SI-BONE, Inc. (SIBN) 2026 Q2 法說會逐字稿

Good afternoon, and welcome to SI BONE's Second Quarter 2026 Earnings Conference Call. (Operator Instructions) As a reminder, this call is being recorded for replay purposes. I would now like to turn the call over to Saqib Iqbal, Vice President, FP&A and Investor Relations at SI BONE. Please go ahead.

下午好，歡迎參加 SI-BONE 2026 年第二季財報電話會議。(接線員指示) 提醒各位，本次電話會議將錄音以供重播。現在我想把電話交給 SI-BONE 財務規劃與分析（FP&A）暨投資人關係副總裁 Saqib Iqbal。請開始。

Earlier today, SIBOM released financial results for the quarter ended June 30, 2026. A copy of the press release is available on the company's website. Before we begin, I'd like to remind you that management's remarks today may include forward-looking statements within the meaning of federal securities laws, which are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1,995.

今天稍早，SIBOM 公布了截至 2026 年 6 月 30 日止季度的財務結果。新聞稿副本可於公司網站取得。在開始之前，我想提醒各位，管理層今天的發言可能包含符合聯邦證券法定義的前瞻性陳述，並依據 1995 年《私人證券訴訟改革法》（Private Securities Litigation Reform Act of 1,995）的安全港條款作出。

These forward-looking statements are subject to a number of risks and uncertainties, including those set forth in our SEC filings, such as our most recent Form 10-K and actual results may differ materially from any forward-looking statements that we make today.

這些前瞻性陳述受到多項風險與不確定性影響，包括我們向 SEC 提交之文件（例如最近一期 Form 10-K）中所列者；實際結果可能與我們今天所作的任何前瞻性陳述有重大差異。

Accordingly, you should not place undue reliance on these statements. These forward-looking statements speak only as of the date that they are made. And we do not assume any obligation to update any forward-looking statements except as required by law. During the call, management may also discuss certain non-GAAP measures, including adjusted EBITDA and free cash flow.

因此，您不應過度依賴這些陳述。這些前瞻性陳述僅反映其作出當日的情況。除法律要求外，我們不承擔更新任何前瞻性陳述的義務。在本次電話會議中，管理層也可能討論若干非 GAAP 指標，包括調整後 EBITDA 與自由現金流。

Unless otherwise noted, any reference to profitability is in terms of positive adjusted EBITDA For a reconciliation of these non-GAAP measures to GAAP accounting, please see the company's full earnings release issued earlier today. unless otherwise noted, all results are compared to the comparable period in the prior year. With that, I'll turn the call over to Laura.

除非另有說明，任何對獲利能力的提及均以調整後 EBITDA 為正值為準。關於這些非 GAAP 指標與 GAAP 會計之對帳，請參閱公司今天稍早發布的完整財報新聞稿。除非另有說明，所有結果均與去年同期相比。接下來，我把電話交給 Laura。

Thanks, Saquib. Good afternoon and thank you for joining us. Our second quarter results demonstrate the strength of our core competencies and the momentum they've created in the business. We founded the company with a clear clinical objective to develop differentiated solutions that enable durable fixation and fusion in high-risk patients with compromised, often osteoporotic bone.

謝謝你，Saquib。下午好，感謝各位加入我們。我們第二季的結果展現了核心能力的強勁，以及其在業務上所帶來的動能。我們創立公司時就有明確的臨床目標：開發具差異化的解決方案，使骨質受損、且常為骨質疏鬆的高風險患者，能夠達到持久的固定與融合。

Our target patients often live with debilitating pain and diminished quality of life. Our focus has allowed us to identify large addressable markets, establish compelling technical and clinical modes, and create a diversified business with multiple avenues for growth. During the quarter, we continued to translate that strategy into new products and markets.

我們的目標患者往往長期承受使人衰弱的疼痛與生活品質下降。我們的聚焦使我們得以辨識龐大的可服務市場、建立具說服力的技術與臨床模式，並打造一個具多元成長途徑的多元化業務。本季度，我們持續將該策略轉化為新產品與新市場。

We extended the application of our biomechanical expertise and proprietary technology beyond the sacroiliac joint into high-value adjacencies across musculoskeletal care. In June, we submitted the 510 application for our third technology with breakthrough device designation. This is our first platform designed for use outside the pelvis and is intended to address a recognized failure point in complex spine procedures.

我們將生物力學專業與專有技術的應用，從薦髂關節延伸至肌肉骨骼照護領域中高價值的相鄰適應症。6 月，我們就第三項獲得突破性器械（breakthrough device）認定的技術提交了 510 申請。這是我們第一個設計用於骨盆以外部位的平台，旨在解決複雜脊椎手術中一個已被認知的失敗點。

Subject to the 510 clearance, we remain on track to begin a phased commercial launch in the fourth quarter, perhaps as early as October. Additionally, we advanced several development programs targeting new markets we expect to enter over the next 18 months and expanded U.S. field capacity in preparation for the upcoming launches. Second quarter performance was strong across markets. Worldwide and U.S.

在取得 510 核准的前提下，我們仍按計畫於第四季開始分階段商業化上市，可能最早在 10 月。此外，我們推進了數個開發計畫，鎖定我們預期在未來 18 個月內進入的新市場，並擴增美國前線團隊產能，以因應即將到來的上市。第二季在各市場的表現都很強勁。全球與美國

revenues were $56 million and $53.2 million respectively, both representing approximately 15% growth. Sequentially, U.S. procedure volume increased approximately 9%, marking our strongest second quarter sequential increase in years, dispelling industry concerns regarding the payer environment. International revenue grew approximately 26% to $2.8 million, led by continued demand for our expanded portfolio. The strong top-line growth yielded meaningful operating leverage.

營收分別為 5,600 萬美元與 5,320 萬美元，兩者皆約成長 15%。以季比季來看，美國手術量約增加 9%，創下多年來第二季最強的季增幅，消除了產業對支付方環境的疑慮。國際營收約成長 26% 至 280 萬美元，主要受惠於我們擴充後產品組合的持續需求。強勁的營收成長帶來顯著的營運槓桿。

Revenue grew nearly twice as fast as operating expenses, contributing to a 178% improvement in adjusted EBITDA. Looking ahead, we believe the business is well positioned for continued revenue growth and further profitability improvement. Our expanding portfolio, improving reimbursement, and additional commercial capacity should deepen our relevance with physicians, reduce economic barriers, and extend our reach. Together, these factors reinforce our confidence in a strong finish to 2026.

營收成長速度幾乎是營業費用的兩倍，促成調整後 EBITDA 改善 178%。展望未來，我們認為公司已具備持續營收成長與進一步提升獲利能力的良好條件。我們不斷擴大的產品組合、改善中的給付（reimbursement），以及新增的商業化產能，應可加深我們對醫師的相關性、降低經濟障礙並擴大觸及範圍。綜合而言，這些因素強化了我們對 2026 年強勁收官的信心。

We believe the impact should be even more meaningful in 2027 as our new product moves through the adoption curve, the territories added this year become more productive, and reimbursement changes support broader utilization.

我們相信在 2027 年影響將更為顯著，因為新產品將沿著採用曲線推進、今年新增的銷售區域將更具生產力，且給付變更將支持更廣泛的使用。

I'll now discuss our three key growth drivers, innovation and market development, position engagement, and commercial execution. Anshul will then cover our fourth priority, operational excellence, along with our financial performance and updated outlook.

接下來我將討論我們三項關鍵成長驅動因素：創新與市場開發、醫師互動，以及商業執行。之後 Anshul 將說明我們第四項優先事項——營運卓越——並回顧財務表現與更新後的展望。

Starting with innovation and market development, innovation is the cornerstone of our long-term growth strategy and has helped us deliver compound annual revenue growth of more than 20% per year over the past five years. We believe we have one of the industry's broadest portfolios focused on patients with compromised bones. These high-risk patients often face difficult recoveries and division rates.

先從創新與市場開發談起。創新是我們長期成長策略的基石，並協助我們在過去五年達成每年超過 20% 的營收複合年成長率。我們相信我們擁有業界最廣泛之一、聚焦於骨質受損患者的產品組合。這些高風險患者往往面臨艱難的復原過程與分裂率。

By improving procedural outcomes, our technologies have the potential to enhance patient quality of life while reducing the economic burden on the healthcare system. We have a track record of developing differentiated technologies, gaining reimbursement coverage, driving physician adoption, and growing significantly faster than the underlying market.

透過改善手術結果，我們的技術有潛力在降低醫療體系經濟負擔的同時，提升患者生活品質。我們在開發差異化技術、取得給付覆蓋、推動醫師採用，以及以顯著快於整體市場的速度成長方面，具備良好紀錄。

In SI joint dysfunction, currently our largest market, the relatively low density bone of the sacrum makes durable fixation challenging. iFuse 3D, TORQ, and Intra-Product Families provide a comprehensive portfolio of metal and allograft solutions for surgeons, as well as the fast-growing base of interventional spine physicians across all sites of service.

在薦髂關節（SI joint）功能障礙領域——目前我們最大的市場——由於薦骨骨密度相對較低，使得持久固定具有挑戰性。iFuse 3D、TORQ 與 Intra-Product 產品家族為外科醫師提供完整的金屬與同種異體移植骨（allograft）解決方案組合，也服務於在各種照護場域快速成長的介入性脊椎醫師族群。

In spinal pelvic fusion, our fastest scaling market, there's an increasing number of patients with bone compromising conditions as osteoporosis and osteopenia. With Granit, we believe we have the best-in-class solution for pelvic fixation and spine fusion procedures.

在脊椎—骨盆融合（spinal pelvic fusion）領域——我們成長最快的市場——因骨質疏鬆與骨質減少症等骨質受損狀況，患者人數持續增加。透過 Granit，我們相信我們擁有同級最佳的骨盆固定與脊椎融合手術解決方案。

Within pelvic trauma, where the majority of our target patients are being treated for low-intensity sacral insufficiency fractures, I've been iFuse TORQ TNT is gaining adoption among surgeons. Our next major catalyst for further accelerating growth is the launch of our first non-pelvic solution. As I highlighted earlier, we submitted the 510 application in June.

在骨盆創傷領域，我們多數目標患者接受的是低能量薦骨不全性骨折治療，iFuse TORQ TNT 正在外科醫師之間獲得採用。我們下一個推動進一步加速成長的重大催化劑，是推出我們第一個非骨盆解決方案。如我先前所強調，我們已於 6 月提交 510 申請。

We're working with suppliers to build surgical capacity and we're on track for the phased commercial launch. Because the solution targets accounts where our team already has established relationships, we expect to leverage our existing commercial infrastructure to support an efficient launch. We also have several programs at different stages of development targeting large, established markets where current treatment approaches leave meaningful room for improvement.

我們正與供應商合作建立手術供應能力，並按計畫推進分階段商業化上市。由於該解決方案鎖定的是我們團隊已建立關係的客戶群，我們預期可運用既有商業化基礎設施來支持高效率的上市。我們也有數個處於不同開發階段的計畫，鎖定規模大且成熟的市場；在這些市場中，現行治療方式仍有顯著的改善空間。

We expect two additional solutions to progress toward design freeze later this year, with potential commercialization targeted over the next 18 months. As we look forward, our longer-term vision extends beyond titanium and allograft solutions. We pioneered 3D printed titanium implants and helped create a new product category.

我們預期今年稍晚還有兩項額外解決方案將朝向設計凍結（design freeze）推進，並以未來 18 個月內商業化為目標。展望未來，我們的長期願景不僅限於鈦金屬與同種異體移植骨解決方案。我們率先推出 3D 列印鈦金屬植入物，並協助創造了一個新的產品類別。

We're actively exploring and testing additional materials to address new disease states and developing AI-driven procedure enablement capabilities. Collectively, these initiatives are transforming SI-Bone from a leader in sacropelvic solutions into a broader spinal pelvic company focused on procedural solutions for compromised bone.

我們正積極探索並測試其他材料，以因應新的疾病狀態，並開發以 AI 驅動的手術賦能能力。整體而言，這些計畫正將 SI-Bone 從薦骨—骨盆解決方案的領導者，轉型為更廣泛的脊椎—骨盆公司，聚焦於針對骨質受損的手術解決方案。

By organizing our innovation around the needs of these high-risk patients, we remain committed to improving procedural and long-term clinical outcomes. Before turning to physician engagement, I'd like to briefly update you on reimbursement. pleased by the reason they proposed an increase of approximately $1,000 to nearly $16,000.

透過圍繞這些高風險患者的需求來組織我們的創新，我們仍致力於改善手術與長期臨床結果。在轉到醫師互動之前，我想先簡要更新一下給付情況。對於他們提議將金額提高約 1,000 美元、至接近 16,000 美元，我們感到欣慰。

CMS has also proposed establishing OBL reimbursement of over $20,000 for CPT code 27279. If the finalized, these changes would improve the economics of treating SI joint dysfunction across all outpatient care settings, expand physician choice, and make these procedures accessible to more patients.

CMS 也提議針對 CPT 代碼 27279 設立超過 20,000 美元的 OBL 報銷。若最終定案，這些變更將改善在所有門診照護場域治療薦髂關節（SI）功能障礙的經濟性，擴大醫師選擇，並使更多病患能夠接受這些手術。

Furthermore, the new family of DRGs for complex spinal fusion procedures, including procedures incorporating granite, is encouraging. Depending on the patient's diagnosis and severity, these new DRGs could increase the average hospital payment by up to $50,000 per procedure.

此外，針對複雜脊椎融合手術（包括納入 granite 的手術）所新增的一系列 DRG 令人鼓舞。視病患的診斷與嚴重程度而定，這些新的 DRG 可能使每例手術的平均醫院給付最高增加 50,000 美元。

We believe this framework better reflects the complexity and resource requirements of treating these high-risk patients, reduces economic objections of our hospital customers, and supports the long-term adoption of granite or with granite. Now, let me discuss the progress on physician engagement. Physician adoption and utilization remain important leading indicators of future procedure growth.

我們認為此架構更能反映治療這些高風險病患的複雜性與資源需求，降低我們醫院客戶的經濟疑慮，並支持 granite 或搭配 granite 的長期採用。現在，讓我談談醫師互動的進展。醫師的採用與使用率仍是未來手術量成長的重要領先指標。

In the second quarter, 1,715 unique physicians performed at least one procedure using our technologies, an increase of approximately 19% versus the same quarter a year ago. For context, the quarterly physician count exceeded the number of unique physicians who used our technologies during full year 2023. We achieved double digit percent growth across each of our call points.

第二季共有 1,715 位不重複醫師至少使用我們的技術進行一例手術，較去年同期約增加 19%。作為參考，單季醫師數已超過 2023 全年使用我們技術的不重複醫師總數。我們在各個觸及點均達成兩位數百分比成長。

Broad-based engagement reflects the clinical relevance of our solutions, as well as the effectiveness of our physician engagement and customer engagement efforts. Our concerted efforts to grow physician awareness and adoption continue to deliver. In the quarter, the number of physicians performing more than one type of procedure increased approximately 15%.

廣泛的互動反映了我們解決方案的臨床相關性，以及我們醫師互動與客戶互動工作的成效。我們持續推動提升醫師認知與採用的整體努力，仍在帶來成果。本季，執行超過一種類型手術的醫師人數約增加 15%。

Physicians active in both the current and prior year quarters averaged approximately three times the case volume of physicians performing their first procedure with us during the quarter. In aggregate, growth in our physician base, broader use of our portfolio, and increasing utilization create a strong foundation for sustained procedure and revenue growth.

在本季與前一年同期皆有執行手術的活躍醫師，其平均病例量約為本季首次使用我們進行手術之醫師的三倍。整體而言，我們醫師基礎的成長、產品組合更廣泛的使用，以及使用率提升，為手術量與營收的持續成長奠定了堅實基礎。

As we introduce additional products that address physician-identified procedural challenges, we expect case volume per physician to become an increasingly important contributor to revenue growth and overall execution efficiency. Now let's turn to commercial execution. We ended the quarter with 93 quota-carrying territory managers who were supported by over 400 agents and junior representatives.

隨著我們推出更多產品以解決醫師所指出的手術流程挑戰，我們預期每位醫師的病例量將成為營收成長與整體執行效率日益重要的貢獻來源。接下來談商業執行。本季末我們共有 93 位具配額責任的區域經理，並由超過 400 位代理商與初階業務代表支援。

We designed the hybrid model so that our territory managers lead clinical education and cultivate high-value physician relationships, while third-party agents and junior representatives provide procedural support and extend our reach across accounts and geographies. Trailing 12 months revenue per territory was approximately $2.2 million, reflecting continued productivity gains and the scalability of our hybrid commercial model.

我們設計此混合模式，讓區域經理主導臨床教育並培養高價值的醫師關係，同時由第三方代理商與初階業務代表提供手術支援，並將我們的觸及範圍延伸至更多帳戶與地理區域。過去 12 個月每個區域的營收約為 220 萬美元，反映生產力持續提升以及我們混合商業模式的可擴展性。

We remain on track to exit 2026 with nearly 100 territories. This is a deliberate expansion ahead of multiple product launches planned for the next 18 months. Building capacity now gives our territory managers the bandwidth to strengthen physician relationships, prepare accounts for upcoming launches, and support rapid post-launch adoption.

我們仍按計畫在 2026 年底達到接近 100 個區域。這是在未來 18 個月規劃多項產品上市之前所進行的有意識擴張。現在建立產能可讓區域經理有足夠餘裕強化醫師關係、為即將上市的產品做好帳戶準備，並支援上市後的快速採用。

We also continue to progress in our commercial partnership with Smith and Nephew. Physician and field engagement is growing, and that's translating into steady improvement in adoption. We're coordinating joint field activity with Smith & Nephew's leadership team and expect momentum to build throughout the rest of 2026.

我們與 Smith & Nephew 的商業合作夥伴關係也持續推進。醫師與前線團隊的互動正在增加，並轉化為採用率的穩步提升。我們正與 Smith & Nephew 的領導團隊協調聯合前線活動，並預期動能將在 2026 年剩餘期間持續增強。

Before I turn the call over to Anshul, I'd like to thank my colleagues for their continued dedication and exemplary execution. With our upcoming product launch and an active pipeline and new solutions, we're adding to our track record of meaningful and differentiated innovation. Together, we're entering an important new phase of growth.

在我把電話會議交給 Anshul 之前，我想感謝同事們持續的投入與卓越的執行。隨著即將到來的產品上市、活躍的產品管線與新解決方案，我們正在延續具實質意義且差異化創新的紀錄。我們正共同邁入一個重要的新成長階段。

This is a direct result of your work, and I'm incredibly proud of what we're building together. Anshul will now discuss our fourth priority, operational excellence, along with additional financial details and our updated outlook.

這是你們工作的直接成果，我對我們共同打造的一切感到非常自豪。接下來 Anshul 將說明我們的第四項優先事項——營運卓越——並補充更多財務細節與我們更新後的展望。

Thanks, Laura. Good afternoon, everyone. I will focus on second quarter revenue growth, profitability, liquidity, and our updated 2026 revenue guidance. unless otherwise noted, all comparisons are with the same period last year. Starting with revenue growth, worldwide revenue was $56 million, representing 15.2% growth.

謝謝你，Laura。各位下午好。我將聚焦於第二季營收成長、獲利能力、流動性，以及我們更新後的 2026 年營收指引。除非另有說明，所有比較皆以去年同期為基準。先從營收成長談起，全球營收為 5,600 萬美元，成長 15.2%。

U.S. revenue increased 14.7% to $53.2 million. U.S. procedure volume increased nearly 15% with double-digit growth across all modalities. On a two-year stack basis, procedure volume grew nearly 20% in the quarter. International revenue increased 25.9% to $2.8 million, driven by growing demand for TORC and TNT.

美國營收成長 14.7% 至 5,320 萬美元。美國手術量成長近 15%，且各項模式均呈現兩位數成長。以兩年疊加（two-year stack）基礎計算，本季手術量成長近 20%。國際營收成長 25.9% 至 280 萬美元，主要受 TORC 與 TNT 需求增加所帶動。

Given this momentum, we are evaluating opportunities to introduce more of our portfolio and future products in existing international markets and to qualify and enter select new target geographies. We believe these initiatives can make our international business an increasingly meaningful and durable contributor to worldwide growth.

鑑於此一動能，我們正在評估在既有國際市場導入更多產品組合與未來產品的機會，並篩選、進入部分新的目標地理區域。我們相信這些舉措可使國際業務成為全球成長中日益重要且更具持久性的貢獻來源。

Turning to profitability. Gross profit increased 14.8% to $44.5 million, gross margin remained strong at 79.5%, supported by the stable average selling price, product cost optimization initiatives, and improved utilization of surgical capacity. Operating expenses increased 7.7%, a rate substantially below revenue growth. resulting in meaningful operating leverage, which was well ahead of what we had indicated at the beginning of 2026.

接著談獲利能力。毛利成長 14.8% 至 4,450 萬美元，毛利率維持強勁於 79.5%，主要受穩定的平均售價、產品成本優化措施，以及手術產能利用率提升所支撐。營業費用成長 7.7%，顯著低於營收成長，帶來有意義的營運槓桿，且明顯優於我們在 2026 年初所指出的水準。

The operating expense increase reflected ongoing investment in R&D, higher commissions associated with revenue growth, and targeted marketing investments supporting recent and upcoming product launches. Net loss narrowed to $4.1 million or $0.09 per diluted share compared to a net loss of $6.2 million or $0.14 per diluted share.

營業費用增加反映了持續投入研發、與營收成長相關的較高佣金，以及支援近期與即將上市產品的精準行銷投資。淨損收斂至 410 萬美元（每股稀釋虧損 0.09 美元），相較之下去年同期淨損為 620 萬美元（每股稀釋虧損 0.14 美元）。

Adjusted EBITDA improved 178% to $2.8 million, representing an adjusted EBITDA margin of approximately 5.1% from top-line growth and the scalability of our infrastructure. As Laura highlighted, we are developing product material and software capabilities that will broaden our product portfolio and address additional clinical needs.

調整後 EBITDA 改善 178% 至 280 萬美元，調整後 EBITDA 利潤率約 5.1%，主要來自營收成長與我們基礎設施的可擴展性。如 Laura 所強調，我們正在發展產品材料與軟體能力，以擴大產品組合並滿足更多臨床需求。

Given our outperformance on profitability in the first half, we are intentionally increasing targeted research and development investment in the back half of the year advance these longer-term programs. While remaining committed to our annual operating leverage and profitability expansion goals.

鑑於上半年獲利表現優於預期，我們將在下半年有意識地增加具針對性的研發投資，以推進這些較長期的計畫。同時仍致力於達成我們年度營運槓桿與獲利擴張目標。

We believe these programs can create differentiated capabilities in treating compromised bone, support faster revenue growth, and significantly increase long-term profit dollars turning to liquidity and cash flow. We ended the quarter with $145.9 million in cash and equivalents, an increase of approximately $1.3 million sequentially.

我們相信這些計畫可在治療骨質受損方面建立差異化能力，支持更快的營收成長，並顯著提高長期的獲利金額。接著談流動性與現金流。本季末我們持有現金及約當現金 1.459 億美元，較前一季約增加 130 萬美元。

We also delivered another quarter of positive cash flow from operations reflecting continued operating rigor and disciplined working capital management. We expect to see higher than normal cash flow variability in the next two quarters, more is mostly driven by the timing of payments for build out of a new headquarters, the vast majority of which is now expected in the third quarter, and the timing of the resulting tenant improvement allowance reimbursement.

我們也再度實現營運活動正向現金流，反映持續的營運嚴謹度與嚴格的營運資金管理。我們預期未來兩季的現金流波動將高於正常水準，主要由於新總部建置付款時點所致，其中絕大部分目前預期將在第三季發生，以及相關的租戶裝修補助（tenant improvement allowance）報銷入帳時點。

We're also investing in surgical capacity to support the new product launch. These temporary yet disciplined investments will strengthen our operating infrastructure, improve our employee experience, and position the company to scale efficiently as we enter our next phase of growth. With approximately $146 million in cash and equivalents, cash flow generation, we can fund our planned development programs while maintaining financial flexibility.

我們也正在投資手術產能以支援新產品上市。這些短期但具紀律的投資將強化我們的營運基礎設施、改善員工體驗，並在我們邁入下一階段成長時，讓公司能夠高效率地擴張。在約 1.46 億美元的現金及約當現金與現金流創造能力支持下，我們可在維持財務彈性的同時，為既定的開發計畫提供資金。

Turning to guidance. Based on strong first-half performance, we are raising the low end of our 2026 worldwide revenue guidance while maintaining the high end. We now expect revenue of $231 million to $233 million, representing approximately 15% to 16% growth. Our prior guidance was $230 million to $233 million, representing approximately 14% to 16% growth.

接著談指引。基於上半年強勁表現，我們在維持 2026 年全球營收指引上緣不變的同時，上調下緣。我們目前預期營收為 2.31 億至 2.33 億美元，約代表 15% 至 16% 的成長。先前指引為 2.30 億至 2.33 億美元，約代表 14% 至 16% 的成長。

We entered the second half with strong momentum and multiple upcoming catalysts, including the anticipated 510 clearance of the new product, as well as the potential benefit of higher reimbursement from Granite in the fourth quarter.

我們以強勁動能進入下半年，且有多項即將到來的催化因素，包括新產品預期取得 510 核准（clearance），以及第四季可能受惠於 Granite 較高的給付（reimbursement）。

Given the timing of the 510K clearance, the phased nature of the launch, and the time required for reimbursement changes to translate into procedure growth, we're maintaining a measured approach on the impact of these catalysts. We are maintaining full-year gross margin guidance at 79%. the midpoint of our revenue range, we need to increase in the 12% area. With that, I will turn the call over to Laura.

考量 510K 核准的時點、分階段上市的性質，以及給付變更轉化為手術量成長所需的時間，我們對這些催化因素的影響仍採取審慎的評估方式。我們維持全年毛利率指引為 79%。在我們營收區間的中位數下，我們需要提升到約 12% 的水準。接下來我把電話交給 Laura。

Thanks, Anshul. Our second quarter results extend our track record of outperformance across revenue and profitability. an expanding portfolio and compromised bone, increasing commercial capacity, and improving reimbursement backdrop, and a multi-year innovation pipeline. We believe we are well-positioned for durable growth and expanding profitability in 2027 and beyond.

謝謝你，Anshul。我們第二季的結果延續了我們在營收與獲利能力方面持續優於預期的紀錄。產品組合持續擴充、（涵蓋）受損骨質（compromised bone）、商業量能提升、給付環境改善，以及多年期的創新產品線。我們相信，我們已具備良好定位，可在 2027 年及之後實現持續性的成長與獲利能力擴張。

With that, we're happy to answer your questions. Operator?

那麼，我們很樂意回答各位的問題。接線員？

(Operator Instructions)

（接線員指示）

Matthew O'Brien, Piper Sandler.

Matthew O'Brien，Piper Sandler。

Oh, thanks. Good afternoon. Thanks for taking the questions. For starters, maybe Anshul, just on the guide for the year, Good to see Q2 come in a little bit above expectations, but if you do the math on the back half, It's about a $500,000 increase to the midpoint, you know, versus the million that you just put up. It also kind of implies that the back half U.S. number decelerates a little bit versus the first half.

喔，謝謝。下午好。謝謝讓我提問。先從全年指引談起，Anshul，第二季確實略高於預期，這點很好；但如果你把下半年的數字算一算，中位數只上調了大約 50 萬美元，相較於你剛剛交出的 100 萬美元（增量）。這也某種程度意味著下半年美國的數字相較上半年會稍微減速。

So, you know, is there something specific? Are you having a little bit harder time getting into these – you know, these latest tranche of clinicians in terms of your full product portfolio or is it There's something else that you really want to call out as far as the guide goes for the back half. And then I do have a follow-up.

所以，你知道，是有什麼特定原因嗎？你們在切入這些——你知道——最新一批臨床醫師、推廣你們完整產品組合時，是不是遇到比較大的難度？還是說，關於下半年指引，你還有其他特別想指出的因素？另外我還有一個追問。

Sure, happy to take that, Matt. On the guidance side, let me just stop. Well, look, we're feeling great about the setup we have going into the back half of the year. Nineteen percent growth in active physician base. That's a very solid physician base to enter the back half of the year with.

當然，很樂意回答，Matt。關於指引，我先停一下。你看，我們對進入今年下半年的布局感到非常有信心。活躍醫師基礎成長 19%。以這樣非常扎實的醫師基礎進入下半年。

The broad-based procedural demand growth that we saw, as you saw the second quarter, sequentially growth grew nine percent on a two-year CAGR 20 percent. The sequential growth was one of the strongest that we've seen in recent in history at that 9% sequentially in the second quotations as well. So that's on what's already in the business.

我們看到的手術需求成長是廣泛性的；如你在第二季所見，手術量季增 9%，以兩年 CAGR 來看約 20%。第二季 9% 的季增幅度，也是我們近年來所見最強勁的季增之一。這些都來自既有業務本身。

Then you layer on additional catalyst around the anticipated launch of the third breakthrough device and also the impact of the new DRGs that just got finalized on Friday, those are additional tailwinds in the business as well. Now, when it comes to guidance, as I said in my prepared remarks as well, We're being consistent with our thoughtful guidance philosophy.

接著再加上額外的催化因素，包括第三項突破性器材（breakthrough device）預期上市，以及上週五剛定案的新 DRG 所帶來的影響，這些也都是業務的額外順風。至於指引，如同我在事先準備的發言中提到的，我們會延續一貫審慎的指引哲學。

We know third quarter seasonality can have a little bit of noise in the business. And also, we want to make sure we're growing into these catalysts that I just outlined around the third breakthrough device and the new DRG impact on the fund. fourth quarter. So we actually feel pretty good about the setup and there could be room for upside as those catalysts play out better than anticipated.

我們知道第三季的季節性可能會讓業務出現一些雜訊。同時，我們也希望確保能夠隨著我剛才提到的催化因素——第三項突破性器材，以及新 DRG 對第四季的影響——逐步成長。因此我們其實對整體布局感覺相當不錯；若這些催化因素的發展優於預期，也可能有上行空間。

Got it. Appreciate that. And then congrats on filing for the third breakthrough device product. Would love to just hear, and I know we're not going to get much on the product itself, but just about the profitability profile of that device. Is it going to be a big drag on gross margins or operating margins for a while?.

了解。謝謝說明。另外也恭喜你們提交第三項突破性器材產品的申請。我想聽聽——我知道你們不會透露太多產品細節——但就這個器材的獲利輪廓而言。它會在一段時間內對毛利率或營業利益率造成很大的拖累嗎？

Are there big works in capital requirements or is it similar to what taking 27? Thanks so much. Yes, Matt, that's a great question. So really excited about the third breakthrough device. that we filed a 510 in June, so it was actually ahead of schedule for us.

資本需求會很大嗎？還是跟 27（產品/專案）類似？非常感謝。是的，Matt，這是個很好的問題。我們對第三項突破性器材非常興奮。我們在 6 月提交了 510（申請），所以其實比我們原先的時程還要提前。

And that sets us up really well on being able to subject to FDA clearance, commercialize this product in the fourth quarter, and as Laura said in her prepared remarks, as early as October. So feeling really good about this. Now, this device actually has some inherent advantages First, it's serving a call point where we already have established relationships.

這讓我們在取得 FDA 核准（clearance）的前提下，能在第四季將該產品商業化；正如 Laura 在事先準備的發言中所說，最早可在 10 月。所以我們對此感覺非常好。此外，這個器材本身也有一些先天優勢：第一，它服務的切入點（call point）是我們已建立關係的地方。

Granite, as you know, has been a great success with spine surgeons and it's going to go off to that same market from a call point perspective. Second, this is targeting one of the largest known unmet needs in spine fusion procedures as well. So it's a known physician challenge that we're going after.

如你所知，Granite 在脊椎外科醫師族群中非常成功，而從切入點的角度來看，這個產品也會面向同一個市場。第二，它鎖定的是脊椎融合手術中最大、最明確的未被滿足需求之一。因此這是我們要解決的一個醫師已知的臨床挑戰。

And number three, it actually fits the physician workflow, so there is no need for extensive training. What that means is once we get through the alpha launch in the fourth quarter, this product actually has potential to rapidly scale. And as you asked about the gross margin implications, we're in the process of building out the surgical capacity to be prepared for a fourth quarter launch.

第三，它符合醫師的工作流程，因此不需要大量訓練。這代表一旦我們在第四季完成 alpha 上市後，這個產品有潛力快速擴張。至於你問到毛利率的影響，我們正在建置手術產能，以便為第四季上市做好準備。

Our gross margin assumptions right now... are at 79% for the year. We were very deliberate in holding those gross margin numbers at 79% despite the outperformance in the first half. That is because we are anticipating depreciation on those assets to start out earlier on and revenue to follow subsequently.

我們目前對毛利率的假設……全年為 79%。即便上半年表現超出預期，我們仍非常審慎地把毛利率維持在 79%。這是因為我們預期這些資產的折舊會較早開始認列，而營收則會在之後才跟上。

Overall, it should actually be an efficient ramp for us because our reps already are in relationship with those docs. They are in a lot of the procedures with Granite already. So we're pretty excited about the commercial ramp as well.

整體而言，對我們來說這應該會是一個效率很高的爬坡（ramp），因為我們的業務代表本來就已經和這些醫師建立關係。他們也已經在許多使用 Granite 的手術中參與其中。所以我們對商業化爬坡也相當期待。

Caitlin Roberts, Canaccord Genuity.

Caitlin Roberts，Canaccord Genuity。

Awesome. Thanks so much for taking the questions and congrats on the quarter. I guess just maybe starting with the procedure volumes, just want to get maybe a little bit more color on what really drove the strength in the quarter and the sequential increase. Any one call point or product to call out there?.

太好了。非常感謝讓我提問，也恭喜本季表現。我想先從手術量開始，想再多了解一些本季強勁表現與季增的主要驅動因素。有沒有哪一個切入點或產品特別值得點出？

I can talk a little bit to what we're seeing on the procedure volume side. It's broad-based, actually. So, we have three different areas of procedures that we're talking about. We have our SI joint fusion procedures, our pelvic fixation procedures, and as we said in our prepared remarks, all of those areas grew in the double-digit.

我可以談一下我們在手術量方面看到的情況。其實是廣泛性的。我們談的是三個不同的手術領域。包括 SI 關節融合手術、骨盆固定手術；而且如我們在事先準備的發言中所說，這些領域都呈現雙位數成長。

And then there's three different call points that we're selling to as well. Spine surgeons, interventional spine, and then trauma surgeons, which are more being approached by distribution and Smith and Nephew. But strong growth there too. So I would say that I would say that the growth that we're actually seeing, Caitlin, is broad-based in the quarter.

另外，我們也面向三個不同的銷售切入點。脊椎外科醫師、介入性脊椎（interventional spine），以及創傷外科醫師；後者更多是透過經銷以及 Smith and Nephew 來接觸。但那邊也有強勁成長。所以我會說，我們實際看到的成長，Caitlin，是本季全面性的。

And then we're excited about where we're headed as well with the new product that Anshul just talked about quite a bit, our... that is planned to come out in the fourth quarter that we filed with the FDA already. And then one thing that hasn't been discussed yet, we actually had a very big day on Friday and it was the confirmation of the new granite DRGs and the Those DRGs specifically reference our granite technology.

接著，我們也對未來的走向感到非常振奮，尤其是 Anshul 剛才談了不少的新產品；我們的……該產品計畫在第四季推出，而且我們已經向 FDA 提交申請。另外還有一件尚未被討論的事：我們其實在週五迎來非常重要的一天，也就是新的 Granite DRGs 獲得確認，而這些 DRGs 明確提及我們的 Granite 技術。

The increase is up to $50,000 for those new DRGs, so that has all been confirmed and will go into place on October 1st. And then in addition, there was also a lot of discussion in the CMS notes about breakthrough devices. There is a grandfather clause that's been put through that does recognize those breakthrough devices and the alternative pathway to receive an NTAP.

這些新 DRGs 的增額最高可達 50,000 美元，相關內容都已確認，並將於 10 月 1 日生效。此外，CMS 的說明文件中也大量討論了突破性器材（breakthrough devices）。其中有一項「祖父條款」已被納入，確實承認這些突破性器材，以及取得 NTAP 的替代途徑。

So we believe we're going to fall into that category as well. So we have a lot of, catalysts that we're talking here that are going to drive these procedure volumes, whether it's reimbursement or new product, in addition to some new platform launches that are going to be coming out as well. So what we're doing is we're expanding our commercial footprint in order to support all of that in the coming quarters.

因此我們相信我們也會落在該類別中。所以我們在這裡談到很多催化因素，將推動這些手術量的成長，不論是給付（reimbursement）或新產品，再加上一些也即將推出的新平台上市。因此我們正在擴大商業佈局，以便在接下來幾季支援上述所有事項。

The only thing I would say, Caitlin, is Laura mentioned the huge physician base and the double-digit growth across all call points. As we launch this third breakthrough device, that's a huge asset for us and a huge competitive advantage. not just for this product, but for future products, but specifically for this product. We do feel great about the position and the ability to really accelerate the adoption for this product even better than, you know, what we've seen with Granite, for example, which was, as we've said in our prepared remarks, one of our fastest scaling products.

Caitlin，我唯一想補充的是，Laura 提到龐大的醫師基礎，以及在所有拜訪點（call points）都呈現雙位數成長。當我們推出第三項突破性器材時，這對我們是很大的資產，也是很大的競爭優勢；不僅對這個產品，對未來產品也是如此，但特別是對這個產品。我們對目前的定位與加速採用的能力感到非常有信心，甚至可能比你知道的、例如 Granite 的採用加速更好；正如我們在事先準備的發言中所說，Granite 是我們擴張速度最快的產品之一。

Awesome. And then maybe just a question on the future products. You had two you noted potentially coming in the next 18 months. Any color on those, such as if they're beyond the sacral pelvic anatomy as well, and if they're enabling tech related. I know you called out software, capabilities as a potential you know [r d] investment and um and just thoughts on m and your interest in that or is the main focus really on the internal investment.

太棒了。接著也許問一下未來產品。你提到未來 18 個月內可能會有兩項產品推出。能否多分享一些細節，例如它們是否也會超出薦骨—骨盆（sacral pelvic）解剖範圍，以及是否與賦能技術（enabling tech）相關。我知道你提到軟體能力可能是潛在的研發投資方向，嗯……也想聽聽你們對併購（M&A）與此的興趣，或主要重點其實仍是內部投資。

Yes. Good questions. And so the way that we've been expanding is thinking about compromised bone as the focus for the company. And what it's allowed us to do is we already have a very strong organic growth engine within company. Our product development capability that we have, whether it's engineering or product marketing or regulatory quality, is a very high performing organization.

是的。好問題。我們擴張的方式，是把「骨質受損（compromised bone）」作為公司的聚焦方向。這讓我們能做到的是：公司內部本來就有非常強的有機成長引擎。我們的產品開發能力，不論是工程、產品行銷，或法規與品質，都是一個表現非常出色的組織。

And then we have the support of the clinical work that we've done, very high quality clinical wor that's focused on these new devices and then the support from a reimbursement perspective. So what we're doing is we're going after those broader categories and it's basically filled our product roadmap with these new products.

此外，我們也有已完成的臨床工作作為支撐，是非常高品質、聚焦於這些新器材的臨床工作，並且也有給付面的支持。因此我們正在切入那些更廣泛的類別，基本上也讓我們的產品路線圖被這些新產品填滿。

And so as I said, we've really developed developed this core capability that's been a focus for us. that we're working with. We expect that we'll probably work with close to 3,000 surgeons just this year alone. And by launching additional products that can be used... those existing surgeons and oftentimes in the same cases it gives us the opportunity to significantly increase our surgeon density as well as our average selling price for those different procedures.

因此如我所說，我們確實已經建立起這個核心能力，並將其作為我們的重點來推進。我們預期光是今年就可能與接近 3,000 位外科醫師合作。透過推出可供……這些既有外科醫師使用、而且往往是在相同病例中使用的更多產品，我們就有機會大幅提升外科醫師密度（surgeon density），以及不同手術的平均售價（ASP）。

So you should think along those lines. We are also expanding some capabilities. We talked a little bit about AI and software capabilities. We think that's a natural extension of what we've been doing with our anatomy-specific implants. Our TNT implant is an example of that. We're also working with new technologies and new materials as well, which we think are important in some of these markets for these patients with compromised bones.

所以你可以朝這個方向來理解。我們也在擴充一些能力。我們稍早談到 AI 與軟體能力。我們認為這是我們在解剖特定植入物（anatomy-specific implants）上所做工作的自然延伸。我們的 TNT 植入物就是一個例子。我們也在研究新技術與新材料；我們認為在某些市場中，對於骨質受損的患者而言，這些都很重要。

So a lot of different organic activities that we're engaged in. As it relates to M&A, that's really not our focus area. Our focus area is really more around what are we going to do organically. to drive growth and accelerate growth. Great, thank you so much.

因此我們正在投入許多不同的有機活動。至於併購（M&A），那並不是我們的重點領域。我們的重點更在於：我們要如何透過有機方式推動成長並加速成長。很好，非常感謝。

Young Li, Jefferies.

Jefferies 的 Young Li。

All right, great. Thanks for taking our questions. I guess to start, I'm just kind of curious, you know, as you expand and increase your profitability, Can you maybe talk a little bit about some of the internal focuses that might get more attention versus others?

好的，很好。謝謝回答我們的問題。我想先問的是，當你們擴張並提升獲利能力時，能否談談一些內部的重點方向：哪些可能會比其他項目獲得更多關注？

I'm thinking things like you talk about more R&D, so the potential to launch more products or extensions, the potential for commercial expansions. I'm thinking adding more territories as well as partnerships as well as OUS expansion. So where do those rank internally?.

我想到的包括：你們提到增加研發（R&D），因此可能推出更多產品或延伸產品；也可能進行商業擴張。我也想到增加更多銷售區域、合作夥伴關係，以及海外（OUS）擴張。這些在內部的優先順序如何排列？

I think if you listen to what I just described, what we're really doing over the last few years in product development, clinical, education, and reimbursement, and so the focus is going to continue to be on driving those core competencies and using them in order to accelerate the growth of the business and get operating leverage as well.

我想如果你聽我剛才的描述，我們過去幾年真正做的是在產品開發、臨床、教育與給付方面持續投入；因此接下來的重點也會持續放在推動這些核心能力，並運用它們來加速業務成長，同時取得營運槓桿（operating leverage）。

So you should expect to continue to see us spend a significant percentage on R&D and that includes our clinical by the way. But you should also expect to see us continue to drive the Salesforce productivity upward from the $2.2 million that we talked about. And you should expect to just see us leverage a lot of those other capabilities that we've built over time.

所以你應該會看到我們持續在研發上投入相當高的比例，順帶一提也包含我們的臨床投入。但你也應該會看到我們持續把銷售團隊（Salesforce）的生產力，從我們提到的 220 萬美元再往上推升。你也會看到我們去槓桿化（leverage）許多其他我們長期建立起來的能力。

So, I would say that from a profitability perspective, we're going to continue to do what we've been. And that's continued to drive the growth on the top line but drive that down to the bottom line from a profitability perspective. And then, as we said, also have a nonpartisan line of sight to free cash flow as well.

因此我會說，從獲利能力的角度，我們會持續做我們一直在做的事。也就是持續推動營收端（top line）成長，同時從獲利角度把成長落到淨利端（bottom line）。另外，如同我們所說，我們也能以不偏不倚（nonpartisan）的視角清楚看到自由現金流（free cash flow）的路徑。

Yes. Young, just to provide a little bit more context as well, even though we added more territories in the quarter, you saw productivity improve at the territory level. So as we think about a commercial expansion, that's going to be very deliberate and targeted, and you should still continue to see productivity improve.

是的。Young，我也補充一些背景：即使我們在本季新增了更多銷售區域，你仍然看到區域層級的生產力有所提升。因此當我們思考商業擴張時，會非常審慎且具針對性，而你也應該仍會看到生產力持續改善。

Now, the initial pace of improvement may be a little bit more moderate. but the benefit of our innovation strategy is by focusing on the same call point, going after known unmet needs, the productivity ramp should be much faster once those territories have been established.

當然，初期改善的速度可能會稍微溫和一些。

So you've seen us use this playbook before, before we launched TORQ and GROW. We ran it, we did expand our sales footprint, but you saw us really quickly accelerate our productivity from what was sub $1 million to $2 million-plus in a span of three years. time around with more product launches at a more regular cadence, we feel really good about the ability to continue to drive productivity over time. So that's one aspect.

所以你以前看過我們使用這套打法，在我們推出 TORQ 和 GROW 之前就是如此。我們當時確實擴大了銷售佈局，但你也看到我們在三年內把生產力從低於 100 萬美元快速提升到 200 萬美元以上。這一次，隨著更規律節奏的更多產品上市，我們對於隨時間持續推動生產力提升的能力感到非常有信心。這是一個面向。

The other aspect, when we think about the spend on the R&D side, That spend, if you look at what we did in the current year as well, you know, we're ahead on the profitability side in the first half of the year. We actually adjusted our OPEX guidance to actually be at 12% growth versus the 12.5% growth while still having the flexibility to invest in some of these. growth-driven initiatives, that could have a meaningful impact on the business as early as late 27 into 2028.

另一個面向是，當我們思考研發端的支出時，如果你看我們在本年度的表現，你知道，我們在上半年獲利端其實超前。我們實際上把 OPEX 指引調整為 12% 的成長、而不是 12.5% 的成長，同時仍保有彈性去投資其中一些以成長為導向的計畫；這些計畫可能最早在 2027 年底到 2028 年就對業務產生有意義的影響。

So we're striking the right balance. Like Laura said, we expect profitability to continue to grow. Our midterm guidance has always been for this year around 1.2, 1.25 operating leverage, even at the midpoint of our revenue guide where I had revenue leverage would oscillate anywhere between 1.25 times to 1.75 times, and we feel very comfortable about that.

所以我們正在取得適當的平衡。如同 Laura 所說，我們預期獲利能力將持續成長。我們的中期指引一直是今年約 1.2、1.25 的營運槓桿；即使以我們營收指引的中點來看，我先前提到營收槓桿可能會在 1.25 倍到 1.75 倍之間波動，而我們對此感到非常有信心。

Okay, great. That's really helpful. And then I guess just on the third breakthrough device and then, you know, you also kind of commented on other new products launching in the next several years. How should we think about these new products expanding your TAM for surgeons as well as number of procedures? Sure.

好的，很棒。這真的很有幫助。接著我想就第三個突破性器械，以及你也提到未來幾年還會推出其他新產品來問一下。我們應該如何看待這些新產品在外科醫師端以及手術量方面擴大你們的 TAM？當然。

Yes. These new procedure types that we're talking about, they will actually expand RTAM. They are not sacroiliac joint procedures. They're not pelvic fixation procedures. So they are additive to the business. And as I said, this next breakthrough is going to be a new type of procedure.

是的。我們正在談的這些新手術類型，實際上會擴大 RTAM。它們不是薦髂關節手術。也不是骨盆固定手術。所以它們會為業務帶來增量。而且如我所說，下一個突破將會是一種新的手術類型。

through device that we're talking about that's launching later this year is one that we can lean into our existing call point, our existing procedures, and our existing distribution capability as well. So that's a good example of what we're doing. what we're planning to do in our product roadmap. So it's continuing to focus on those existing call points and identify the opportunity.

我們所談的、將於今年稍晚推出的那款突破性器械，是一個我們可以倚重既有拜訪對象（call point）、既有手術，以及既有通路能力的產品。所以這是我們在產品藍圖上正在做、也計畫要做的事情的一個很好的例子。也就是持續聚焦那些既有的拜訪對象並找出機會。

We really have a laser focus on increasing surgeon density. We have such a big asset between our sales force, hybrid focus, including third-party agents, but then also just the sheer number of physicians that we're working with right now, spine surgeons and interventionalists in particular.

我們非常聚焦於提升外科醫師密度。我們在銷售團隊與混合式布局上擁有很大的資產，包括第三方代理；此外，還有我們目前合作的龐大醫師數量，特別是脊椎外科醫師與介入治療醫師。

It gives us the ability to deliver additional products. And we're not talking about me to products these are breakthrough devices addressing unmet clinical needs and developing new markets basically and becoming the market leader in those different spaces so we're very excited about where we're going and you know as I said everything is falling into place for us from a product perspective and a reimbursement perspective as well.

這讓我們有能力導入更多產品。而且我們談的不是跟風型（me-too）產品；這些是突破性器械，旨在滿足未被滿足的臨床需求，基本上是在開發新市場，並在不同領域成為市場領導者，所以我們對未來走向感到非常興奮。

(Operator Instructions)

（接線員指示）

David Saxon, Needham & Company.

David Saxon，Needham & Company。

Great. Good afternoon, Laura and Anshul. Thanks for taking my questions and congrats on the quarter. So, looks like territories ticked up and I think in the past you've talked about getting to 100 over time. So I wanted to ask about how you're approaching hiring and actually getting to 100 in the context of this upcoming product launch and kind of the broader pipeline over the next 18 months.

太好了。Laura 和 Anshul，下午好。謝謝你們回答我的問題，也恭喜本季表現。看起來你們的區域數有所增加，我記得過去你們談過長期要達到 100 個。所以我想問，在即將到來的產品上市，以及未來 18 個月更廣泛的產品管線背景下，你們如何看待招募並實際達到 100 個的做法？

Like, are these independent workflows or are you thinking about kind of accelerating the hiring to capitalize on what you have with this breakthrough device and then these other products you're talking about.

例如，這些是彼此獨立的工作流程嗎？還是你們在思考加速招募，以把握這個突破性器械以及你們提到的其他產品所帶來的機會？

Yes. Hiring is definitely a key focus for us right now. As you know, over the last three years, we've kept our number of territory managers relatively constant. And the reason why we did that was the operating leverage that we were able to get on, she'll mention going from $1 million to over $2 million in 2020 sales rep productivity over these last few years, and that really was an area of focus for us.

是的。招募目前絕對是我們的重點之一。如你所知，過去三年我們把區域經理的人數維持得相對穩定。我們之所以這麼做，是因為我們能取得營運槓桿；她會提到，銷售代表生產力在這幾年從 2020 年的 100 萬美元提升到超過 200 萬美元，而那確實是我們的聚焦領域。

And also just leveraging that hybrid organization that we have with our more junior territory representatives covering cases, and then our third party agents as well. But we are going into a different period in the history of the company. And the new device that we're coming out with, this third breakthrough device, has been a very important area for us to build our internal capabilities and to hire additional quota-carrying territory managers.

另外，我們也運用我們的混合式組織：由較資淺的區域代表支援手術案例，以及第三方代理。但我們正進入公司歷史上的不同階段。我們即將推出的新器械，也就是第三個突破性器械，對我們而言是建立內部能力並增聘更多具業績配額（quota-carrying）的區域經理的一個非常重要的領域。

We're doing that in a couple of ways. One way is to promote some of those high-quality territory representatives that have been with the company for some period of time, split the territory, and provide them with their own book of business. also hiring people from outside of the company as well.

我們透過幾種方式來做。其中一種方式是提拔一些在公司服務一段時間、品質很高的區域代表，將區域拆分，並讓他們擁有自己的客戶組合（book of business）。同時也會從公司外部招募人才。

So things have changed. We ended the quarter with 93 territory managers. As we said, our plan is to grow that to close to 100 by the end of the year, and you're going to see some more hiring into 2027 too. And the goal is it usually takes around six months for territory manager in order to get productive and so are hiring in anticipation of these upcoming launches.

所以情況已經改變。我們在本季結束時有 93 位區域經理。如我們所說，我們的計畫是在年底前把這個數字提升到接近 100，你也會看到我們在 2027 年也會再進一步招募。目標是：區域經理通常需要大約六個月才能產生生產力，因此我們會提前招募，以因應即將到來的產品上市。

Okay. That's helpful. Thanks for that, Laura. And then on the Smith and Nephew partnership, I'd love to hear kind of the early feedback you're getting. And then in terms of, you know, procedure volumes, how are you seeing those ramp in the new centers they're getting you in?

好的。這很有幫助。謝謝你，Laura。接著關於 Smith and Nephew 的合作夥伴關係，我很想聽聽你們目前收到的早期回饋。另外就手術量而言，你們看到他們帶你們進入的新中心，量的爬升情況如何？

And then just in general, Like how long do you expect it to take to fully ramp that partnership and then, you your thoughts on how meaningful that partnership could be in terms of revenue contribution longer term, but also in 2027. Thanks so much.

更一般性地說，你們預期要多久才能讓這個合作夥伴關係完全爬升到位？以及你們對這個合作在較長期的營收貢獻、以及在 2027 年可能有多重要的看法。非常感謝。

Yes. I think this is a very important partnership that we've developed because what we really want to do is focus our existing territory managers on, ortho and neuro spine surgeons as well as interventional spine physicians as well. So Smith and Nephew, they really have the depth of relationship with orthopedic trauma surgeons. And it is a different call point.

是的。我認為這是我們建立的一個非常重要的合作夥伴關係，因為我們真正想做的是，讓現有的區域經理聚焦在骨科與神經脊椎外科醫師，以及介入脊椎醫師。Smith and Nephew 在骨科創傷外科醫師方面確實有很深的關係深度。而那是不同的拜訪對象（call point）。

Our TNT product, our toy product, the ability to address sacral insufficiency fractures with those surgeons we think is absolutely critical. In terms of the relationship with Smith and Nephew, the partnership is progressing well. The cases are underway.

我們的 TNT 產品、我們的 toy 產品，能夠協助這些外科醫師處理薦骨不全性骨折（sacral insufficiency fractures），我們認為這點至關重要。就與 Smith and Nephew 的關係而言，合作進展良好。手術案例已經在進行中。

There's a lot of physician engagement that's including both the territory manager from Smith and Nephew as well as our own territory manager and we really like the collaboration that we're seeing between our two organizations. operationally we're continuing to train their field organization and expand surgical capacity, additional trays that are given out into the field, inventory implants that are getting out into the field.

有大量的醫師互動，包含 Smith and Nephew 的區域經理以及我們自己的區域經理；我們非常喜歡看到兩個組織之間的協作。

But if you think about a normal onboarding cycle with new physicians, I had mentioned that it takes around six months for a territory manager to get up to speed. We're seeing something similar to this with the Smith and Nephew relationship. So really preparing for that seasonally strong fourth quarter is how we're thinking about it.

但如果你想想新醫師的一般導入週期，我先前提到區域經理大約需要六個月才能上手。我們在 Smith and Nephew 的合作關係上也看到類似的情況。因此，我們的思考方式是為季節性較強的第四季做好準備。

Great. Thanks so much for all that.

很好。非常感謝你們分享這些。

Richard Newitter, Truist Securities.

Richard Newitter，Truist Securities。

Hi. Thanks for taking the questions. Maybe, Anshul, just while you have all of us here, So I guess, you know, appreciate the small bump to the midpoint of the guidance range for the year. But for third quarter, within the context of your seasonality comments, it looks like the street's modeling about $55.5 million

嗨。謝謝讓我提問。也許 Anshul，趁大家都在這裡，我想問一下：我們確實看到你們把全年指引區間的中點小幅上調，這點很感謝。但就第三季而言，結合你們對季節性的評論，看起來市場（street）模型大約是 5,550 萬美元。

Is that a good place to be in the right level of seasonality and all the push-pulls that we have kind of thinking quarter to quarter? And I guess I'll have to follow up after that. But anything else you'd call out from a quarterly cadence standpoint, too, down the P&L as well?.

以季節性與我們逐季會遇到的各種拉扯因素來看，這樣的水準是否合理、是否是合適的位置？我之後還會再追問。另外，從季度節奏的角度來看，在損益表（P&L）上還有沒有其他你會特別提醒的地方？

No, Richard, so obviously, as you know, we don't guide to quarters, but historically, you've seen seasonality in the third quarter. A lot of times it's vacations. It's also conferences that may show up, although this time NASA is going on in the business is the strong physician base, the expanded sales force, the opportunity with. interventional with the intra-family of products.

不，Richard，所以很明顯，如你所知，我們不提供按季度的指引，但從歷史來看，你也看到第三季有季節性。很多時候是因為休假。也可能是會議所致；不過這次，業務面上正在進行的NASA（相關活動），以及強大的醫師基礎、擴大的銷售團隊，還有介入領域與Intra系列產品家族所帶來的機會。

And like Laura said, you know, continuing to do the work we're doing with TNT. So I think our focus is how do we work through that seasonality, but right now what's embedded is that 1% to 2% sequential decline.

而且就像Laura說的，你知道，我們會持續推進與TNT相關的工作。所以我認為我們的重點是如何度過那個季節性，但目前內含的假設是環比下滑1%到2%。

Okay. And then maybe just for follow-up, I guess as I look at the drivers that you have, it sounds like you're embedding some conservatism in answering Matt's question to the back half deceleration. It sounds like all SQL, you know, deceleration. If business trends hold, you should do better and you're not factoring in a ton of contribution from some meaningful tailwinds like the reimbursement and new product launch contribution.

好的。那接著可能再追問一下：我看你們提到的驅動因素，聽起來你們在回答Matt關於下半年放緩的問題時，納入了一些保守假設。聽起來都是SQL（順序/環比）放緩。如果業務趨勢維持，你們應該能做得更好，而且你們也沒有把像是給付（reimbursement）與新產品上市貢獻這類重要順風所帶來的大量貢獻納入。

So I guess the question here is, all else equal, is there any reason why 4Q shouldn't hold if not accelerate from – or shouldn't accelerate from 2Q levels? And then also just if you can answer, do we get concern over utilization trends out there in the recent months, especially for Spine and Ortho.

所以我想問的是：在其他條件相同下，有沒有任何理由讓第四季不應該維持、甚至不應該從第二季水準加速？另外也想請你們回應：最近幾個月外部的使用量（utilization）趨勢是否令人擔憂，特別是在脊椎（Spine）和骨科（Ortho）。

And if you've seen anything, your quarter-over-quarter unit growth wouldn't suggest that, but I'm just curious if you can just give us a sense of what you're hearing out there from your customers and if there's anything that you would flag.

如果你們有看到任何跡象——你們的季度對季度單位成長看起來並不支持那種擔憂——但我只是好奇，能否請你們分享一下從客戶那邊聽到的情況，以及是否有任何你們會特別提醒的事項。

Thank you. Yes. Again, Richard, not getting to quarterly guidance expectation setting, but you're spot on when you think about all the things that we have going on for our business, especially as we approach that October 1. There are quite a few things that could drive upside in the fourth quarter, and that gives us excitement.

謝謝。是的。再次說明，Richard，我們不會針對季度提供指引或設定預期，但你在思考我們業務正在發生的所有事情時抓得很準，尤其是當我們接近10月1日。確實有不少因素可能推動第四季上行，這也讓我們感到興奮。

But some of that is, as we said, we want to moderate our own expectations. from a guidance perspective, just given the timing of when some of those come into play. So, you know, the fostered and anticipated impact of the DRGs, our assumption is it takes some time for the reimbursement to flow through and get reflected in the procedure volume.

但其中一部分是，如我們所說，從指引角度我們希望適度調整自身預期，主要是考量其中一些因素實際發酵的時間點。所以，關於DRG的促成與預期影響，我們的假設是給付需要一些時間才能傳導，並反映在手術量上。

But in this case, it's a new DRG. It automatically maps all grant information procedures to the new DRG. There is no special coding requirement as such, which was the case in NTAP. That's number one. Number two is, you know, we're prepping for bigger than an alpha launch when we go out with this new breakthrough device product, but our assumption is the fourth quarter will be an alpha launch.

但在這個案例中，這是一個新的DRG。它會自動把所有Granite相關手術對應到新的DRG。不像NTAP那樣需要特別的編碼要求。這是第一點。第二點是，你知道，我們在推出這個全新突破性器械產品時，正在為比alpha上市更大的推廣做準備，但我們的假設是第四季會先以alpha上市為主。

As you've heard from our prepared remarks, it's not going after the same call point. It's a known disease state. It's training light. So based on how we see the alpha launch expand, we could accelerate that in the fourth quarter. That could be potential upside. And then the last thing that our guidance does assume is sort of low single digit ASP degradation.

如你從我們事先準備的發言中聽到的，它不是針對相同的拜訪對象（call point）。這是一個已知的疾病狀態。所需訓練較少。因此，基於我們對alpha上市擴展方式的判斷，我們可能在第四季加速推進。這可能帶來上行空間。最後，我們的指引也假設ASP（平均銷售價格）會有低個位數的下滑。

Part of that is just as we think about some of the things that could ramp in interventional, which uses fewer implants, or in trauma, which uses fewer implants. That's the underlying assumption. Now, you know, this new product that we want to launch is complementary to granite. It could be used in the same case as granite. So you could actually have --

其中一部分是因為，當我們思考某些可能在介入領域加速放量的項目（其使用的植入物較少），或在創傷（trauma）領域加速放量的項目（同樣使用較少植入物）時，這就是底層假設。這是我們的基本假設。不過，你知道，我們想推出的這個新產品是對Granite的互補。它可以在同一個病例中與Granite一起使用。所以你其實可能會有--

I was curious, what has been the interventionalist feedback on NTI so far since launch? And are you seeing outsized demand in those 22 incremental states or is it more broad based? Thank you very much, I have one more. Yes, thanks for the question. We are excited about InterTI. I was actually at the Aspen meeting a couple of weeks ago and what we have now the broadest portfolio in SI joint fusion..

我想了解一下：自上市以來，介入醫師（interventionalist）對NTI目前的回饋如何？另外，你們在新增的22個州看到特別強勁的需求嗎，還是需求更為廣泛分布？非常感謝，我還有一個問題。是的，謝謝你的提問。我們對InterTI感到很興奮。我其實在幾週前參加了Aspen會議，而我們現在擁有最完整的SI關節融合產品組合。

We're obviously the market leader in this space. We have historically worked with spine surgeons but seeing very rapid growth in interventional and the intra-product line is driving that. And so the goal that we have is to provide a variety of solutions that meet the needs of the patients, the surgeons, the physicians, the site of service. And so, IntraTI has a unique role to play.

我們顯然是這個領域的市場領導者。過去我們主要與脊椎外科醫師合作，但我們看到介入領域成長非常快，而Intra產品線正在推動這個成長。因此，我們的目標是提供多樣化的解決方案，以滿足病患、外科醫師、醫師以及服務場域（site of service）的需求。因此，IntraTI在其中扮演獨特的角色。

It is a 27279 product. It is a device. It is posterior. It's single use. So in theory it can be used at all sites of service and by surgeons or physicians alike. And so we're actually pretty excited about what we're seeing with intra-TI and the initial reception of it.

它是一個27279產品。它是一個器械。它是後路（posterior）。它是一次性使用。所以理論上它可以在所有服務場域使用，外科醫師或醫師都可以使用。因此，我們對於Intra-TI目前的表現以及初期市場反應其實相當振奮。

We do think that some of these reimbursement tailwinds going into 2027 are going to continue to drive adoption. option of IntraTI as a solution for 27279 and it can be inpatient, outpatient, ASC, or in office as well. So all of these things bode well for our business and where we're really seeing all of this is just the rapid adoption by interventionalists of our technologies.

我們確實認為，進入2027年的一些給付順風將會持續推動IntraTI作為27279解決方案的採用；它也可以在住院、門診、ASC（門診手術中心）或診所內使用。所以這些因素都對我們的業務很有利，而我們真正看到的，是介入醫師對我們技術的快速採用。

Thank you, Laura. And then just to expand upon the Smith and Nephew partnership, I totally appreciate that it may take up to six months to be fully up and running with the territory managers. But can you just provide some context relative to, let's say, a year ago, how many incremental level one and level two trauma centers do you now have access to where you can, you plug, torque, TNT, among other products. Thank you.

謝謝你，Laura。接著想再延伸問一下Smith & Nephew合作夥伴關係：我完全理解要到六個月才可能讓區域經理全面到位、順利運作。但你能否提供一些背景：相較於例如一年前，你們現在新增可觸及的第一級與第二級創傷中心（level one/level two trauma centers）大概有多少，讓你們可以導入Plug、Torque、TNT等產品？謝謝。

Yes, I mean, we don't usually give that specific sort of information, but there's a couple hundred level one, level two trauma centers that we're going after, specifically working with Smith and Nephew. It is an area where our sales are small, so there's a lot of opportunity for growth in that particular space.

是的，我們通常不會提供那麼具體的資訊，但我們與Smith & Nephew合作，目標鎖定的第一級、第二級創傷中心大概有數百家。這個領域我們目前的銷售規模還小，所以在那個市場空間有很大的成長機會。

And we do think that there's a really nice symbiotic relationship between us, Ann Smith, and Nephew, given the breakthrough device that we have addressing this unmet clinical need with sacral insufficiency fractures, but then their depth of relationship on the trauma side specifically.

我們也認為，我們與Smith & Nephew之間存在非常好的互補共生關係：我們有突破性器械可解決薦骨不全性骨折（sacral insufficiency fractures）這個未被滿足的臨床需求，而他們在創傷領域，特別是在關係深度方面非常強。

And ultimately, our goal is to keep our sales force focused on spine and interventional, and then leverage that capability with Smith & Nephew on the trauma side.

最終，我們的目標是讓我們的銷售團隊專注在脊椎與介入領域，並在創傷端與Smith & Nephew合作，借力其能力。

Matt Blackman, TD Cowen.

Matt Blackman，TD Cowen。

Hi, Laura and Anshul. It's Drew on for Matt tonight. Thanks for taking the questions. Just first on utilization, Laura, you kind of touched on this through your prepared remarks and some of the answers to the questions, but one of the things you said was we expect case volumes per physician to increase. become an increasing contributor to revenue growth.

嗨，Laura和Anshul。今晚我代表Matt發言，我是Drew。謝謝讓我們提問。首先關於使用量（utilization），Laura，你在事先準備的發言以及對一些問題的回答中有稍微提到；你提到的一點是，我們預期每位醫師的病例量會增加，並成為營收成長中愈來愈重要的貢獻來源。

And you know, just when I look over the last couple years, we've seen 20% active surge in growth, while utilization is really not much moved much. So maybe what can the business look like heading into 2027? I mean, how much of utilization can be driven from taking the economic arguments out of off the table, what's the limiting factors for utilization?

你知道，當我回顧過去幾年時，我們看到活躍度成長激增了20%，但使用率其實並沒有太大變化。所以，展望2027年，這項業務可能會是什麼樣子？我的意思是，在把經濟層面的論點從討論中拿掉之後，使用率有多少能被推動？限制使用率的因素是什麼？

Just maybe just talk a little bit more about what you're seeing and why investors should have confidence that utilization growth can really kind of finally start. Yes, I think it's a great question. And Drew, quite frankly, I think it's what I'm most excited about for the business going forward.

也許再多談一點你所看到的情況，以及為什麼投資人應該有信心，使用率成長真的可以算是終於開始起來。是的，我認為這是個很好的問題。而且Drew，坦白說，這也是我對未來業務最感到興奮的部分。

We have done an extraordinary of first of all building a first class sales organization. We've invested a lot in it and developing this hybrid organization where we're working with third party agents and junior reps. It's given us this bare terms of volume. And this quarter is no exception.

首先，我們在打造一個一流的銷售組織方面做了非常卓越的工作。我們在這方面投入很多，並發展出這種混合式組織：同時與第三方代理商以及初階業務代表合作。這在量的層面上帶給我們優勢。而本季也不例外。

An increase of 19% in the number of physicians that did at least one case in the second quarter. It's 1,715 cases in the second quarter. physicians that did at least one procedure with us. That number rivals most of the largest players in this market. And so, you know, where we can really grab operating leverage is by increasing this utilization number.

第二季至少做過一例手術的醫師人數增加了19%。第二季共有1,715例手術，這些醫師至少與我們進行過一次手術。這個數字可與該市場中多數最大型的業者相匹敵。因此，你知道，我們真正能取得營運槓桿的地方，就是提高這個使用率數字。

And I do think that the product launches that we're talking about here are particularly important. And I'm not talking about 18 months from now, I'm talking about the next product launch that we are going to as early as October start to see sales of that particular product. Those are procedures that the same surgeon base that we've been growing for all of these years.

而且我確實認為，我們在這裡談到的產品上市特別重要。我不是在說18個月之後，我說的是下一個產品上市——我們最早在10月就會開始看到該產品的銷售。這些手術是由我們多年來持續擴大的同一批外科醫師群來執行。

Those surgeons are very excited about using this particular product. And as I said, in some cases they're going to be using it in independent procedures. In other cases they're going to be using it with our existing granite products. as well. So it really represents a very specific opportunity for us to truly leverage utilization and increase our surge in density.

這些外科醫師對於使用這項特定產品非常興奮。而如我所說，在某些情況下，他們會在獨立的手術中使用它。在其他情況下，他們也會把它與我們現有的granite產品一起使用。因此，這確實代表我們在真正放大使用率、提升我們的密度成長激增方面，有一個非常明確的機會。

Thanks, Laura. And just a question to you, and I'm sure you're going to love this one. I was kind of given some of Laura's comments right there. You were just talking too about really your R&D spending. You're going to have more reps into 2027.

謝謝你，Laura。我也想問你一個問題，我相信你會喜歡這題。我算是延續你剛才的一些評論。你剛剛也談到你們的研發支出。你們到2027年會有更多業務代表。

As we do think about 2027's leverage capabilities, should we be thinking about the lower end of the range that you gave at 1.2? Or is there enough positives, tailwinds that you could actually see maybe something better than that in leverage for next year. Thanks for taking the questions.

當我們思考2027年的槓桿能力時，我們是否應該以你給的區間下緣1.2來看？或者是否有足夠多的正面因素、順風，使得你們明年在槓桿上其實可能會比那更好？謝謝你回答問題。

Yeah. Drew You're right. I won't be responding to that question yet because I'm not providing guidance. But, you know, the way the business is set up, a lot of that leverage and the spend that you're seeing happen this year will be reflected in what we can see in the long-term growth rate of the business.

是的。Drew，你說得對。我現在還不會回應那個問題，因為我不提供指引。不過，就這個業務的架構而言，你今年看到的許多槓桿與支出，將會反映在我們對公司長期成長率的展望上。

A lot of the things that you've heard us talk about today, those are not one-time catalysts, those are multi-year catalysts, whether it's the new products like TNT and Intra-TI continuing to grain traction, whether it's a better reimbursement for granite with the new DRGs, the potential for higher SI joint reimbursements at ASCs and outpatient as well as the potential for OBL for 7-9.

今天你聽到我們談到的很多事情，都不是一次性的催化劑，而是多年的催化劑：不論是像TNT和Intra-TI這些新產品持續獲得市場動能，或是透過新的DRGs讓granite獲得更好的給付，還有在ASC與門診端SI關節給付提高的可能性，以及7-9在OBL端的潛力。

Then you've got the potential for NTAP that we plan to apply for the third breakthrough device that if approved, and we have a pretty good track record of that going effective October 1, 2027. So you've actually got a lot of potential. got a lot of revenue tailwinds in the business. And that gives us confidence that the operating leverage will continue to improve in the outer years.

此外，我們也計畫為第三個突破性醫材申請NTAP；若獲核准——而我們在這方面的成功紀錄相當不錯——將於2027年10月1日生效。所以你其實有很多潛在因素，有很多營收順風在這個業務中。這也讓我們有信心，營運槓桿在更長期的年度中會持續改善。

Now, timing of whether it's 1.3 times next year or is it 1.5 times next year, will be dependent on where we are in the investment cycle for a product, but we're feeling very grow, more dollars coming to the bottom line.

至於明年是1.3倍還是1.5倍的時點，將取決於我們在某項產品的投資週期所處的位置，但我們對於成長感到非常有信心，也就是會有更多美元落到最終盈餘。

And we just talked about the cash flow inflection as well, Laura did earlier in the Q&A. That's huge for us. If you look at the last four, five quarters, four of the last five quarters, we worked positive cash flow from operations. at our cash balance has actually grown year over year since Q2 of last year, and that's after making investment in the surgical capacity.

我們也談到了現金流的拐點，Laura在先前的問答中也提到。這對我們非常重要。如果你看過去四、五個季度，在最近五個季度中有四個季度，我們的營運現金流為正；而且自去年第二季以來，我們的現金餘額年增，這還是在我們對手術產能進行投資之後。

So we're not just thinking about the stronger top line. We're thinking about the stronger top line, the continued operating leverage, maintaining the asset-light business so we can get more profit dollars to the bottom line, start moving from adjust the EBITDA to more GAAP profitability, but also then start inflecting on a sustained basis on free cash flow.

所以我們不只是思考更強的營收成長。我們也在思考更強的營收成長、持續的營運槓桿、維持輕資產的商業模式，讓更多利潤美元落到最終盈餘，開始從調整後EBITDA走向更多GAAP獲利能力，同時也開始在自由現金流上進入可持續的拐點。

Okay. And I'm showing no further questions. I would now like to turn the conference back to Laura for closing remarks.

好的。我這邊顯示沒有進一步的問題。現在我想把電話會議交回給Laura作結語。

I'd just like to say thank you to everybody. I appreciate you participating in our call, as well as your interest in SI Bone. And we look forward to seeing you all at upcoming conferences and non-deal roadshows. Goodbye.

我只想對大家說聲謝謝。感謝各位參與我們的電話會議，也感謝各位對SI Bone的關注。我們期待在接下來的各項會議以及非交易路演中與各位見面。再見。

And this concludes today's conference call. Thank you for participating. You may now disconnect.

今天的電話會議到此結束。感謝各位參與。您現在可以掛線。