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• Imagine a company like Medtronic or Stryker, but entirely dedicated to innovating devices and solutions for spine surgery.
• They are the Zimmer Biomet of spine surgery, with a strong focus on advanced procedural technology and improving patient outcomes.

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• Spinal Implants: A comprehensive portfolio of screws, rods, plates, and interbody devices designed to stabilize the spine and facilitate fusion during various spinal surgeries.
• Access Systems: Specialized instruments and retractors developed to provide efficient and minimally disruptive surgical access to the spine.
• Biologics: Bone graft substitutes and other biologic materials intended to enhance bone growth and fusion in spinal surgical procedures.
• Image-Guided Navigation & Robotics: Advanced technologies, including navigation systems and robotic platforms, that assist surgeons with precision and visualization during spinal surgery.

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Alphatec (ATEC) sells primarily to other companies within the healthcare sector.

Its major customers are the healthcare providers that perform spinal surgeries and purchase the necessary medical devices and technologies. These include:

• Hospitals: This category encompasses a wide range of facilities, including large academic medical centers, community hospitals, and specialized surgical hospitals. These institutions are the primary venues where spinal fusion procedures are performed, making them direct purchasers of Alphatec's spinal implants, surgical access systems, and related instruments.
• Ambulatory Surgical Centers (ASCs): With an ongoing shift of certain spine procedures to outpatient settings, ASCs have become increasingly significant customers. These facilities specialize in same-day surgeries and require the same high-quality devices as traditional hospitals.
• Integrated Delivery Networks (IDNs) and Healthcare Systems: These are organizations that own and operate multiple hospitals, clinics, and other healthcare facilities across a region or country. IDNs often centralize their purchasing decisions, negotiating contracts and product selections with medical device manufacturers like Alphatec to standardize care and achieve cost efficiencies across their network.

Alphatec primarily reaches these customers through a combination of a direct sales force and independent distributors, who build relationships with surgeons and hospital administration. Due to the diversified nature of its customer base across numerous healthcare providers globally, Alphatec does not typically disclose specific individual hospitals or healthcare systems as major customers, nor do these entities commonly represent publicly traded companies whose stock symbols would be relevant in this supplier-customer context.

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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 possesses over 20 years of experience in the orthopedic industry. Prior to joining Alphatec, Mr. Miles was Vice Chairman of NuVasive from September 2016 to September 2017, where he was responsible for driving strategic plans for the future of spine surgery. He also served as a member of NuVasive's Board of Directors from August 2016 to September 2017, and as President and Chief Operating Officer from February 2015 to September 2016. His previous roles at NuVasive included President of Global Products and Services, President of the Americas, Executive Vice President of Product Marketing and Development, and various other marketing leadership positions from 2001 to 2015. Before NuVasive, Mr. Miles was Director of Marketing for Oratec Interventions, Inc., and Director of Marketing for minimally invasive systems and cervical spine systems for Medtronic Sofamor Danek. He also held several positions with Smith & Nephew. Mr. Miles holds a B.S. in Finance from Mercer University. He is on the Board of Advisors for InnovaHealth Partners, a private equity firm.

Todd Koning, Executive Vice President and Chief Financial Officer

Todd Koning has served as Executive Vice President and Chief Financial Officer of Alphatec since April 2021. He brings over 20 years of focused medical device finance, accounting, and international experience. Before Alphatec, Mr. Koning spent three years with Masimo Corporation, most recently as Senior Vice President of Finance and Chief Accounting Officer. In that role, he was responsible for corporate planning and analysis, global accounting, SEC reporting, financial systems, and investor outreach. Prior to Masimo, Mr. Koning served as Vice President of Finance at NuVasive, Inc. He also held the position of Vice President of Finance at Ellipse Technologies, Inc., which was acquired by NuVasive in 2016. His career also includes various domestic and international finance and accounting leadership roles at Boston Scientific Corporation and Guidant Corporation. Mr. Koning holds an M.B.A. from Purdue University and a B.S. in Engineering from Michigan State University.

Scott Lish, Chief Operating Officer

Scott Lish has served as Chief Operating Officer of Alphatec 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 joining NuVasive (sic, should be Alphatec), Mr. Lish worked for two years as a Manufacturing Engineer for Zimmer Dental. He holds an M.S. degree in Material Science and a B.E. degree in Mechanical Engineering from the Thayer School of Engineering at Dartmouth, as well as a B.A. degree in Engineering Sciences from Dartmouth College.

Craig Hunsaker, Executive Vice President, People & Culture

Craig Hunsaker has served as Executive Vice President, People & Culture at Alphatec since September 2016. In this role, he is responsible for 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. Mr. Hunsaker's professional career includes 16 years practicing law at large technology-focused law firms, advising and defending companies and management on people and trade secrets decisions, while holding various leadership positions. He left full-time legal practice in 2009 to join NuVasive, Inc., where he served as Vice President, Legal Affairs, and then as Senior Vice President, Global Human Resources from late 2009 through March 2014. From April 2014 until joining Alphatec, Mr. Hunsaker owned a consulting business, assisting employers in employment law and human resources, including as Senior Advisor, Human Resources at General Atomics. He received his J.D. from Columbia University School of Law and his B.S. in International Business & Finance from Brigham Young University.

Dave Sponsel, Executive Vice President, Sales

Dave Sponsel has served as Executive Vice President, Sales at Alphatec since April 2019. Mr. Sponsel began his career at Alphatec Spine as Area Vice President, Sales, South in May 2018. Prior to joining Alphatec, he held the position of General Manager, Spine Division for Medacta, USA, where he was responsible for sales, marketing, product management, and product development. Before that, he had an 11-year experience in sales and sales leadership with Stryker Spine, where he was recognized as Sales Director of the Year in 2014. Mr. Sponsel received a B.S. from Indiana State University in Business Management.

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The key risks to Alphatec's (ATEC) business are primarily financial instability, regulatory hurdles for new products, and vulnerabilities within its supply chain.

1. Financial Risks: Alphatec faces significant financial challenges, including critical debt levels, negative equity, and ongoing cash burn. The company has a history of losses, which raises concerns about its ability to achieve sustained profitability. There is a continuous need for additional funding through debt raises, which can lead to further dilution for shareholders. The company's stock price has shown volatility in response to financial results and concerns about its debt load and financing options.
2. Regulatory Risks: As a medical technology company, Alphatec's growth and market position are highly dependent on successfully obtaining regulatory approvals for its products, particularly new innovations like its robotic system. Delays or failures in securing FDA or other necessary regulatory clearances could significantly impede product launches and market penetration, thereby limiting growth.
3. Supply Chain Vulnerabilities: Alphatec is exposed to risks related to its supply chain, including potential disruptions from geopolitical factors like tariffs and trade wars. The company's reliance on a key sole-supplier, such as Invibio in the UK for biocompostable plastic, exacerbates this risk. Such disruptions could lead to increased costs of sales and operational inefficiencies.

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1. Continued Surgeon Adoption and Increased Procedural Volumes: Alphatec has consistently demonstrated strong surgeon adoption and utilization of its spinal surgery solutions. The company reported a 26% increase in net new surgeon users in Q3 2025 and procedural volume growth of 28%, reflecting expanding clinical traction. This ongoing surgeon engagement is expected to drive durable revenue growth as more surgeons integrate ATEC's technologies into their practices and increase their case volumes.
2. Expansion of Procedural Solutions, particularly PTP and LTP: Alphatec's differentiated procedural approaches, specifically the Prone Transpsoas (PTP) and Lateral Transpsoas (LTP) spine surgery systems, are significant contributors to sales and market share gains. These minimally invasive techniques, designed to improve surgical outcomes and streamline procedures, continue to gain momentum. The recent launch of the PTP Corpectomy System further expands Alphatec's capabilities for more complex spine cases, deepening surgeon engagement and contributing to procedure volume growth.
3. New Product Launches, including a Robotic System: Alphatec is actively expanding its product portfolio. The company has introduced new products such as expandable and corpectomy implants, which are anticipated to contribute significantly to sales growth. A major catalyst on the horizon is the planned launch of a robotic system in 2026. This system is designed to integrate seamlessly into ATEC's surgical ecosystem, combining neurophysiological data, AI-driven navigation, and automation to standardize complex spine procedures, thereby enhancing accuracy and expanding market reach.
4. Growth of the AlphaInformatiX Platform and Integrated Technologies: The AlphaInformatiX platform, which integrates various advanced technologies like EOS imaging, SafeOp Surgical, and AI-driven analytics (e.g., EOS Insight), is crucial for enhancing surgical decision-making and improving predictability. This integrated approach is generating distinction-driven demand and is expected to sustain Alphatec's competitive edge. The EOS revenue segment, in particular, has shown strong growth, increasing by 29% in Q3 2025.
5. International Market Expansion: Alphatec has begun to expand its global footprint, notably by performing its first surgeries in Japan, which is recognized as the world's second-largest spine market. This strategic entry into new international markets presents a substantial opportunity for future revenue growth by tapping into a broader patient and surgeon base.

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Share Repurchases

• Alphatec did not report significant common stock share repurchases in the last 3-5 years; instead, share outstanding increased by 5.63% in one year.
• In March 2025, Alphatec used approximately $268.4 million of net proceeds from a convertible notes offering to repurchase $253.0 million aggregate principal amount of its outstanding 0.75% convertible senior notes due 2026.

Share Issuance

• In October 2023, Alphatec completed a public offering of 14,300,000 shares of common stock at $10.50 per share, raising gross proceeds of $150,150,000.
• In March 2025, Alphatec priced an offering of $350,000,000 aggregate principal amount of 0.75% convertible senior notes due 2030, with an option for initial purchasers to buy an additional $55,000,000. The net proceeds from this offering were approximately $339.0 million (or approximately $392.4 million if the option was fully exercised).
• In December 2020, as part of a strategic financing for the EOS imaging acquisition, Alphatec raised $138 million in a private placement of common stock at $11.11 per share.

Inbound Investments

• In December 2020, Alphatec secured $138 million through a private placement of common stock as part of a strategic financing, with the investment led by Squadron Capital LLC and supported by Perceptive Advisors, Avidity Partners, and First Light Asset Management.

Outbound Investments

• In 2021, Alphatec acquired EOS imaging for approximately $88 million in equity value plus debt, with a total purchase price of $116.9 million including debt retirement, to integrate advanced diagnostics into its AlphaInformatiX platform.
• In April 2023, Alphatec acquired the REMI robotic navigation system from Fusion Robotics for $55 million, expecting it to contribute to revenue in 2025.

Capital Expenditures

• Alphatec's capital expenditures were -$83.22 million in 2024, -$80.51 million in 2023, -$49.45 million in 2022, -$68.54 million in 2021, and -$23.10 million in 2020.
• The company has focused on foundational infrastructure investments between 2021 and 2023.
• Capital expenditures are geared towards strategic growth initiatives supporting sales expansion and new product development.