Top-line Revenue Growth
Total Q1 revenue of $192M, up 14% year over year; surgical revenue $178M, up 17% year over year.
Strong Procedural and Surgeon Adoption
Cases increased 21% year over year and new surgeon users grew 23% year over year, indicating durable adoption and volume-led growth.
Adjusted EBITDA and Profitability Expansion
Adjusted EBITDA of $21M in Q1 (11% of revenue), up 97% year over year; company reports ~45% drop-through on incremental revenue and trailing twelve-month EBITDA now >$100M.
Gross Margin and Operating Leverage
Gross margin 71.6%, improved by over 120 basis points year over year; operating expenses grew ~6% year over year, below revenue growth, demonstrating operating leverage.
Procedure-Level ASP Strength
Core procedural ASPs showed strength: lateral +2% YoY, ALIF +4% YoY, cervical +8% YoY.
Cash Position and Cash Flow
Ending cash approximately $140M; positive operating cash flow for the fourth consecutive quarter; free cash used ~$11M in Q1 (within expected range) and full-year free cash flow guidance of at least $20M.
Strategic Financing Improvement
Closed new Term Loan A and revolving credit facility that extends maturities to 2031, reduces interest expense by >$6M annually and is estimated to save up to ~$35M in interest over the facility life (rate SOFR + 275 bps).
EOS Platform Traction and Installed Base Growth
Installed base of global EOS units increased 7% YoY; EOS Edge installed base grew 39% YoY; EOS Insight accounts more than doubled and EOS Insight adoption shows meaningful implant pull-through and ~30% revenue lift per surgeon after adoption.