Medtronic for spine technologies.

Zimmer Biomet for spinal implants.

• SafeOp Neural InformatiX System: A platform designed to reduce the risk of intraoperative nerve injury during spinal surgery.
• Sigma Access Systems: Pedicle-based access and patient positioning systems providing direct visualization of anatomical landmarks for lumbar interbody fusion.
• Squadron Lateral Retractor: A surgical retractor designed to maximize patient outcomes during lateral spinal approaches.
• Invictus Spinal Fixation Systems: Thoracolumbar fixation systems, including minimally invasive (MIS) and modular options, for a range of spinal pathologies.
• OsseoScrew System: A specialized screw system developed to restore the integrity of the spinal column.
• Arsenal Spinal Fixation System: A comprehensive thoracolumbar fixation platform addressing various degenerative to deformity spinal pathologies.
• Aspida Anterior Lumbar Plating System: A fixation system for anterior lumbar interbody fusion procedures.
• AMP Anti-Migration Plate: A plate designed to prevent implant migration.
• OCT Spinal Fixation System: A system for posterior occipital-cervical-thoracic spinal fixation.
• Trestle Luxe Anterior Cervical Plate System: A fixation system for anterior cervical interbody fusion.
• Insignia Anterior Cervical Plate System: Another type of fixation system for anterior cervical fusion.
• Interbody Implants: Various types of implants such as IdentiTi Porous Ti, Transcend Lateral, and Battalion Posterior Interbody Implants used in spinal fusion.
• Biologics: Products like Cervical Structural Allograft Spacers, 3D ProFuse Demineralized Bone Scaffold, and Amnioshield Amniotic Tissue Barrier used to support spinal fusion and healing.
• EOS Imaging Products: Imaging solutions for spinal assessment and planning.

Alphatec (ATEC) is a medical technology company that designs, develops, and advances technologies for the surgical treatment of spinal disorders. The company sells its products primarily to other companies and institutions within the healthcare sector.

Based on the provided company description, no specific names of customer companies are identified. However, the description states that Alphatec sells its products through a network of independent distributors and direct sales representatives. Therefore, its major customers can be categorized as:

• Independent Distributors: These are companies that purchase Alphatec's products for resale to various healthcare providers.
• Hospitals and Surgical Centers: These healthcare facilities are the ultimate end-users of Alphatec's spinal disorder technologies, acquiring them for use by surgeons during medical procedures. Sales to these institutions can occur either through the aforementioned independent distributors or directly via Alphatec's direct sales representatives.

As no specific names or public symbols for these customer companies are provided in the background information, they cannot be listed individually.

• EOS imaging

Patrick S. Miles, Chairman and Chief Executive Officer

Patrick S. Miles has served as Chairman and Chief Executive Officer of Alphatec Holdings and Alphatec Spine since October 2017. He has over 20 years of experience in the orthopaedic industry, having previously served as Vice Chairman of NuVasive from September 2016 to September 2017 and as NuVasive's President and Chief Operating Officer from February 2015 to September 2016. Under his leadership, Alphatec sold its international operations to Globus Medical for $80 million in 2017, allowing the company to sharpen its focus exclusively on the U.S. spine market.

J. Todd Koning, Executive Vice President & Chief Financial Officer

Todd Koning has served as Executive Vice President and Chief Financial Officer since April 2021, bringing over 20 years of focused medical device finance, accounting, and international experience. Before joining Alphatec, he was Senior Vice President of Finance and Chief Accounting Officer at Masimo Corporation for three years. Prior to that, he served as Vice President of Finance at NuVasive, Inc.

Scott Lish, Chief Operating Officer

Scott Lish has served as Chief Operating Officer since January 2024. He began his career at Alphatec in October 2017 as Vice President, Research and Development, and was promoted to Senior Vice President, Research and Development in October 2020. Before Alphatec, Mr. Lish worked as a Manufacturing Engineer for Zimmer Dental.

Craig E. Hunsaker, Executive Vice President, People & Culture

Craig Hunsaker has served as Executive Vice President, People & Culture since September 2016, overseeing all aspects of employee recruitment, development, engagement, and corporate culture. He also served as the company's General Counsel & Corporate Secretary from March 2017 to July 2023 and has 16 years of experience practicing law.

Joseph Walland, Senior Vice President, Imaging Solutions

Joseph Walland has served as Senior Vice President, Imaging Solutions since January 2022, having previously held the position of Vice President, Sales Channel Development since December 2020. Prior to joining Alphatec, Mr. Walland held the position of U.S. Chief Executive Officer at Medicrea, a spinal technology company, where he led the sale of that company to Medtronic in November 2020. For thirteen years before Medicrea, he held various sales and marketing leadership positions at Stryker Spine from 2004 to 2017.

• Path to Sustainable Profitability and High Debt Load: Despite robust revenue growth, Alphatec continues to report significant GAAP (Generally Accepted Accounting Principles) net losses, indicating that its core business is not yet consistently covering all expenses and financing costs. The company carries a substantial debt load and has a high debt-to-equity ratio, reflecting its aggressive growth strategy. This reliance on borrowing, coupled with negative tangible book value for shareholders and the need for additional capital raises, presents a critical financial risk.
• Intense Competition and Market Pressure: Alphatec operates in a highly competitive medical device market segment, facing numerous larger, well-established companies with greater resources, broader product portfolios, and more entrenched relationships. This competitive environment can lead to pricing pressures, a potential loss of market share, and necessitates continuous innovation and product differentiation to maintain its position. The competition also extends to attracting and retaining skilled independent sales agents, on whom Alphatec relies for product distribution.
• Regulatory and Supply Chain Risks: As a medical technology company, Alphatec is subject to extensive regulatory requirements from the FDA and international bodies. Non-compliance with these regulations can result in severe penalties, product recalls, market withdrawals, and significant damage to the company's reputation and financial stability. Additionally, the company faces supply chain risks due to its reliance on a limited number of third-party suppliers for key raw materials, including a single source for critical components like PEEK. Disruptions in the supply chain, potentially caused by global economic and political conditions or public health crises, could materially impact manufacturing and operational continuity.

• Spinal Implants and Surgical Devices Market: The global spinal implants and surgical devices market was valued at USD 12.21 billion in 2024 and is projected to reach USD 16.57 billion by 2032, growing at a Compound Annual Growth Rate (CAGR) of 4.3% from 2026 to 2032. North America dominates this market. The U.S. spinal implant and vertebral compression fracture (VCF) market was valued at $6.4 billion in 2023 and is expected to increase to $7.1 billion with a CAGR of 1.5%.
• Spinal Fixation Systems Market: The global spinal fixation systems market size was estimated at USD 13.75 billion in 2024 and is projected to reach USD 26.50 billion by 2032, growing at a CAGR of 8.1% from 2025 to 2032. North America is expected to be the fastest-growing region, capturing a market share of 38.5%, with the United States dominating the global market with a 25.2% share. The metal spinal fixation systems market, a component of this, was valued at USD 21.4 billion in 2024 and is projected to surpass $40 billion by 2033 with a CAGR of 5.9% through 2033.
• Interbody Spine Implants Market (Interbody Fusion Cages): The global interbody spine implants market size was valued at USD 1.99 billion in 2024 and is projected to reach USD 2.54 billion by 2033, with a CAGR of 2.51% during the forecast period (2025-2033). Another estimate places the market at USD 2.56 billion in 2024, projected to grow to USD 3.24 billion by 2030 at a CAGR of 3.10%. North America is the most significant global shareholder in this market, and held the dominant share in 2023. The global implant lumbar interbody fusion cage market size was estimated at USD 2514.5 million in 2024, with North America holding over 40% of the global revenue (USD 1005.80 million). The U.S. market for implant lumbar interbody fusion cages was valued at USD 793.58 million in 2024.
• Spine Biologics Market: The global spine biologics market size was estimated at USD 3.25 billion in 2024 and is projected to grow at a CAGR of 4.9% from 2025 to 2030. Other estimates include USD 3.65 billion in 2025, growing to USD 6.50 billion by 2034 with a CAGR of 6.65%, and USD 4.42 billion in 2024, expanding to USD 7.34 billion by 2034 with a CAGR of 5.20%. North America dominated the global market with a revenue share of 48.2% in 2024. The U.S. spine biologics market captured the largest revenue share of 80% in 2024 within North America.

1. Continued Surgeon Adoption and Increased Utilization of Procedural Solutions

2. Launch and Adoption of New Enabling Technologies and Products

3. Expansion of Procedural Offerings, particularly in Lateral and Deformity Segments

4. Introduction of Next-Generation Biologics

Share Issuance

• Alphatec announced inducement awards granted to 16 new employees in 2025, totaling 67,643 restricted stock units (RSUs) that will vest over four years.

Outbound Investments

• In January 2026, Alphatec announced the acquisition of exclusive U.S. distribution rights for Theradaptive's OsteoAdapt®, a next-generation rhBMP-2 solution in Phase II clinical trials for spinal fusion. This acquisition is expected to enhance the company's procedural offerings and address market concentration challenges.

Capital Expenditures

• In Q3 2025, the company had a cash outflow of approximately $13.89 million in investing cash flow, reflecting strategic investment in surgical instrument sets and property, plant, and equipment (PP&E) to support revenue growth.
• Alphatec achieved positive free cash flow of $3 million for the full year 2025 and anticipates generating at least $20 million of free cash flow in 2026.
• Required investments in working capital and higher capital expenditures are expected to limit cash generation in 2026.