Slides
Page 1
ATEC SPINE: DELIVERING DIFFERENTIATED GROWTH PAT MILES, CHAIRMAN & CEO J.P.MORGAN HEALTHCARE CONFERENCE | JANUARY 13, 2026
Page 2
FORWARD -LOOKING STATEMENTS This presentation contains "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995 that involve risks and uncertainty. Such statements are based on management's current expectations and are subject to a number of risks and uncertainties that could cause actual results to differ materially from those described in the forward-looking statements. The Company cautions investors that there can be no assurance that actual results will not differ materially from those projected or suggested in such forward-looking statements as a result of various factors. Forward-looking statements include, but are not limited to: references to the Company’s revenue, balance sheet, growth, adjusted EBITDA, profitability, free cash flow, financial outlook and commitments; planned product launches, timelines, introductions, regulatory submissions or clearances; expansion of international markets; increases in U.S. market share and procedural volume, the ability to drive surgeon adoption, gain hospital access and create clinical distinction; the development and monetization of informatics platforms; the ability to transform the sales channel; and the Company’s ability to finance its operations and sufficiency of its cash runway. Important factors that could cause actual operating results to differ significantly from those expressed or implied by such forward-looking statements include, but are not limited to: the uncertainty of success in developing and commercializing new products or products currently in the pipeline; the uncertainties in the Company’s ability to execute upon its strategic operating and long-range plan; the uncertainties regarding the ability to successfully license or acquire new products, and the commercial success of such products; failure to achieve acceptance of the Company’s products by the surgeon community; failure to obtain FDA or other regulatory clearance or approval or unexpected or prolonged delays in the process; continuation of favorable third-party reimbursement; unanticipated expenses or liabilities or other adverse events affecting cash flow or the Company’s ability to achieve profitability; uncertainty of additional funding; product liability exposure; an unsuccessful outcome in any litigation; patent infringement claims; claims related to the Company’s intellectual property; competitive pressures and market dynamics; and the Company’s ability to meet its financial obligations and achieve expected financial outcomes. A further list and description of these and other factors, risks and uncertainties can be found in the Company's most recent annual report, and any subsequent quarterly and current reports, filed with the U.S. Securities and Exchange Commission. ATEC disclaims any intention or obligation to update or revise any forward-looking statements, whether as a result of new information, future events, or otherwise, unless required by law. 2
Page 3
TODAY’S AGENDA STRONG TRACK RECORD OF EXECUTION DEEP BENCH OF GROWTH CATALYSTS FOUNDATION DESIGNED FOR A LONG RUN AUDIENCE Q&A PAT MILES , CHAIRMAN & CEO PAT MILES , CHAIRMAN & CEO TODD KONING , CFO 3
Page 4
STRONG TRACK RECORD OF EXECUTION DEEP BENCH OF GROWTH CATALYSTS FOUNDATION DESIGNED FOR A LONG RUN 4
Page 5
ATEC IS UNIQUELY POSITIONED 100% SPINE FOCUS COMPELLING SURGEON ADOPTION THROUGH CLINICAL DISTINCTION LEADING & ADVANCING LATERAL EARNING SHARE, DRIVING ADOPTION WITH VALENCE DEFORMITY LEADERSHIP & EOS INSIGHT® PROCEDURAL GROWTH ENGINE, POISED FOR A PTP - LIKE RUN INFRASTRUCTURE BUILT FOR LONG RUN FOUNDATIONAL INVESTMENTS ENABLE SCALE AND LONGEVITY DURABLE & PROFITABLE SALES GROWTH PROFITABLE AND CASH FLOWING 5
Page 6
$764M For full year TOTAL REVENUE | 1. Management estimate | 2. Based on the midpoint of the preliminary full-year 2025 revenue range | 3. See full-year guidance provided in the Company’s Q3 2025 press release; guidance reaffirmed Total revenue growth 25% GROWTH LEADERSHIP 12% of revenue; improving 700 bps YoY $91M ADJUSTED EBITDA PROFITABLE, REVENUE - GROWTH LEADERSHIP 2025 FINANCIAL HIGHLIGHTS POSITIVE Full year FREE CASH FLOW 6 2 2 3 3
Page 7
Revenue $482M $1B Adjusted EBITDA ($9M) $180M Adjusted EBITDA Margin (2%) 18% Free Cash Flow ($159M) $65M 20% REVENUE CAGR 2,000 BPS MARGIN EXPANSION CASH FLOW BREAKEVEN 2025 Sector-leading revenue growth with upside potential 36% drop through on incremental sales | See guidance provided in the Company’s long-range plan presentation from March 2024 2023 7 2027 OUR LRP COMMITMENTS IN 2024 UNIQUE VALUE CREATION: RAPID TOP - LINE GROWTH + STRONG LEVERAGE
Page 8
Revenue $482M $764M 1 $1B Adjusted EBITDA ($9M) $91M 2 $180M Adjusted EBITDA Margin (2%) 12% 2 18% Free Cash Flow ($159M) POSITIVE 2 $65M 2025 2023 8 2027 DELIVERING ON COMMITMENTS DRIVING SECTOR - LEADING, PROFITABLE GROWTH 20% REVENUE CAGR 2,000 BPS MARGIN EXPANSION CASH FLOW BREAKEVEN 2025 Sector-leading revenue growth with upside potential 36% drop through on incremental sales | 1. Based on the midpoint of the preliminary full-year 2025 revenue range | 2. See full-year guidance provided in the Company’s Q3 2025 press release; guidance reaffirmed | See guidance provided in the Company’s long-range plan presentation from March 2024
Page 9
2026 FINANCIAL OUTLOOK COMMITTED TO CONTINUING INDUSTRY - LEADING PROFITABLE GROWTH & INN OVATION Total revenue; 17% growth $890M GROWTH LEADERSHIP $130M POWERFUL LEVERAGE Adjusted EBITDA; 15% margin 9 $20M FREE CASH FLOW Investing in growth and generating cash
Page 10
OUR STRATEGY IS STEADFAST OUR EXECUTION IS RELENTLESS COMPEL SURGEON ADOPTION CREATE CLINICAL DISTINCTION 2 1 EXPAND, ELEVATE & ENABLE SALES FORCE3 EXECUTING OUR VISION WITH PRECISION AND MOMENTUM — FULFILLING COMMITMENTS Architect unparalleled procedural solutions that improve patient outcomes Earn loyalty through differentiated technology, training, and clinical value Build a high-performing, aligned sales force designed to scale and win 10
Page 11
COMPELLING SURGEON ADOPTION SURGEON UTILIZATION AVG CASES/ SURGEON DURABLE SURGEON UTILIZATION GROWTH 11 2018 2019 2020 2021 2022 2023 2024 2025
Page 12
STRONG TRACK RECORD OF EXECUTION DEEP BENCH OF GROWTH CATALYSTS FOUNDATION DESIGNED FOR A LONG RUN 12
Page 13
ADULT DEFORMITY SURGERY 3% >5% TOTAL KNEE TOTAL HIP REPLACEMENT5 years 10 years 10 - 15% 1 to 3 years DEGENERATIVE SURGERY 25 - 30% 2 to 5 years % OF SURGERIES THAT REQUIRE REVISION 1 HISTORICAL INDUSTRY INVESTMENT THESIS FOCUSED ON FLAWED CURRENCY 2000 TODAY SURGICAL TREATMENT DECISION FACTORS THE SPINE MARKET NEEDS ATEC | 1. References on file13
Page 14
100% Spine focus KNOW - HOW Unmatched expertise PROCEDURALIZATION Assembling technologies that improve entire spine procedures—not widgets CLINICAL DISTINCTION Driving surgeon adoption with the most compelling portfolio INFORMATICS ATEC IS DIFFERENT Integrating data to improve clinical decision-making across the entire continuum of care 14 THE REQUIREMENT IS TRANSFORMATION — NOT JUST OPTIMIZATION
Page 15
PROVEN SUCCESS & LEADERSHIP IN LATERAL Proceduralization and expanding indications of PTP and LTP address more complex pathologies EOS ® , SAFEOP ® & VALENCE Informatics and technology ecosystem enables variable mitigation to improve outcomes EVOLVING TO THE NEXT CHAPTER Procedural approach in an informatics-rich environment—data will inform the procedure UNRIVALED LEADERSHIP IN LATERAL ADVANCING OUR PROVEN LATERAL FOUNDATION IN A DATA - DRIVEN ENVIRON MENT 15
Page 16
SEAMLESSLY INTEGRATED & ARCHITECTED EXCLUSIVELY FOR SPINE: PTP C ATALYST PROCEDURALLY INTEGRATED Purpose-built for spine, seamlessly integrated into procedural workflows OPTIMIZED O.R. FOOTPRINT All-in-one system with an in-field camera that empowers surgeon control and resolves traditional line- of-sight issues ACCESS & ADOPTION — DEMOCRATIZED Delivers navigation and robotics to more sites of care while lowering the barrier to PTP adoption, maximizing surgeon utility VALENCE: SIMPLE. INTEGRATED. ACCESSIBLE. 16
Page 17
SCALING SAFEOP THROUGH EXPANDED CLINICAL APPLICATIONS FROM LATERAL LEADERSHIP TO BROADER CLINICAL UTILITY, AUTOMATED A CROSS ALL PROCEDURES 17 ADVANCED SSEPs FOR NERVE HEALTH increasing signal fidelity to deliver automated, actionable information in more complex procedures FACILITATED MEPs extending SafeOp’s role beyond lateral into higher complexity deformity and cervical spine procedures NEURAL & BONY NAVIGATION SafeOp integrated with Valence creating a surgeon-centric, end-to-end procedural workflow competitors can’t replicate
Page 18
CERVICAL: ELEVATING SOPHISTICATION PROCEDURAL APPROACH INFORMING CERVICAL PORTFOLIO EXPANSION EXPANDED CERVICAL PORTFOLIO opening doors for access and adoption ADVANCING PROCEDURALIZATION to enhance safety and patient outcomes across cervical SAFEOP ® MEPs/SSEPs empowering surgeons with real-time data for informed decision-making 18
Page 19
MORE THAN JUST THE MOST COVETED IMAGING A PROPRIETARY FOUNDATION FOR INFORMATICS EOS: THE INVESTMENT GIVING US THE STRATEGIC ADVANTAGE IN SPINE 19 ACQUIRED UNIQUE, COVETED TECHNOLOGY ▪ Full-body, standardized end-to-end imaging ▪ Standing, functional global alignment ▪ No stitching or magnification errors ▪ Less radiation: 5x< traditional DR ▪ Reduced exam time ▪ Inform spine surgery throughout continuum of care ▪ Harness objective standardized imaging to create spine’s first AI / ML- driven predictive analytics VISION 2021
Page 20
TRANSFORMING IMAGING INTO INFORMATICS —ACTIONABLE INSIGHTS PRE-OP POST-OP FOLLOW-UP AUTOMATED ALIGNMENT LR 2024 3D RECONSTRUCTION AND NORMATIVE VALUES 20
Page 21
INFORMATICS POWERING PATIENT -SPECIFIC SPINE CARE SURGICAL PLANNING AND PATIENT - SPECIFIC IMPLANTS 510(k) CLEARED BONE MINERAL DENSITY X 2025 CUSTOM ROD 21
Page 22
ACCELERATING DEFORMITY INFLUENCE THROUGH EOS INTEGRATION END - TO - END ECOSYSTEM POSITIONS ATEC TO BECOME THE PROCEDURAL LEA DER IN DEFORMITY 22
Page 23
ADVANCING PEDIATRIC DEFORMITY ELEMENTS OF FULL DEFORMITY SOLUTION ARE CONVERGING TO ENABLE ANO THER PTP - LIKE RUN PEDIATRIC POSITIONING CURVE CORRECTION MEASURED USING INTRAOP ALIGNMENT MOST - COVETED IMAGING AUTOMATED ALIGNMENT 3D SURGICAL PLANNING WITH AXIAL ROTATION BEST - IN - CLASS FIXATION NEUROMONITORING 23
Page 24
PROCEDURALIZATION : THE ENGINE BEHIND ATEC’S GROWTH DIFFERENTIATION THROUGH DEEP PROCEDURAL INVESTMENT (WHERE OTHERS IN SPINE WON’T) ACCESS BIOLOGICS FIXATION IMPLANTS INFORMATIX POSITIONERS CUSTOM RODS NAVIGATION 24
Page 25
VAST UNTAPPED OPPORTUNITY IN U.S. SIGNIFICANTLY UNDERPENETRATED WITH ENORMOUS UPSIDE <10% Share of U.S. market* | *Management estimates25 >30% Share in well-covered territories* SAME STORE SALES CONTINUE TO DRIVE OVERALL GROWTH FASTEST - GROWING SEGMENTS: LATERAL & DEFORMITY 26% Revenue growth in established territories U . S . T L I F & P L I F (conventional techniques that can be treated with PTP)$2B U . S . L A T E R A L M A R K E T$1B ~20% S H A R E ~$10B U . S . S P I N E M A R K E T
Page 26
AUSTRALIA/ NEW ZEALAND JAPAN Market Size* $250M $450M Office & Warehouse ✓ ✓ Direct Sales Org ✓ ✓ 2025 Revenue ~$10M <$5M PTP Surgeries >1,000 2026 Launch Deliberate international investments: AUS/NZ ➢ >1,000 PTPs performed ➢ EOS Insight launched Q4 2025 JAPAN ➢ 400 LTPs in 2025 ➢ Launch of PTP expected in 2026 | *Management estimates FOUNDATION FOR INTERNATIONAL GROWTH—MAJOR RUNWAY AHEAD FOCUSED ON MARKETS WITH STRONG SURGEON INFLUENCE AND ATTRACTIVE ECONOMICS 26
Page 27
STRONG TRACK RECORD OF EXECUTION DEEP BENCH OF GROWTH CATALYSTS FOUNDATION DESIGNED FOR A LONG RUN 27
Page 28
ADVANCING SPINE THROUGH PROPRIETARY DATA-DRIVEN PROCEDURAL ECOSYSTEM INTEGRATED TECHNOLOGY STACK — INFORMED DECISION - MAKING TO ELEVATE SPINE CARE INSIGHT PORTAL AI/ML MODELS PRE-OP Standardized Global Imaging 3D Surgical Planning & Simulation Automated Diagnostic Assessments AI ALIGNMENT 3D SURGICAL PLANNING BONE QUALITY EOS IMAGING POST-OP INTRA-OP Patient Specific Implants Navigated/Robot Assisted HW Placement Real-time Neurophysiology Monitoring Intra-Op Alignment Reconciliation CUSTOM RODS NAVIGATION & ROBOTICS MOBILE CLOUD CONNECTION PLAN RECONCILIATION AUTOMATED NERVE MONITORING Consistent Post-Op Imaging & Alignment Patient Trends & Outcomes Practice Analytics & Clinical Research EOS IMAGING AI ALIGNMENT PATIENT ANALYTICS 28 Synthetic CT from MRI SYNTHETIC CT
Page 29
($50) $0 $50 $100 $150 $200 FOUNDATION FOR SCALABLE GROWTH FOUNDATIONAL INVESTMENTS 2018 - 2020 INFRASTRUCTURE BUILD 2021 - 2023 PROFITABLE SALES GROWTH 2 0 2 4 O n w a r d • Lever infrastructure investments • Integrate data and informatic platform into surgical experience • Expand and elevate procedural approaches • Algorithm-based growth model • Focal growth of key international markets | 1. Trajectory to 2027 based on LRP commitments 29 • Furthered informatic ecosystem foundation via EOS® and Valence acquisitions • State-of-the-art HQ deliberately designed to maximize sales & surgeon training • Expanded distribution footprint—Memphis • Scalable internal systems • International investments L R • Spine expertise and know-how • Portfolio overhauled to create clinical distinction • Informatic foundation: SafeOp® • Strategic distribution transition E S T . A D J U S T E D E B I T D A $ 1
Page 30
2026 FINANCIAL OUTLOOK COMMITTED TO CONTINUING INDUSTRY - LEADING PROFITABLE GROWTH & INN OVATION Total revenue; 17% growth $890M GROWTH LEADERSHIP $130M POWERFUL LEVERAGE Adjusted EBITDA; 15% margin 30 $20M FREE CASH FLOW Investing in growth and generating cash
Page 31
ATEC IS THE PREFERRED DESTINATION IN SPINE. 100% SPINE FOCUS COMPELLING SURGEON ADOPTION THROUGH CLINICAL DISTINCTION LEADING & ADVANCING LATERAL EARNING SHARE, DRIVING ADOPTION WITH VALENCE DEFORMITY LEADERSHIP & EOS INSIGHT® PROCEDURAL GROWTH ENGINE, POISED FOR A PTP - LIKE RUN INFRASTRUCTURE BUILT FOR LONG RUN FOUNDATIONAL INVESTMENTS ENABLE SCALE AND LONGEVITY DURABLE & PROFITABLE SALES GROWTH PROFITABLE AND CASH FLOWING 31
Page 32
Q&A PAT MILES , CHAIRMAN & CEO TODD KONING , CFO 32