highlights. Matt will review our detailed financial results and full year 2023 outlook, and then we'll host a question-and-answer session.

謝謝。大家下午好。今天加入我的是首席執行官 Chris Barry；和首席財務官 Matt Harbaugh。 Chris 將概述 NuVasive 第四季度和 2022 年全年的業務成果和趨勢以及創新亮點。 Matt 將回顧我們的詳細財務業績和 2023 年全年展望，然後我們將舉辦問答環節。

The earnings release, which we issued earlier this afternoon, is posted on the IR section of our website and has been filed on Form 8-K with the SEC. We have also posted supplemental financial information. As a reminder, this call is being recorded, and an archive will be available on the IR website later today.

我們今天下午早些時候發布的收益發布發佈在我們網站的 IR 部分，並已通過 8-K 表格提交給美國證券交易委員會。我們還發布了補充財務信息。提醒一下，此通話正在錄音中，今天晚些時候將在 IR 網站上提供存檔。

Before we get started, I'd like to remind you that our comments during this call will include forward-looking statements, which are based on current expectations and involve risks and uncertainties, assumptions and other factors, which could cause actual results to differ materially from those expressed or implied by such forward-looking statements. The factors that could cause actual results to differ materially are described in NuVasive's news releases and periodic filings with the SEC. Except as required by law, we assume no obligation to update any forward-looking statements or information, which speak as of their respective date.

在我們開始之前，我想提醒您，我們在本次電話會議中的評論將包括前瞻性陳述，這些陳述基於當前預期並涉及風險和不確定性、假設和其他因素，可能導致實際結果存在重大差異來自此類前瞻性陳述所表達或暗示的內容。 NuVasive 的新聞稿和定期向美國證券交易委員會提交的文件中描述了可能導致實際結果出現重大差異的因素。除非法律要求，否則我們不承擔更新任何前瞻性陳述或信息的義務，這些陳述或信息截至各自日期。

In addition, this call will include certain non-GAAP financial measures. Reconciliations of these measures to the most directly comparable GAAP financial measures are included in today's earnings release and the supplemental financial information, both of which are accessible on NuVasive's website.

此外，此次電話會議還將包括某些非 GAAP 財務措施。這些措施與最直接可比的 GAAP 財務措施的調節包含在今天的收益發布和補充財務信息中，兩者都可以在 NuVasive 的網站上訪問。

And now I'd like to introduce Chris Barry.

現在我想介紹一下 Chris Barry。

Thank you, Juliet, and good afternoon, everyone. Earlier today, we reported fourth quarter and full year 2022 financial results. On today's call, I will provide highlights of 2022 and review our outlook for 2023, which is supported by our fundamentals of growth strategy and our definitive agreement to combine with Globus Medical. Matt will share additional financial details on the fourth quarter and full year 2022 performance as well as 2023 net sales guidance.

謝謝你，朱麗葉，大家下午好。今天早些時候，我們公佈了 2022 年第四季度和全年的財務業績。在今天的電話會議上，我將提供 2022 年的亮點並回顧我們對 2023 年的展望，這得到了我們增長戰略基本面和我們與 Globus Medical 合併的最終協議的支持。 Matt 將分享有關第四季度和 2022 年全年業績以及 2023 年淨銷售額指引的更多財務細節。

I couldn't be more excited about our combination with Globus Medical as it brings together 2 well-regarded technology companies in the musculoskeletal industry. The combined company will have an incredible commercial scale, an exceptional portfolio of clinically proven solutions supported by strong commercial and clinical professional development teams and excellent capabilities to serve our customers effectively.

我對我們與 Globus Medical 的合併感到無比興奮，因為它匯集了肌肉骨骼行業的兩家備受推崇的技術公司。合併後的公司將擁有令人難以置信的商業規模、由強大的商業和臨床專業開發團隊支持的經過臨床驗證的卓越解決方案組合以及有效為客戶提供服務的卓越能力。

Being able to change the future of spine and orthopedic care while unlocking our vision to change a patient's life every minute is now even more achievable together with Globus. More on our announcement later in my remarks.

能夠改變脊柱和骨科護理的未來，同時釋放我們每分鐘改變患者生活的願景，現在與 Globus 一起更容易實現。稍後在我的評論中詳細介紹我們的公告。

Our progress over the full year 2022 reflects how our market-leading 360 portfolios and globalization efforts are advancing the company's core growth strategy. And I'm excited to see how our investments over the past 3 years have further positioned us to accelerate growth in 2023.

我們在 2022 年全年的進展反映了我們市場領先的 360 度投資組合和全球化努力如何推進公司的核心增長戰略。我很高興看到我們過去 3 年的投資如何進一步幫助我們在 2023 年加速增長。

NuVasive delivered fourth quarter 2022 net sales of $305.4 million, an increase of approximately 1% on a reported basis and approximately 5% on a constant currency basis compared to the prior year period. Foreign currency negatively impacted our net sales performance by approximately $11 million primarily driven by the Japanese yen and the euro. As expected, case mix favored lower-acuity cases, both relative to the market and our procedural mix. However, we remain optimistic that higher-acuity cases will ramp up throughout the year.

NuVasive 2022年第四季度的淨銷售額為3.054億美元，與去年同期相比，報告基礎上增長約1%，按固定匯率計算增長約5%。外幣對我們的淨銷售業績產生了約 1100 萬美元的負面影響，主要受日元和歐元的影響。正如預期的那樣，相對於市場和我們的程序組合，案例組合更傾向於敏銳度較低的案例。然而，我們仍然樂觀地認為，更高敏銳度的病例將在全年增加。

In our international business, we achieved double-digit growth of approximately 11% on a constant currency basis compared to the prior year period, led by corresponding growth, the continued return of MAGEC and PRECICE titanium products. For the full year, our 2022 net sales came in at $1.202 billion, an increase of 5.5% on a reported basis and 8.5% on a constant currency basis compared to the prior year.

在我們的國際業務方面，與去年同期相比，我們實現了約 11% 的兩位數增長，這主要得益於 MAGEC 和 PRECICE 鈦產品的持續回報。全年，我們 2022 年的淨銷售額為 12.02 億美元，與上一年相比，報告增長 5.5%，按固定匯率計算增長 8.5%。

In a challenging environment, we grew our U.S. Spinal Hardware and U.S. Surgical Support business as well as our international business. We achieved greater than 20% growth in cervical in the U.S. and delivered a strong global performance from NSO. Completing its first full year of commercial launch, Pulse platform net sales showed solid growth in the U.S. and international markets.

在充滿挑戰的環境中，我們發展了美國脊柱硬件和美國手術支持業務以及我們的國際業務。我們在美國的頸椎病領域實現了超過 20% 的增長，並在 NSO 取得了強勁的全球業績。 Pulse 平台在完成其商業發布的第一個完整年度後，淨銷售額在美國和國際市場呈現穩健增長。

Despite ongoing macro environmental headwinds, we continue to make progress on our growth strategy. During 2022, we delivered core growth through the proliferation of our 360 strategy, globalization, new product introductions and introduced intelligent surgery built on the foundation of the Pulse platform with new partnerships, commercial distribution agreements and asset acquisitions related to our innovation pipeline.

儘管宏觀環境不利因素持續存在，但我們繼續在增長戰略方面取得進展。在 2022 年期間，我們通過 360 度戰略的擴散、全球化、新產品推出和引入基於 Pulse 平台的智能手術以及與我們的創新渠道相關的新合作夥伴關係、商業分銷協議和資產收購實現了核心增長。

Starting with our core business. We have significant runway in key procedural segments that our 360 portfolios, X360, C360, P360 and Complex continue to target. Our innovation gives us a strong competitive position to extend our leadership in the anterior segment and take share where we've historically been underrepresented.

從我們的核心業務開始。我們在我們的 360 產品組合 X360、C360、P360 和 Complex 繼續瞄準的關鍵程序領域擁有重要的跑道。我們的創新使我們具有強大的競爭地位，可以擴大我們在前肢領域的領導地位，並在我們歷來代表性不足的領域佔據份額。

This year marks 20 years of our flagship procedure, XLIF. Today, with approximately 300,000 procedures performed, more than 450 peer-reviewed publications and 50 XLIF products launched, our success in introducing procedurally integrated solutions have made us a leader in the $900 million anterior segment. In addition, this year also marks 5 years of the X360 procedure, our lateral approach to single-position surgery.

今年是我們的旗艦程序 XLIF 誕生 20 週年。今天，我們執行了大約 300,000 次手術，發表了超過 450 篇經過同行評審的出版物，並推出了 50 種 XLIF 產品，我們在引入程序集成解決方案方面的成功使我們成為價值 9 億美元的眼前牙市場的領導者。此外，今年也是 X360 手術的 5 週年，這是我們的單體位手術橫向入路。

Last month, another study published in the Spine Journal demonstrated the benefits of lateral single-position surgery versus patients that needed to be flipped mid-procedure. Operative time significantly decreases from approximately 5 hours to 1.5 hours. There's less fluoroscopic dosage, a shortened length of hospital stay and a 36% reduction in post-op complications.

上個月，發表在 Spine Journal 上的另一項研究證明了側向單體位手術與需要在手術中翻轉的患者相比的好處。手術時間從大約 5 小時顯著減少到 1.5 小時。透視劑量減少，住院時間縮短，術後並發症減少 36%。

We remain committed to delivering innovation that will improve clinical, operational and financial outcomes for surgeons, hospitals and patients. This year, our next-generation expandable technology, MOD-EX XLIF, will begin clinical evaluations, and the introduction of Modulus ALIF blades will support the continued interest in Modulus ALIF as an interbody implant of choice.

我們仍然致力於提供創新，以改善外科醫生、醫院和患者的臨床、運營和財務結果。今年，我們的下一代可擴展技術 MOD-EX XLIF 將開始臨床評估，而 Modulus ALIF 刀片的推出將支持人們對 Modulus ALIF 作為首選椎間植入物的持續興趣。

Within the $1.7 billion posterior segment, we plan to tackle the tremendous opportunity with our P360 portfolio, providing comprehensive, pathology-driven solutions from the posterior position. MOD-EX PO continues clinical evaluations in the U.S. market, and the recent commercial launch of the NuVasive tube system is providing our surgeon customers less invasive surgical access for both TLIF and decompression application.

在價值 17 億美元的後牙部分，我們計劃利用我們的 P360 產品組合抓住巨大機遇，從後牙位置提供全面的、病理學驅動的解決方案。 MOD-EX PO 繼續在美國市場進行臨床評估，最近 NuVasive 管系統的商業發佈為我們的外科醫生客戶提供了 TLIF 和減壓應用的微創手術通路。

Turning to the $2.6 billion cervical segment. Our C360 portfolio continues to deliver greater than 20% growth. We have a highly differentiated portfolio that continues to take share and maintain high surgeon interest. The Simplify Cervical Disc exceeded our expectations, furthering our ability to capture more of the $450 million cTDR market and creating pull-through for the rest of the C360 portfolio. The team is committed to additional enhancements for the Simplify Disc with plans to launch advanced instrumentation in the second half of this year.

轉向價值 26 億美元的頸椎部分。我們的 C360 產品組合繼續實現超過 20% 的增長。我們擁有高度差異化的產品組合，將繼續佔據市場份額並保持外科醫生的高度興趣。 Simplify Cervical Disc 超出了我們的預期，進一步增強了我們在價值 4.5 億美元的 cTDR 市場中佔據更多份額的能力，並為 C360 產品組合的其餘部分帶來了突破。該團隊致力於進一步增強 Simplify Disc，併計劃在今年下半年推出先進的儀器。

Our ACDF interbody implant Modulus Cervical received expanded indications for AttraX Putty, allowing surgeons to utilize the cost-effective biologic across our Modulus thoracolumbar and cervical solutions. And our most recent addition, Reliance Cervical, continues to receive positive feedback with plans to launch an additional occipital system enhancement in Q4 2023.

我們的 ACDF 椎體間植入物 Modulus Cervical 獲得了 AttraX Putty 的擴展適應症，使外科醫生能夠在我們的 Modulus 胸腰椎和頸椎解決方案中利用具有成本效益的生物製劑。我們最近新增的 Reliance Cervical 繼續收到積極反饋，併計劃在 2023 年第四季度推出額外的枕骨系統增強功能。

Central to our core growth strategy is enabling technology. While other enabling technologies today deliver limited clinical utility, Pulse differentiates itself and that it can be used in 100% of spine procedures. Pulse is demonstrating definitive pull-through in hospitals that have adopted the technology. Our surgeon customers are experiencing the benefits of the platform. We have continued our global momentum by reaching 2,000-plus commercial cases.

我們核心增長戰略的核心是支持技術。雖然當今其他支持技術的臨床實用性有限，但 Pulse 與眾不同，它可用於 100% 的脊柱手術。 Pulse 在採用該技術的醫院中展示了最終的成功。我們的外科醫生客戶正在體驗該平台的好處。我們通過達到 2,000 多個商業案例繼續我們的全球發展勢頭。

Our R&D and global operations teams are completing the next system-level software release for Pulse launching this summer. The upcoming release will enhance the line of sight for navigation, add new instrument compatibility, improved remote support and services and further streamline the overall surgeon and OR staff experience.

我們的研發和全球運營團隊正在為今年夏天推出的 Pulse 完成下一個系統級軟件版本。即將發布的版本將增強導航視線，增加新的儀器兼容性，改進遠程支持和服務，並進一步簡化外科醫生和手術室工作人員的整體體驗。

As I conclude my remarks, our planned combination with Globus Medical to create an innovative global musculoskeletal company helps accelerate our near- and long-term strategy. With presence in more than 50 countries and supported by over 5,000 employees, the new organization will be well positioned to deliver on our vision of intelligent surgery. Our combined spine and orthopedic portfolio is needed throughout the continuum of care to help deliver better clinical outcomes.

在我結束髮言時，我們計劃與 Globus Medical 合併以創建一家創新的全球肌肉骨骼公司，這有助於加快我們的近期和長期戰略。新組織在 50 多個國家/地區開展業務，並得到 5,000 多名員工的支持，將能夠很好地實現我們的智能手術願景。在整個連續護理過程中，我們需要結合脊柱和骨科產品組合，以幫助提供更好的臨床結果。

As a reminder, the complementary combination expands our reach to surgeons and patients around the world with limited commercial overlap in key markets, creates a comprehensive portfolio of innovative spine and orthopedic technologies, continues our commitment to meaningful innovation, expands our operational capabilities and creates compelling upside net sales potential as well as a strong financial profile and value-creation opportunity for shareholders.

提醒一下，互補的組合擴大了我們對世界各地外科醫生和患者的影響，在關鍵市場的商業重疊有限，創造了一個全面的創新脊柱和骨科技術組合，繼續我們對有意義的創新的承諾，擴大我們的運營能力並創造引人注目的上行淨銷售額潛力以及強大的財務狀況和為股東創造價值的機會。

I remain confident in our stand-alone strategy. But together with Globus Medical, we can do so much more. We're combining 2 of the most well-regarded companies in the musculoskeletal industry to accelerate our vision to change a patient's life every minute and further our purpose to transform surgery, advance care and change lives.

我對我們的獨立戰略仍然充滿信心。但與 Globus Medical 一起，我們可以做得更多。我們正在合併肌肉骨骼行業中最受尊敬的兩家公司，以加快我們每分鐘改變患者生活的願景，並進一步實現我們改變手術、推進護理和改變生活的目標。

Now I'll turn the call over to Matt.

現在我會把電話轉給馬特。

Thank you, Chris, and good afternoon. I'm going to provide our fourth quarter and full year 2022 financial results and drivers as well as our full year 2023 net sales guidance. Our detailed financial results have been provided in today's press release and supplemental information.

謝謝你，克里斯，下午好。我將提供我們第四季度和 2022 年全年的財務業績和驅動因素，以及我們 2023 年全年的淨銷售指導。我們在今天的新聞稿和補充信息中提供了詳細的財務結果。

During my remarks, I will be discussing both GAAP and non-GAAP measures. Please see our press release for GAAP to non-GAAP reconciliations. I'll reference our fourth quarter results first and then provide our full year 2022 results. Unless otherwise noted, all comparisons are to the prior year period.

在我的發言中，我將討論 GAAP 和非 GAAP 措施。請參閱我們的 GAAP 與非 GAAP 對賬新聞稿。我將首先參考我們的第四季度業績，然後提供我們 2022 年全年的業績。除非另有說明，否則所有比較均與去年同期相比。

We delivered above-market net sales growth in 2022 driven by core spine growth, new product introductions, globalization and further adoption of Pulse. Worldwide net sales for the fourth quarter were $305.4 million, a 1.1% increase as reported and a 4.8% increase on a constant currency basis. Foreign currency exchange fluctuations had an unfavorable impact of approximately $11 million during the fourth quarter.

在核心脊柱增長、新產品推出、全球化和 Pulse 的進一步採用的推動下，我們在 2022 年實現了高於市場的淨銷售額增長。第四季度全球淨銷售額為 3.054 億美元，報告增長 1.1%，按固定匯率計算增長 4.8%。外匯匯率波動在第四季度產生了大約 1100 萬美元的不利影響。

Worldwide net sales for the full year 2022 were $1.202 billion, a 5.5% increase as reported and an 8.5% increase on a constant currency basis. For the full year 2022, foreign currency exchange fluctuations had an unfavorable impact of approximately $34 million. International net sales for the fourth quarter were $68.4 million, which was a decrease of 4.9% as reported and an increase of 10.7% on a constant currency basis.

2022 年全年全球淨銷售額為 12.02 億美元，報告增長 5.5%，按固定匯率計算增長 8.5%。對於 2022 年全年，外匯波動產生了約 3400 萬美元的不利影響。第四季度國際淨銷售額為 6840 萬美元，報告下降 4.9%，按固定匯率計算增長 10.7%。

For the full year 2022, international net sales were $282.3 million, a 4.9% increase as reported and a 17.7% increase on a constant currency basis. Constant currency growth showed positive momentum in key international markets during 2022 driven by core spine growth and NSO products.

2022 年全年，國際淨銷售額為 2.823 億美元，報告增長 4.9%，按固定匯率計算增長 17.7%。在核心脊柱增長和 NSO 產品的推動下，2022 年主要國際市場的持續貨幣增長顯示出積極勢頭。

Now turning to our U.S. net sales. Here are some key highlights by product line. U.S. Spinal Hardware net sales for the fourth quarter of 2022 were $167.8 million, representing a 4.6% increase. Our cervical portfolio achieved greater than 20% net sales growth, once again led by the C360 portfolio and the Simplify Cervical Disc. For the full year 2022, U.S. Spinal Hardware net sales were $652.1 million, a 6.8% increase.

現在轉向我們的美國淨銷售額。以下是按產品線分類的一些主要亮點。 2022 年第四季度美國脊柱硬件淨銷售額為 1.678 億美元，增長 4.6%。我們的頸椎產品組合實現了超過 20% 的淨銷售額增長，再次由 C360 產品組合和 Simplify Cervical Disc 引領。 2022 年全年，美國脊柱硬件淨銷售額為 6.521 億美元，增長 6.8%。

U.S. Surgical Support net sales for the fourth quarter of 2022 were $69.2 million, roughly flat compared to the prior year period. Growth in the services business and Pulse was offset by declines in biologics net sales. For the full year 2022, U.S. Surgical Support net sales were $267.5 million, a 3.3% increase.

美國外科支持公司 2022 年第四季度的淨銷售額為 6920 萬美元，與去年同期大致持平。服務業務和 Pulse 的增長被生物製品淨銷售額的下降所抵消。 2022 年全年，美國外科支持淨銷售額為 2.675 億美元，增長 3.3%。

Moving to operating results. Fourth quarter non-GAAP gross profit was $214.7 million compared to $219.1 million in the prior year period. For the full year 2022, non-GAAP gross profit was $866 million compared to $832.8 million in the prior year. Non-GAAP gross margin as a percentage of net sales for the fourth quarter of 2022 was 70.3%, a decrease of 220 basis points compared to 72.5% in the prior year period. The year-over-year decline was primarily driven by unfavorable foreign currency impacts and a $6 million increase in inventory-related costs.

轉向經營業績。第四季度非美國通用會計準則毛利潤為 2.147 億美元，而去年同期為 2.191 億美元。 2022 年全年，非美國通用會計準則毛利潤為 8.66 億美元，上年為 8.328 億美元。 2022 年第四季度非美國通用會計準則毛利率占淨銷售額的百分比為 70.3%，與去年同期的 72.5% 相比下降了 220 個基點。同比下降的主要原因是不利的外匯影響和庫存相關成本增加 600 萬美元。

Non-GAAP gross margin as a percentage of net sales for the full year 2022 was 72%, a decrease of 110 basis points compared to 73.1% in the prior year period. The year-over-year decline was primarily driven by unfavorable foreign currency impacts and procedural mix.

2022 年全年非美國通用會計準則毛利率占淨銷售額的百分比為 72%，與去年同期的 73.1% 相比下降了 110 個基點。同比下降的主要原因是不利的外匯影響和程序組合。

Fourth quarter 2022 non-GAAP operating expenses were flat year-over-year at $180.2 million. For the full year 2022, non-GAAP operating expenses were $716.9 million, an increase of 4.3% compared to $687.3 million. The increase was mainly driven by variable expenses associated with net sales growth, higher depreciation costs from investments in surgical instrument sets and inflationary impacts, particularly in travel and freight.

2022 年第四季度非美國通用會計準則運營費用為 1.802 億美元，同比持平。 2022 年全年，非美國通用會計準則運營費用為 7.169 億美元，較 6.873 億美元增長 4.3%。增長的主要原因是與淨銷售額增長相關的可變費用、手術器械投資的折舊成本增加以及通貨膨脹的影響，特別是在差旅和貨運方面。

Fourth quarter 2022 non-GAAP operating margin was 11.3%, a decrease of 160 basis points compared to 12.9% in the prior year period. The year-over-year change was primarily driven by the decrease in gross margin, as discussed earlier. For the full year 2022, non-GAAP operating margin was 12.4%, a decrease of 40 basis points compared to 12.8% in the prior year, primarily due to lower gross margins.

2022 年第四季度非美國通用會計準則營業利潤率為 11.3%，與去年同期的 12.9% 相比下降了 160 個基點。如前所述，同比變化主要是由於毛利率下降所致。 2022 年全年，非美國通用會計準則營業利潤率為 12.4%，較上年的 12.8% 下降 40 個基點，主要原因是毛利率較低。

Non-GAAP other income and expense for the fourth quarter was $3.1 million of expense compared to $8.8 million of expense in the prior year period. The decrease was primarily driven by lower unrealized foreign currency losses. For the full year 2022, non-GAAP other income and expense was $14.1 million of expense compared to $28.2 million of expense in the prior year. The decrease was primarily driven by higher levels of interest income in 2022, lower unrealized foreign currency losses and lower interest expense as a result of retiring the 2021 convertible notes in March 2021.

第四季度的非美國通用會計準則其他收入和支出為 310 萬美元，而去年同期為 880 萬美元。減少的主要原因是未實現的外匯損失減少。 2022 年全年，非 GAAP 其他收入和支出為 1,410 萬美元，上年為 2,820 萬美元。減少的主要原因是 2022 年利息收入水平提高、未實現外幣損失減少以及因 2021 年 3 月收回 2021 年可轉換票據而導致的利息支出減少。

Non-GAAP tax expense for the fourth quarter of 2022 was $8.8 million compared to $9.3 million in the prior year period. Our fourth quarter 2022 effective tax rate was 28% compared to 31% in the prior year period. For the full year 2022, non-GAAP effective tax rate was 23% compared to 25% in the prior year.

2022 年第四季度的非美國通用會計準則稅收費用為 880 萬美元，而去年同期為 930 萬美元。我們 2022 年第四季度的有效稅率為 28%，而去年同期為 31%。 2022 年全年，非美國通用會計準則有效稅率為 23%，上年為 25%。

For the fourth quarter of 2022, we reported GAAP net income of $24.1 million or diluted earnings per share of $0.42 compared to a net loss of $36.7 million or diluted loss per share of $0.71 in the prior year period. Included in our GAAP results for the fourth quarter were favorable impacts of foreign currency exchange fluctuations of approximately $15 million. This increase was primarily associated with the strength of the Australian dollar compared to the U.S. dollar related to our 2021 acquisition of Simplify Medical.

2022 年第四季度，我們報告的 GAAP 淨收入為 2410 萬美元或攤薄後每股收益 0.42 美元，而去年同期為淨虧損 3670 萬美元或攤薄後每股虧損 0.71 美元。我們第四季度的 GAAP 業績中包括約 1500 萬美元的外匯波動的有利影響。與我們 2021 年收購 Simplify Medical 相關的美元相比，這一增長主要與澳元走強有關。

On a non-GAAP basis, we reported fourth quarter net income of $22.6 million or diluted earnings per share of $0.43 compared to net income of $20.7 million or diluted earnings per share of $0.40 in the prior year period. For the full year 2022, GAAP net income was $40.4 million or diluted earnings per share of $0.76 compared to GAAP net loss of $64.1 million or diluted loss per share of $1.24 in the prior year.

在非 GAAP 基礎上，我們報告第四季度淨收入為 2260 萬美元或攤薄後每股收益 0.43 美元，而去年同期的淨收入為 2070 萬美元或攤薄後每股收益為 0.40 美元。 2022 年全年，GAAP 淨收入為 4040 萬美元或攤薄後每股收益 0.76 美元，而上一年的 GAAP 淨虧損為 6410 萬美元或攤薄後每股虧損 1.24 美元。

Included in our GAAP results for the full year were unfavorable impacts of foreign currency exchange fluctuations of approximately $19.2 million related to our Simplify Medical acquisition. On a non-GAAP basis, we reported full year 2022 net income of $103.9 million or diluted earnings per share of $1.98 compared to non-GAAP net income of $87.8 million or diluted earnings per share of $1.68 in the prior year.

我們全年的 GAAP 業績中包括與我們收購 Simplify Medical 相關的約 1,920 萬美元的外匯匯率波動的不利影響。在非 GAAP 基礎上，我們報告 2022 年全年淨收入為 1.039 億美元或稀釋後每股收益 1.98 美元，而上一年的非 GAAP 淨收入為 8780 萬美元或稀釋後每股收益為 1.68 美元。

Turning to the balance sheet. We had cash and cash equivalents of $248.7 million as of December 31, 2022. In addition, we continue to have an undrawn $550 million revolving credit facility, and our total net debt leverage is 3.3x. We generated $14.3 million in free cash flow during the fourth quarter compared to $11.9 million in the prior year period. For the full year 2022, we generated $29.9 million in free cash flow compared to $71.1 million in the prior year. In 2022, we increased our investment in surgical instrument sets to support net sales growth and new product launches.

轉向資產負債表。截至 2022 年 12 月 31 日，我們的現金和現金等價物為 2.487 億美元。此外，我們仍有未提取的 5.5 億美元循環信貸額度，我們的總淨債務槓桿率為 3.3 倍。我們在第四季度產生了 1,430 萬美元的自由現金流，而去年同期為 1,190 萬美元。 2022 年全年，我們產生了 2990 萬美元的自由現金流，而上一年為 7110 萬美元。 2022年，我們增加了對手術器械組的投資，以支持淨銷售額增長和新產品發布。

And now turning to NuVasive's full year 2023 net sales guidance. As we assess the operating environment, we believe there will continue to be macroeconomic volatility and impact in 2023, including quarterly foreign currency fluctuations, inflationary risks and supply constraints. While we can't predict the timing and extent of those impacts, we believe we will continue to benefit from the investments we've made and the positive momentum we're seeing in our business. We expect continued procedural recovery, further adoption and growth from new product introductions, continued globalization and a strong net sales pipeline.

現在轉向 NuVasive 的 2023 年全年淨銷售額指導。在評估經營環境時，我們認為 2023 年宏觀經濟波動和影響將繼續存在，包括季度外匯波動、通脹風險和供應限制。雖然我們無法預測這些影響的時間和程度，但我們相信我們將繼續受益於我們所做的投資和我們在業務中看到的積極勢頭。我們預計程序會持續復甦、新產品的進一步採用和增長、持續的全球化和強勁的淨銷售渠道。

Given those factors, we expect worldwide net sales growth of between 6% to 8% for the full year 2023 on a constant currency basis compared to the prior year. If rates hold near their levels as of February 15, 2023, we expect reported net sales growth to also be 6% to 8%. We expect some quarterly growth rate implications from exchange rate fluctuations but minimal impact to net sales growth on a full year basis.

鑑於這些因素，我們預計與上一年相比，按固定匯率計算，2023 年全年全球淨銷售額將增長 6% 至 8%。如果利率保持在 2023 年 2 月 15 日的水平附近，我們預計報告的淨銷售額增長也將達到 6% 至 8%。我們預計匯率波動會對季度增長率產生一些影響，但對全年淨銷售額增長的影響微乎其微。

Due to our pending merger with Globus Medical, which we expect to close midyear, we are not providing operating margin or EPS guidance at this time. We continue to focus on driving our business in 2023 while improving operating margin and achieving profitable growth.

由於我們預計將在年中完成與 Globus Medical 的合併，我們目前不提供營業利潤率或 EPS 指導。我們將繼續專注於在 2023 年推動我們的業務發展，同時提高營業利潤率並實現盈利增長。

Now I'd like to ask the operator to please open the call for questions.

現在我想請接線員打開問題電話。

(Operator Instructions) Our first question comes from Matt Miksic with Barclays.

（操作員說明）我們的第一個問題來自巴克萊銀行的 Matt Miksic。

Matt, are you there?

馬特，你在嗎？

Can you hear me okay?

你能聽到我說話嗎？

I can now.

我現在可以。

Great. Sorry for that. So appreciate all the little color on the pipeline. I wanted to just ask 1 question, if I could, about the announced transaction with Globus and sort of some of the internal reaction of the company. And then I have 1 follow-up on the pipeline. So maybe, Chris and Matt, just to get a sense of -- one of the views out there has been that the cultures of these companies has -- is different, might not mesh so well. I think we've seen something different. And I'd love to get a sense of how the teams are reacting to the news and your view on sort of the culture match between the organizations. And I have 1 quick follow-up.

偉大的。對不起。所以欣賞管道上的所有小顏色。如果可以的話，我只想問一個問題，關於與 Globus 宣布的交易以及公司的一些內部反應。然後我對管道進行了 1 次跟進。因此，Chris 和 Matt，也許只是為了了解——其中一種觀點認為這些公司的文化是不同的，可能不會很好地融合在一起。我想我們看到了不一樣的東西。我很想了解團隊對新聞的反應以及您對組織之間文化匹配的看法。我有 1 個快速跟進。

Yes. Thanks for the question, Matt. Listen, I'll say this that I've had a chance to spend time with both teams over the last couple of weeks, and I found a lot more similarities than I found differences. I think, in general, both sides are excited. I think the strategic rationale is clear.

是的。謝謝你的問題，馬特。聽著，我要說的是，在過去的幾周里，我有機會與這兩個團隊共度時光，我發現的相似之處多於不同之處。我認為，總的來說，雙方都很興奮。我認為戰略依據很明確。

If you really step back, both organizations are very patient-focused. We like to say we change a patient's life every minute. They say, improve the quality of life for patients with musculoskeletal disorders. We both have a strong history of innovation. It's in our DNA. They have a clear and decisive approach to operational rigor and financial discipline. I think we have a marketing prowess and a best-in-class surgeon engagement and training capability. You mesh those things together, I think you create a world-class organization across multiple dimensions. And I think everybody sees that.

如果你真的退後一步，這兩個組織都非常以病人為中心。我們喜歡說我們每分鐘都在改變患者的生活。他們說，改善肌肉骨骼疾病患者的生活質量。我們都有悠久的創新歷史。它存在於我們的 DNA 中。他們對運營的嚴謹性和財務紀律採取明確而果斷的方法。我認為我們擁有營銷實力和一流的外科醫生參與和培訓能力。你將這些東西結合在一起，我認為你創建了一個跨越多個維度的世界級組織。我想每個人都看到了這一點。

Now clearly, change is challenging, but I've been uniquely impressed at the -- I don't want to say the ease, but how the differences have melted away and people have really gotten behind it. Now clearly, we've got ways to go. But I'm -- I like to say that we don't have contradictory cultures. We have complementary cultures with complementary capabilities that we can drive together. So that's kind of where we are today.

很明顯，改變是具有挑戰性的，但我對這一點印象深刻——我不想說輕鬆，但差異是如何消失的，人們真的支持它。現在很明顯，我們還有很多路要走。但我——我想說我們沒有矛盾的文化。我們擁有互補的文化和互補的能力，我們可以共同推動。這就是我們今天所處的位置。

Again, we're 2 weeks in. But I've been very impressed with the Globus team. I've been impressed how the NuVasive team has come together and gotten behind this. It's early days, but I'm encouraged.

同樣，我們已經 2 週了。但是 Globus 團隊給我留下了深刻的印象。 NuVasive 團隊團結一致並全力支持這件事給我留下了深刻的印象。現在還早，但我很受鼓舞。

Second question, Matt?

第二個問題，馬特？

Yes. Yes, that's super helpful. So the one question I had on the pipeline is just that the posterior segment that you've now talked about a few times and come into ramping up is this portfolio around getting after like it used to be maybe like an MIS TLIF opportunity. When can we see that start to maybe move the needle or be reflected in some of the results?

是的。是的，這非常有幫助。所以我在管道上遇到的一個問題就是你現在已經談過幾次並開始加速的後段是這個投資組合，就像它過去可能像 MIS TLIF 機會一樣。我們什麼時候可以看到這可能開始改變方向或反映在某些結果中？

Yes. Thanks for the question. We're excited about P360, we talked this before. Where you've seen us focus our efforts like X360, we've had phenomenal results. You've seen that more recently with C360, where we doubled down in the cervical portfolio, added an acquisition with Simplify and now posted 5-plus quarters of greater than 20% growth within that portfolio.

是的。謝謝你的問題。我們對 P360 感到興奮，我們之前談過這個。在您看到我們像 X360 這樣集中精力的地方，我們取得了非凡的成果。你最近看到了 C360，我們在頸椎投資組合中翻了一番，增加了對 Simplify 的收購，現在在該投資組合中有超過 5 個季度的增長超過 20%。

We're just now getting off the starting line. It's a $1.7 billion segment. We have a low single-digit growth -- I mean low single-digit share, excuse me. We've recently launched our NuVasive tubular system, retractor system to, I think, give us an advantage in areas like TLIF and decompression. We'll do clinical trials starting this year with MOD-EX PO. So you'll see meaningful contribution this year from our focus in P360.

我們現在才剛剛起跑。這是一個價值 17 億美元的細分市場。我們有一個低個位數的增長——我的意思是低個位數的份額，對不起。我們最近推出了我們的 NuVasive 管狀系統、牽開器系統，我認為這使我們在 TLIF 和減壓等領域具有優勢。我們將從今年開始使用 MOD-EX PO 進行臨床試驗。因此，今年您將看到我們對 P360 的關注做出了有意義的貢獻。

Now clearly, we're still counting on X360 and C360 to be the growth drivers. But we're now off the starting line, I would say, with P360 with what I consider to be substantial runway in this segment that we saw.

現在很明顯，我們仍然指望 X360 和 C360 成為增長動力。但我們現在已經脫離了起跑線，我想說，P360 和我認為在我們看到的這個細分市場中的重要跑道。

Our next question comes from Shagun Singh with RBC Capital Markets.

我們的下一個問題來自 RBC Capital Markets 的 Shagun Singh。

I have 2 questions, one on the deal and one on just Q4 exit rates and guidance. On the deal, I was just wondering if you could talk a little bit about the current stock price reaction in the context of the deal. Why do you think this is the right deal that investors should vote on, maybe just what you're hearing from investors? And what is your key messaging to them?

我有兩個問題，一個是關於交易，一個是關於第四季度的退出率和指導。關於這筆交易，我只是想知道你是否可以談談交易背景下當前股價的反應。為什麼你認為這是投資者應該投票的正確交易，也許正是你從投資者那裡聽到的？您向他們傳達的關鍵信息是什麼？

And then for my second question, I was just wondering if you can talk about the confidence in the 6% to 8% growth. Why is that the right number given the Q4 exit rate? I think you called out high- versus lower-acuity cases in spine, and that recovery seems to be different. Can you just talk about that?

然後對於我的第二個問題，我只是想知道你是否可以談談對 6% 到 8% 增長的信心。鑑於第四季度的退出率，為什麼這個數字是正確的？我認為你指出了脊柱的高敏度病例和低敏度病例，而且恢復似乎是不同的。你能談談嗎？

Thanks, Shagun. Listen, I, obviously, as everybody else, is watching the stock price reaction. Listen, I know that the market has sort of been fixated on stock price and predicated deals in the space. I focus our efforts and our look as we looked at this deal at a clear strategic rationale that complementary global commercial organizations with minimum overlap, truly innovative and broad portfolio in spine and orthopedics, R&D -- world-class R&D organization on both sides of the bench, if you will, within this with tremendous surgeon education capabilities, manufacturing and distribution synergies that we look to leverage compelling upside revenue potential and shareholder value creation.

謝謝，沙根。聽著，很明顯，我和其他人一樣，正在關注股價反應。聽著，我知道市場有點關注股票價格和該領域的預測交易。當我們審視這筆交易時，我將我們的努力和目光集中在一個明確的戰略基礎上，即以最小的重疊互補全球商業組織，真正創新和廣泛的脊柱和骨科產品組合，研發——世界級的研發組織雙方bench，如果你願意的話，在此範圍內，我們希望利用巨大的外科醫生教育能力、製造和分銷協同效應，利用令人信服的上行收入潛力和股東價值創造。

And I would say I was very confident in our stand-alone plan. But nothing accelerates our strategy more than this deal. So we just got to come to terms with, we went down this road because we thought it was the best way to create value and create value for shareholders in the long term. And I think there's a lot of people reacting in the short term. But to be clear, we looked at this, we looked at several other opportunities over the last several years as we always do, we always came back to this is the most compelling combination and unlocks the most shareholder value over time.

我會說我對我們的獨立計劃非常有信心。但沒有什麼比這筆交易更能加速我們的戰略了。所以我們不得不接受，我們走這條路是因為我們認為這是創造價值和為股東創造長期價值的最佳方式。而且我認為短期內會有很多人做出反應。但需要明確的是，我們研究了這一點，過去幾年我們一如既往地研究了其他幾個機會，我們總是回到這是最引人注目的組合，並隨著時間的推移釋放最大的股東價值。

I think over time, people will come to terms of that. I'm excited about this. I'm confident in this deal. And like I said, we're early days. We've got a lot of work to do. I've got to get out and talk to a lot of our investors, which I'll be doing over the next several weeks, telling them how excited I'm about getting behind this deal.

我認為隨著時間的推移，人們會接受這一點。我對此很興奮。我對這筆交易充滿信心。就像我說的，我們還處於早期階段。我們有很多工作要做。我必須出去和我們的很多投資者交談，我將在接下來的幾週內這樣做，告訴他們我對支持這筆交易有多興奮。

Yes. Shagun, with regard to your question, we feel good about the 6% to 8%. I would say we're continuing to feel good about our prospects internationally in low- to mid-double-digit growth. We're going to still see great success in Simplify. We're going to continue to grow Pulse. As you're thinking about calendarization, we're thinking upper 200s for the first quarter. And if you look at that compared to last year, that will be a really strong start to the year.

是的。 Shagun，關於你的問題，我們對 6% 到 8% 感到滿意。我想說的是，我們繼續對我們在國際上實現中低兩位數增長的前景感到樂觀。我們仍將在 Simplify 中看到巨大的成功。我們將繼續發展 Pulse。當您考慮日曆化時，我們正在考慮第一季度的 200 美元以上。如果你把它與去年相比，那將是今年一個非常強勁的開端。

Our next question comes from Josh Jennings with Cowen.

我們的下一個問題來自 Josh Jennings 和 Cowen。

This is Eric on for Josh. I was hoping to just ask about the NuVasive pipeline and Pulse specifically. I was just curious to hear your thoughts on pursuing a application for Pulse. And then also if you're able to provide any placement metrics on Pulse at the moment, that would be helpful.

這是喬希的埃里克。我希望專門詢問 NuVasive 管道和 Pulse。我只是想听聽您對 Pulse 應用程序的想法。然後，如果您目前能夠在 Pulse 上提供任何展示位置指標，那將會很有幫助。

Thanks for the question, Eric. Listen, we've been excited and -- about what we've done with Pulse so far. We've done over 2,000 commercial cases. We've got a broad pipeline of technology coming with Pulse. In the short term, we've got software upgrades in the summer that will create, we believe, greater global expansion this year.

謝謝你的問題，埃里克。聽著，我們一直很興奮——關於我們迄今為止對 Pulse 所做的一切。我們已經完成了 2,000 多個商業案例。 Pulse 帶來了廣泛的技術管道。在短期內，我們在夏季進行了軟件升級，我們相信這將在今年實現更大的全球擴張。

We've always talked about pursuing robotics in the future for Pulse. It's always been a part of the road map, and it still is. So the -- obviously, the opportunity we see ahead with Globus accelerates our opportunity with robotics, enabling tech in general.

我們一直在談論在未來為 Pulse 追求機器人技術。它一直是路線圖的一部分，現在仍然是。所以 - 顯然，我們看到 Globus 未來的機會加速了我們在機器人技術方面的機會，使技術成為可能。

If you back up, if you recall, our 4 major growth drivers -- our 4 major strategies, I should say, core growth, which was really the 360 strategies that we've talked about. Second was intelligent surgery. And this is all about the software capability, truly innovate and change patients' lives in spine surgery. And if you think about the combination of the 2 companies to come together, it more than accelerates anything that we could have done as a standalone. So they're world-class -- they have a world-class technology with a robotic system. We think that potentially creates an accelerator for our ability to drive intelligent surgery. So we're excited.

如果你回顧一下，如果你還記得我們的 4 個主要增長動力——我們的 4 個主要戰略，我應該說，核心增長，這實際上是我們談到的 360 戰略。二是智能手術。而這一切都與軟件功能有關，真正創新並改變脊柱手術患者的生活。而且，如果您考慮將這兩家公司合併在一起，它不僅可以加速我們作為獨立公司可以完成的任何事情。所以他們是世界級的——他們擁有世界級的機器人系統技術。我們認為這可能會為我們推動智能手術的能力創造一個加速器。所以我們很興奮。

For just Pulse in general, units placed for over a year, we've seen double-digit pull-through. So a lot of the things that we've done over the last year really set us up and create a lot of optimism for how we move ahead with Pulse.

一般而言，就 Pulse 而言，放置了一年多的單位，我們已經看到了兩位數的拉動率。因此，我們在過去一年中所做的很多事情確實讓我們對如何推進 Pulse 產生了很多樂觀情緒。

As far as placement metrics, we've sold the majority of these units. We still have the capability to place, but we've sold the majority of the units. I've always said before, my goal is to create flexibility. And when we prove out the business model that we're getting kind of pull-through that we're seeing with some of the units that I said -- like I said are replaced for more than a year, that might open up the opportunity to do a little more placements.

就安置指標而言，我們已經售出了大部分這些單位。我們仍然有能力放置，但我們已經售出大部分單位。我之前一直說，我的目標是創造靈活性。當我們證明我們正在通過我所說的一些單位看到的商業模式時，我們會看到這種商業模式 - 就像我說的那樣被替換了一年多，這可能會打開機會做更多的展示位置。

But so far, generally speaking, we've sold most of our units. We're still remaining flexible and have several different programs for people to acquire the technology. But again, I'd say it's still early days at year-end with a lot of opportunity to go.

但到目前為止，一般來說，我們已經售出大部分單位。我們仍然保持靈活性，並有幾個不同的項目供人們獲取技術。但我要說的是，年底還為時過早，還有很多機會可以去。

Our next question comes from Matthew Taylor with Jefferies.

我們的下一個問題來自 Jefferies 的 Matthew Taylor。

This is Young Li in for Matt. I guess was wondering maybe if you can highlight some of the major NuVasive businesses that are more complementary in nature with Globus, less overlaps, I'm thinking cervical, OUS, NSO, neuromonitoring. Anything else you would highlight? And then for the rest of the business, if you can maybe talk a little bit more about which ones might have slightly more overlap?

這是 Matt 的 Young Li。我想知道你是否可以強調一些主要的 NuVasive 業務，這些業務在本質上與 Globus 更具互補性，重疊更少，我在考慮宮頸、OUS、NSO、神經監測。你還有什麼要強調的嗎？然後對於其餘的業務，您是否可以多談談哪些業務可能有更多的重疊？

We've looked at this a lot of different ways. I'll just say that the portfolio is highly complementary. Clearly, there's some level of overlap, but again, spine is a fragmented market. There's a lot of competitors out there. So even where we have overlap, we still have a lot of competition.

我們已經用很多不同的方式來看待這個問題。我只是說投資組合是高度互補的。顯然，存在一定程度的重疊，但同樣，脊椎是一個分散的市場。那裡有很多競爭對手。所以即使我們有重疊，我們仍然有很多競爭。

So they have a strength-enabling technology. Obviously, we've done well in areas like lateral. They've done a fantastic job with areas like enabling tech. We've more recently done a really nice job, I think, with our cervical portfolio.

因此，他們擁有增強力量的技術。顯然，我們在橫向等領域做得很好。他們在啟用技術等領域做得非常出色。我認為，我們最近在頸椎產品組合方面做得非常好。

We doubled down in globalization a few years back, and I think we've got an opportunity there to create synergy between the 2 organizations. We're likely a little further ahead with our global footprint. So generally speaking, there's a lot of complementary nature to the way the 2 companies can .

幾年前我們在全球化方面加倍努力，我認為我們有機會在這兩個組織之間創造協同效應。我們的全球足跡可能會更進一步。所以一般來說，這兩家公司的方式有很多互補性。

That was one of the compelling areas when we sat down and looked at this, although competitors, just the way the 2 companies have evolved and innovated over the course of our history, we've sort of been on a parallel path but actively engaged in a lot of different areas. So generally speaking, we feel very good about the complementary nature of the portfolio.

當我們坐下來審視這個問題時，這是引人注目的領域之一，儘管競爭對手，就像這兩家公司在我們的歷史進程中發展和創新的方式一樣，我們一直走在平行的道路上，但積極參與很多不同的領域。所以總的來說，我們對投資組合的互補性感覺很好。

We talked a lot about the commercial overlap. A lot of people ask me, how overlapped are you commercially? And I want to be really clear on this one. In the majority of accounts -- and this is a U.S. statement, in the majority of accounts, we don't have any overlap, meaning one company has revenue, but the other does not. Of the accounts where both companies have business, in almost all instances, one company has significantly more business than the other, an incredible international runway.

我們談了很多關於商業重疊的問題。很多人問我，你們在商業上有多少重疊？我想在這一點上非常清楚。在大多數賬戶中——這是一份美國聲明，在大多數賬戶中，我們沒有任何重疊，這意味著一家公司有收入，但另一家公司沒有。在幾乎所有情況下，在兩家公司都有業務的客戶中，一家公司的業務明顯多於另一家，這是一條令人難以置信的國際跑道。

So if you think about the opportunity for us with the backdrop of what I just said, selling the 360 portfolio, including X360 and Simplify in the Globus Medical accounts, selling Excelsius and Expendables in the NuVasive accounts, the ability to sell NSO and PRECICE in GMED and Globus' existing orthopedic and trauma portfolio, all of that should bring, hopefully, the context and some backdrop that we are confident in our ability to successfully integrate our commercial teams and as you ask, very confident in the complementary nature of the portfolio and how that creates value to our patients, to our surgeons and to our shareholders.

因此，如果您在我剛才所說的背景下考慮我們的機會，出售 360 產品組合，包括 Globus Medical 賬戶中的 X360 和 Simplify，出售 NuVasive 賬戶中的 Excelsius 和 Expendables，出售 NSO 和 PRECICE 的能力GMED 和 Globus 現有的骨科和創傷產品組合，所有這些都應該帶來我們有信心成功整合我們的商業團隊的背景和背景，正如您所問的，對產品組合的互補性非常有信心以及這如何為我們的患者、我們的外科醫生和我們的股東創造價值。

All right. Great. I appreciate the detailed color there. Maybe one on the U.S. market, wanted to hear a little bit more. It sounds like there's some macro headwinds still but getting more stable. Where do you think we are in the recovery curve? If you can maybe talk a little bit about the potential impacts from maybe backlogs or staffing easing for 2023.

好的。偉大的。我很欣賞那裡的詳細顏色。也許是美國市場上的人，想多聽一點。聽起來仍然存在一些宏觀逆風，但變得更加穩定。您認為我們處於復蘇曲線的哪個位置？如果你能談談 2023 年可能積壓或裁員的潛在影響。

Yes. I mean, I think it's -- '22 is a very, very volatile year from a lot of different perspectives. You sort of started with the COVID challenge in January and February of 2022, and then you ran smacked out into instability in the war in Ukraine, and then you ran into staffing shortages and currency fluctuations. I think over the course of the year, we found, I guess, more stability, although I would just say we probably got comfortable reacting to the challenges.

是的。我的意思是，我認為這是——從很多不同的角度來看，22 年是非常、非常不穩定的一年。你從 2022 年 1 月和 2 月的 COVID 挑戰開始，然後你遇到了烏克蘭戰爭的不穩定，然後你遇到了人員短缺和貨幣波動。我認為在這一年中，我猜我們發現了更多的穩定性，儘管我只想說我們可能很樂意應對挑戰。

As I look at '23, I still think there's volatility and I still think there's challenges. I still think they're staffing shortages in some way, shape or form. There's currently clearly still some currency volatility. But the good news is, I think, as an industry, we've had a chance to sort of react. So now we can be a little more proactive and at least predict.

當我回顧 23 年時，我仍然認為存在波動，我仍然認為存在挑戰。我仍然認為他們在某種程度上、形狀或形式上存在人員短缺。目前顯然仍有一些貨幣波動。但好消息是，我認為，作為一個行業，我們有機會做出某種反應。所以現在我們可以更主動一點，至少可以預測一下。

Now currency gets worse or there's further unrest or who knows -- after the last few years, who knows what happens. But I think we're set up to have a more stable year in '23. And with that stability, I think we continue to move back to a normal. And hopefully, that normal is sort of like into the pre-COVID normal.

現在貨幣變得更糟或者有更多的動盪或者誰知道 - 在過去幾年之後，誰知道會發生什麼。但我認為我們已經準備好在 23 年迎來更加穩定的一年。有了這種穩定性，我認為我們會繼續恢復正常。希望這種常態有點像 COVID 之前的常態。

Hard to predict where we are along that continuum today. But I would expect that '23 will be more stable than '22. I can't imagine it wouldn't be. And I think we have now the better prediction capabilities looking forward than we've had over the last several years. So all that underlying statement is, I'm optimistic that '23 will be a much more stable and predictable year than what we've seen in the last couple.

很難預測我們今天在這個連續體中所處的位置。但我預計 23 年會比 22 年更穩定。我無法想像它不會。而且我認為我們現在擁有比過去幾年更好的預測能力。所以所有潛在的陳述都是，我樂觀地認為 23 年將比我們在過去幾年中看到的更加穩定和可預測。

Our next question comes from Matt Blackman with Stifel.

我們的下一個問題來自 Stifel 的 Matt Blackman。

This is Emily on for Matt. Just a couple on Simplify. I was hoping for a bit more color on the rollout progress, product pull-through, especially for Simplify users who are new to NuVasive, maybe where it has exceeded your expectations and if we're still kind of in the early innings for that.

這是 Emily 為 Matt 做的。只是一對夫婦的簡化。我希望在推出進度、產品推廣方面有更多的色彩，特別是對於 NuVasive 的新用戶 Simplify 用戶，也許它已經超出了您的預期，如果我們仍處於早期階段的話。

And then maybe if you could touch on the competitive dynamics, if you get the sensor growth that's coming more from share taking as opposed to market expansion and if there's been any changes there with the recent disc launches from Sentinel.

然後也許如果你能觸及競爭動態，如果你獲得更多來自份額而不是市場擴張的傳感器增長，以及最近從 Sentinel 推出的光盤是否有任何變化。

Thank you, Emily, for the question. We're very excited about the progress we've made with Simplify. And I would say it's really exceeding our expectations across the board. We've seen -- we're beating our deal model. We're on or ahead of pace on some of the integration that we have. We've completed most of the activities, waiting for agencies' response to fully integrate into West Carrollton.

艾米麗，謝謝你提出這個問題。我們對 Simplify 取得的進展感到非常興奮。我會說這真的超出了我們的全面預期。我們已經看到——我們正在擊敗我們的交易模式。在我們擁有的一些集成方面，我們正在或領先於步伐。我們已經完成了大部分活動，等待機構的回應以完全融入 West Carrollton。

The other thing that's exciting about this is we had the opportunity to relook at the market when we did our Investor Day back in October. And what was exciting about that is as we're watching the growth of our product, which we think is the leading technology in the cTDR space, we also recognize the market has grown greater than 50% since we measured the market last time. So we have a leading technology in the -- probably the fasting expanding space in the spine market today. So for all those things, we're excited.

另一件令人興奮的事情是，當我們在 10 月份舉辦投資者日時，我們有機會重新審視市場。令人興奮的是，當我們看到我們的產品增長時，我們認為這是 cTDR 領域的領先技術，我們也認識到自上次衡量市場以來，市場增長超過 50%。因此，我們擁有領先的技術——可能是當今脊柱市場快速擴張的空間。因此，對於所有這些事情，我們感到很興奮。

We've trained upwards of 800-plus surgeons. We've got roughly about, let's say, greater than 500 active today. So we've got a lot of runway. There's still opportunities for, we think, Simplify in the cTDR market to grow. We think patient awareness, patients want motion preservation. We think surgeon awareness continues to increase. We think the data that's associated with this procedure continues to show positive results versus things like ACDF. And the reimbursement gap is closing. It's not closed yet, but it's closing. And so those things all give us a lot of confidence that we've got opportunities.

我們已經培訓了 800 多名外科醫生。比方說，我們今天大約有 500 多個活躍用戶。所以我們有很多跑道。我們認為，Simplify 在 cTDR 市場中仍有增長的機會。我們認為患者意識，患者想要運動保存。我們認為外科醫生的意識在不斷提高。我們認為與 ACDF 之類的東西相比，與此程序相關的數據繼續顯示出積極的結果。報銷差距正在縮小。它還沒有關閉，但它正在關閉。所以這些事情都給了我們很大的信心，我們有機會。

As far as competitive dynamics of market share versus market expansion, we know we're taking share. Obviously, the incumbents, M6, Mobi-C, we think we're doing well. We're also taking advantage of the market expansion. So I don't have a number per se to say how much is marketing expansion and how much is share, but just suffice to say, I'm confident in our runway. I'm confident in the fact that it's pulling through the broader C360 portfolio. We've grown that 20-plus percent for the last 5 quarters. And I feel confident the runway going forward to be continued that trend.

就市場份額與市場擴張的競爭動態而言，我們知道我們正在分享。顯然，現任者，M6，Mobi-C，我們認為我們做得很好。我們也在利用市場擴張。因此，我本身沒有數字可以說明營銷擴張有多少，份額有多少，但足以說明，我對我們的跑道充滿信心。我相信它正在推動更廣泛的 C360 產品組合。在過去的 5 個季度中，我們增長了 20% 以上。而且我有信心未來的跑道將繼續保持這種趨勢。

Our next question comes from Vik Chopra with Wells Fargo.

我們的下一個問題來自富國銀行的 Vik Chopra。

Two for me. First one for Chris. Chris, you talked about the complex of the higher-acuity cases getting better. Could you perhaps put a finer point on that? And what gives you confidence that they will ramp throughout the year? And my follow-up is for Matt. Matt, can you just maybe talk about seasonality in 2023 as you see it both on revenues and on OpEx?

兩個給我。第一個給克里斯。克里斯，你談到了更高敏銳度的病例變得更好的複雜性。您能否對此提出更明確的觀點？是什麼讓您有信心他們會在全年增加？我的後續行動是針對馬特的。馬特，你能不能談談 2023 年的季節性，因為你在收入和運營支出上都看到了這一點？

Thanks, Vik. I said this last quarter, I believe, I haven't seen any discernible difference in the velocity of cases. What I said was we're going to annualize our mix. We've seen obviously a more, I should say, muted number of complex cases in relation to the growth we saw in areas like cervical. So our overall revenue per case was down because we had a mix disruption in 2022.

謝謝，維克。我在上個季度說過，我相信，我沒有看到案件速度有任何明顯差異。我說的是我們要對我們的組合進行年度化。我們顯然看到了更多，我應該說，與我們在宮頸等區域看到的生長相關的複雜病例數量較少。因此，我們每箱的總收入下降了，因為我們在 2022 年遇到了混合中斷。

Although, having said that, we still grew the business 8.5%. So I was proud of how -- specifically, when I look -- and I talked to this before, when I look at the volume growth, the volume growth is much greater than the revenue growth because of this dynamic that we've seen with our mix. Good news is I don't know that I see a change in velocity of high-acuity cases yet, but what I do see is we've annualized our mix. So we should get a much -- a generally equal benefit from volume to revenue where, in the 2022 time frame, we were at a deficit.

儘管如此，我們的業務仍然增長了 8.5%。所以我很自豪——具體來說，當我看到——我之前談過這個，當我看到銷量增長時，銷量增長遠大於收入增長，因為我們已經看到了這種動態我們的組合。好消息是我不知道我是否看到高敏度病例的速度發生變化，但我確實看到我們已經對我們的組合進行了年度化。因此，在 2022 年的時間框架內，我們處於赤字狀態，因此我們應該從數量到收入中獲得大致相等的收益。

So if it picks back up, that's great. I haven't seen anything that would indicate that it's picking up and increasing in velocity. But generally, if the market stabilizes and staffing concerns go down and the floors on the hospital are not constrained, then hopefully, the throughput will increase. And that should benefit some of the high-acuity cases, if that makes sense.

因此，如果它恢復正常，那就太好了。我還沒有看到任何跡象表明它正在加速和增加速度。但總的來說，如果市場穩定下來，人員配備問題減少，醫院樓層不受限制，那麼吞吐量有望增加。如果這有意義的話，這應該會使一些高度敏感的病例受益。

Yes. Vik, this is Matt. Thanks for the question. We feel really good about the 6% to 8%, as I said earlier. We're thinking upper 200s for the first quarter. From a currency perspective, we're expecting a negative impact in the first and second quarter, and then it will be muted in the back half of the year. And on balance, it pretty much nets to plus or minus $1 million.

是的。維克，這是馬特。謝謝你的問題。正如我之前所說，我們對 6% 到 8% 感覺非常好。我們正在考慮第一季度的 200 美元以上。從貨幣的角度來看，我們預計第一季度和第二季度會產生負面影響，然後在下半年會減弱。總的來說，它幾乎可以淨增或減去 100 萬美元。

Vik, I'll just add one more thing, though, that's interesting that I will say. Coming out of last -- Q4 of 2022, we did see some softness in the very end of the quarter, in the latter December, where usually some of our strongest weeks of the year, fairly muted.

Vik，不過，我還要補充一件事，我會說這很有趣。在 2022 年第四季度結束後，我們確實在本季度末看到了一些疲軟，在 12 月下旬，通常是我們一年中最強勁的幾個星期，相當低調。

Now correspondingly, I've seen less of a dropoff in January. Now January doesn't represent the quarter, but it would indicate there may be a little more of a smoothness in the seasonality coming into this year. Now whether that progresses throughout the year and you have a smoother seasonality to '23 is something we'll be -- we'll have to watch. But December to January, usually have a peak and a valley. We saw less of a peak, but we're also seeing lots of a valley, if that makes sense.

現在相應地，我看到 1 月份的下降較少。現在 1 月並不代表該季度，但它表明今年的季節性可能會更加平穩。現在，這是否會在全年取得進展，並且到 23 年會有更平穩的季節性，這是我們將要做的——我們必須拭目以待。但十二月到一月，通常有高峰和低谷。我們看到的高峰較少，但如果有道理的話，我們也看到了很多山谷。

Our next question comes from David Saxon with Needham & Company.

我們的下一個問題來自 Needham & Company 的 David Saxon。

This is Joseph calling for David. Maybe just wanted to do 2 questions around the overlap with Globus. I guess, just looking at the accounts where you don't have any overlap with Globus, could you maybe talk about your main competitors in those accounts, if they are Globus?

這是約瑟夫在呼喚大衛。也許只是想圍繞與 Globus 的重疊問題提出 2 個問題。我想，只要看看您與 Globus 沒有任何重疊的賬戶，您能否談談您在這些賬戶中的主要競爭對手（如果他們是 Globus）？

I mean there's 8 to 10 companies that make up 80% of the market. So if it's not us or Globus, it's one of them. And depending on where you are, it could be any one of those. So Medtronic is a market leader. So if you want to throw a dart at it, you'd probably hit them first, but there's many others out there.

我的意思是有 8 到 10 家公司佔據了 80% 的市場份額。因此，如果不是我們或 Globus，那就是其中之一。根據您所在的位置，它可能是其中任何一個。所以美敦力是市場領導者。所以如果你想朝它扔飛鏢，你可能會先打他們，但還有很多其他人在那裡。

Okay. Yes, that makes sense. And then, I guess, internationally, if you could touch on that, what the overlap looks like. Is it similar to the U.S.?

好的。是的，這是有道理的。然後，我想，在國際上，如果你能談談，重疊是什麼樣子的。跟美國一樣嗎？

We've got work to do there. But generally speaking, I can't speak for Globus here. But off the top of my head, I want to say they had low double-digit type of revenue representation of U.S. versus OUS, maybe 10% to 11%. But we've amassed -- roughly about 25% of our revenue comes from markets outside the U.S., and that's growing substantially for us, 7.7% in constant currency in 2022.

我們有工作要做。但總的來說，我不能在這裡代表 Globus。但在我的腦海中，我想說他們在美國與 OUS 的收入代表率較低，可能是 10% 到 11%。但我們已經積累了——我們大約 25% 的收入來自美國以外的市場，這對我們來說正在大幅增長，到 2022 年按固定匯率計算將增長 7.7%。

So we'll get to the bottom of where we have overlapped. But safe to say, I think both of us in early innings and in low single-digit share positions in most markets. Japan is a market that we have a significant amount of strength, as an example. We're the #2 share player, and they're probably very lower -- a lower share player in that market. So that's clearly a synergy opportunity.

因此，我們將深入了解我們重疊的地方。但可以肯定地說，我認為我們倆都處於早期階段，並且在大多數市場中都處於較低的個位數份額位置。例如，日本是我們擁有大量實力的市場。我們是份額排名第二的玩家，他們的份額可能非常低——該市場份額較低的玩家。所以這顯然是一個協同增效的機會。

We'll be working through that as we go through the pre-integration planning. We got a lot of work to do there. But at first glance, we're optimistic that there is a significant opportunity and minimal overlap. Now we haven't gone to the granularity we've gone to in the U.S. yet, but we will. And like I said, we're confident we've got an opportunity there as well.

我們將在進行集成前規劃時解決這個問題。我們在那裡有很多工作要做。但乍一看，我們樂觀地認為存在重大機會且重疊最小。現在我們還沒有達到我們在美國已經達到的粒度，但我們會的。就像我說的，我們有信心在那裡也有機會。

Our next question comes from Allen Gong with JPMorgan.

我們的下一個問題來自摩根大通的 Allen Gong。

This is actually Lily on for Allen. EPS in the quarter was a bit softer than what we and The Street were thinking. So if you could just dig a little deeper into the P&L dynamics you saw in the quarter and what the main driver of the margin fall was, that would be helpful.

這實際上是 Lily on for Allen。本季度的每股收益比我們和華爾街的預期要低一些。因此，如果您能更深入地了解您在本季度看到的損益動態以及利潤率下降的主要驅動因素是什麼，那將會很有幫助。

Yes. I think the tax rate was a little bit higher than what people were modeling. And I would say, in general, interest expense is an area that has more volatility around it than it is being modeled. And I would like to say for 2023, for interest expense, we think $25 million is a good number to use.

是的。我認為稅率比人們建模的要高一點。我想說的是，總的來說，利息支出是一個比模型中的波動性更大的領域。我想說，對於 2023 年的利息支出，我們認為 2500 萬美元是一個很好的數字。

Got it. That's really helpful. And then maybe just digging into the guidance a bit more. Could you talk a bit about your confidence in getting to the top half of the 6% to 8% range? And what are the drivers that are needed to get there?

知道了。這真的很有幫助。然後可能只是更深入地研究指南。你能談談你對達到 6% 到 8% 範圍上半部分的信心嗎？到達那裡所需的驅動程序是什麼？

Yes. So I'll hit that one. We're confident in the guidance range. Clearly, I've talked about this. We haven't seen a normal year since 2019. So to the earlier question, I think -- I forget who asked it, but how do we look at '23 from a stability perspective, I think if you get the high end to the guidance, we need the macroeconomics to subside -- I should say, the macroeconomic headwinds to subside.

是的。所以我會打那個。我們對指導範圍充滿信心。顯然，我已經談到了這一點。自 2019 年以來，我們還沒有看到正常的一年。所以對於之前的問題，我想——我忘了是誰問的，但我們如何從穩定性的角度來看 23 年，我想如果你得到高端指導，我們需要宏觀經濟消退——我應該說，宏觀經濟逆風消退。

We need to beat currency. We need to see staffing shortages go away. But the fact is, we feel pretty good. We've got the X360 portfolio and the new product contracts we talked about. The C360 portfolio continues to grow. We continue to drive Pulse. Simplify continues to be a growth driver. Our international business continues to grow in the double-digit range.

我們需要打敗貨幣。我們需要看到人員短缺問題消失。但事實是，我們感覺還不錯。我們已經有了 X360 產品組合和我們談到的新產品合同。 C360 產品組合繼續增長。我們繼續推動 Pulse。 Simplify 繼續成為增長動力。我們的國際業務繼續以兩位數的速度增長。

So to get above that 8% range or get to the higher end, I just need the market to come online for once in the last few years and give us a little bit of stability and minimize some of the headwinds we face. So providing those things happen, I feel pretty confident that we're in the range of the year, and we're optimistic that there's some upside if the market continues to get better.

因此，要超過 8% 的範圍或達到更高的水平，我只需要市場在過去幾年上線一次，給我們一點穩定性，並儘量減少我們面臨的一些不利因素。因此，如果這些事情發生，我非常有信心我們處於今年的範圍內，並且我們樂觀地認為，如果市場繼續好轉，就會有一些上行空間。

(Operator Instructions) Our next question comes from Drew Ranieri with Morgan Stanley.

（操作員說明）我們的下一個問題來自摩根士丹利的 Drew Ranieri。

Just to start, really going back to the deal announcement, both the companies have kind of talked about free cash flow generation being a key value driver of the deal. And Matt, I think I heard in your remarks that you talked about 2022 as a key investment year for sets. As you're thinking about '23, can you maybe talk about any specific areas where you're continuing to push your foot down on the gas from an investment perspective in sets or anything that you're pulling back on? Just how should we kind of think about set deployment, set investment contributing to that 6% to 8% top line growth for '23?

剛開始，真正回到交易公告，兩家公司都談到自由現金流的產生是交易的關鍵價值驅動因素。馬特，我想我在你的發言中聽到你談到 2022 年是佈景的關鍵投資年。當你在考慮 23 年時，你能談談你在哪些特定領域繼續從投資的角度踩油門或你正在撤回的任何事情嗎？我們應該如何考慮設置部署，設置投資為 23 年帶來 6% 至 8% 的收入增長？

Yes. Thanks for the question, Drew. Clearly, we had talked -- at Investor Day, we talked a lot about the programs that we believe would drive up margin. We continue to say we're going to invest in the company. And we've done that. We've done that through the course of '22. And we'll continue to provide sets. We'll continue to execute our 2023 plan. We'll continue to execute our R&D programs. We're continuing to operate the business. I mean all those things will continue business as usual. Business continuity will be the key for us over the next several weeks and months as we move from the sign to close period.

是的。謝謝你的問題，德魯。顯然，我們已經談過——在投資者日，我們談了很多我們認為會提高利潤率的項目。我們繼續說我們要投資這家公司。我們已經做到了。我們已經在 22 年的過程中做到了這一點。我們將繼續提供套裝。我們將繼續執行我們的 2023 年計劃。我們將繼續執行我們的研發計劃。我們將繼續經營業務。我的意思是所有這些事情將照常進行。在接下來的幾周和幾個月裡，隨著我們從簽約期過渡到關閉期，業務連續性將成為我們的關鍵。

The things that I will likely pause on are sort of these multiyear initiatives. Examples are ERP consolidations, things that just don't make a lot of sense to do until we move into the context of the new entity. SKU rationalization is one I talked about, I believe, in October. And under the context of global inventory within the combined entity, we just need to take a pause and see what that looks like.

我可能會暫停的事情是這些多年計劃。 ERP 整合就是一個例子，在我們進入新實體的環境之前，這些事情沒有多大意義。我相信 SKU 合理化是我在 10 月份談到的。在合併實體內的全球庫存背景下，我們只需要暫停一下，看看它是什麼樣子。

So listen, all the things that we think drive our business forward today and continue to maintain top line growth, we'll continue. Things that we need to rethink in the context of a combined entity, we'll pause and rethink. So that -- I don't know if I'm answering your question specifically, but that's kind of the way we're looking at it.

所以聽著，我們認為今天推動我們的業務向前發展並繼續保持收入增長的所有事情，我們將繼續。我們需要在合併實體的背景下重新考慮的事情，我們將暫停並重新考慮。所以——我不知道我是否在具體回答你的問題，但這就是我們看待它的方式。

And then just maybe a growth driver-type question on international. You're just talking about Japan has been a strong market for you. You're kind of leading the charge there versus Globus. But as you look at the combined portfolio, putting everything together, is there any geography that you think you have a better opportunity to kind of win as a combined company that you previously didn't have before with the scale?

然後可能只是一個關於國際的增長驅動類型的問題。你只是在談論日本對你來說一直是一個強大的市場。與 Globus 相比，您有點領先。但是，當您查看合併後的投資組合，將所有內容放在一起時，是否有任何地理位置您認為您有更好的機會作為一家您以前沒有的規模的合併後公司贏得勝利？

And just a second question, if I may, on there. With Pulse, you said definitive pull-through, pretty strong language. So can you kind of give us a sense of in the cases that you're seeing how much like that means in terms of wallet share per procedure? Just any more context there would be great.

還有第二個問題，如果可以的話。在 Pulse 中，你說了明確的突破，非常強大的語言。那麼，在您看到每個程序的錢包份額方面有多大意義的情況下，您能否讓我們了解一下？只要有更多的上下文就會很棒。

As far as that we're -- I think we're better positioned to win. In which geographies? I mean, I don't want to be contrived here, but I would say all of them. I mean, if you look at, like I said before, our ability to access the enabling tech capability that Globus possess and continues to innovate around what we've done, like I said, whether 360 portfolios, things like Simplify, our global footprint, the NSO and PRECICE opportunity, coupled with their orthopedic and trauma portfolio, I think we're stronger in every market we play in just as a rule. It's one of the key drivers of why we're doing this deal.

就我們而言——我認為我們更有能力贏得勝利。在哪些地區？我的意思是，我不想在這裡做作，但我會說所有這些。我的意思是，如果你看看，就像我之前說的那樣，我們有能力獲得 Globus 擁有的支持技術能力，並繼續圍繞我們所做的事情進行創新，就像我說的那樣，無論是 360 投資組合、Simplify 之類的東西，還是我們的全球足跡， NSO 和 PRECICE 機會，再加上他們的骨科和創傷產品組合，我認為我們通常在我們參與的每個市場上都更強大。這是我們進行這筆交易的關鍵驅動因素之一。

As far as Pulse, I would just say there's been double-digit net sales growth in the account. So you compare that to our total global growth of 8.5% and even take that into consideration, it's probably more of a U.S. phenomenon for the most part. Double digits with those customers that have had the system in for, let's say, a year or so, we've seen double-digit growth. So substantially better than what you would say the average is if you look at our U.S. growth number or if you translate that even to our global growth number, substantially higher.

就 Pulse 而言，我只想說該帳戶的淨銷售額增長了兩位數。因此，您將其與我們 8.5% 的全球總增長率進行比較，甚至考慮到這一點，這在很大程度上可能更像是一種美國現象。對於那些已經使用該系統的客戶，比方說，一年左右，我們看到了兩位數的增長。如果您查看我們的美國增長數字，或者如果您將其轉化為我們的全球增長數字，則比您所說的平均水平要高得多。

There are no further questions at this time. I would like to turn the floor back over to Chris Barry, NuVasive's CEO, for closing comments. Please go ahead.

目前沒有其他問題。我想將發言權轉回給 NuVasive 的首席執行官 Chris Barry，以徵求結束意見。請繼續。

Thanks, Maria. Thanks to everybody for participating today in the earnings call. Hopefully, it came through the -- how excited I'm about creating an innovative global musculoskeletal company together with Globus. I'm also very excited about where we've come with NuVasive and our confidence in our stand-alone strategy. But I am confident that this is the best path forward for us to create shareholder value and further enhance how we partner with surgeons, and ultimately, better treat patients.

謝謝，瑪麗亞。感謝大家參加今天的財報電話會議。希望它能通過——我對與 Globus 一起創建一家創新的全球肌肉骨骼公司感到非常興奮。我也對我們與 NuVasive 取得的進展以及我們對我們的獨立戰略的信心感到非常興奮。但我相信，這是我們創造股東價值並進一步加強我們與外科醫生合作的最佳途徑，並最終更好地治療患者。

So thank you all for attending today and hope to talk to you next time.

謝謝大家今天的出席，希望下次再和大家聊。

You may now disconnect your lines at this time. Thank you for your participation, and have a great day.

此時您可以斷開線路。感謝您的參與，祝您有美好的一天。