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Q3 2026 FINANCIAL RESULTS PAT MILES, CHAIRMAN & CEO | TODD KONING , EVP & CFO | OCTOBER 29, 2026
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FORWARD -LOOKING STATEMENTS This presentation and the accompanying conference call contain "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995 that involve risks and uncertainties. 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, and financial outlook and commitments; planned product launches, timelines, introductions, regulatory submissions or clearances; and the Company's ability to compel surgeon adoption, drive procedural growth, improve biologics performance, and gain market share. 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 new products or products currently in the pipeline; the uncertainties in the Company's ability to execute upon its strategic operating 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; the Company's inability to improve biologics performance and product mix; competitive pressures and market dynamics; 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 and the form of such funding; product liability exposure; an unsuccessful outcome in any litigation; patent infringement claims; claims related to the Company's intellectual property; and the Company's ability to meet its financial obligations. 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
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INDUSTRY- LEADING PROFITABLE GROWTH Q3 2026 HIGHLIGHTS 3 14% 20% $38M Surgical Revenue Growth Case Volume Growth Adjusted EBITDA $6M$20M EOS Revenue Free Cash Generated 25% Net-New Surgeon Growth | Reference non-GAAP reconciliation in appendix $221M Total Revenue
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Q3 REVENUE PERFORMANCE Q3 2026 YOY$ YOY% Surgical Revenue $202M $25M 14% EOS Revenue $20M - (1%) TOTAL REVENUE $221M $25M 13% $25M Surgical Revenue YoY $ Growth STRONG REVENUE GROWTH DRIVEN BY SURGICAL VOLUME | May not foot due to rounding | Reference non-GAAP reconciliation in appendix4 • 25% growth in surgeon users • 20% surgical volume growth, driven by strong adoption of our procedural approach • Revenue per case declined 5%, primarily reflecting lower biologics attachment and, to a lesser extent, softer market-related procedure mix
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Q3 2026 NON- GAAP P&L HIGHLIGHTS Q3 2026 YOY TOTAL REVENUE $221M 13% MEANINGFUL OPERATING LEVERAGE DESPITE SOFTER TOPLINE • Gross margin improvements driven by inventory efficiency, cost improvements, and product mix • Operating expenses grew 8%, well below revenue growth • Adj. EBITDA grew 46% YoY; drop-through of 49% YoY Gross Margin % 71.9% 180 bps R&D % 6.9% (90 bps) SG&A % 55.2% (160 bps) Total Operating Expense % 62.0% (260 bps) OP PROFIT MARGIN % 9.8% 430 bps | May not foot due to rounding | Reference non-GAAP reconciliation in appendix5 0% 5% 10% 15% 20% 25% 30% 35% 40% $0 $5 $10 $15 $20 $25 $30 $35 $40 Q3 24 Q4 24 Q1 25 Q2 25 Q3 25 Q4 25 Q1 26 Q2 26 Q3 26 AEBITDA $M AEBITDA % ADJUSTED EBITDA $ $38M 46% % of Sales 17.3% 400 bps
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Q3 BALANCE SHEET STRONG CASH GENERATION SUPPORTS CONTINUED INVESTMENT AND FINANCI AL FLEXIBILITY BALANCE SHEET Q3 2026 Cash $80M Available Borrowing1 $55M CASH + AVAILABLE CASH $135M | 1 The Company had $55M of undrawn credit available on its revolving line of credit at period end | 2 GAAP cash provided by operating activities less cash used on inventory | 3 Free cash flow defined as cash generated by operating activities less PP&E | May not foot due to rounding 6 Fifth consecutive quarter of positive trailing 12-month free cash flow Simplified capital structure by repaying 2026 convertible notes CASH FLOW Q3 2026 Operating Cash Flow2 $34M Inventory and PP&E ($29M) FREE CASH FLOW3 $6M 2030 Convertible Notes $405M 2031 Term Loan A & Revolver $244M GROSS DEBT $649M
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2026 REVENUE OUTLOOK $862M STRONG SURGICAL DEMAND DRIVES 15% GROWTH FY’26E YOY Surgical Revenue $789M 15% EOS Revenue $73M (5%) TOTAL REVENUE $862M 13% Total Revenue SURGICAL DRIVERS: • High-teens Case Volume Growth • LSD Rev per Case Decline +$102M YoY Surgical Revenue 7
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2026 FINANCIAL OUTLOOK MAINTAINING STRONG ADJUSTED EBITDA DESPITE LOWER REVENUE OUTLOOK EXPANDING PROFITABILITY + CASH GENERATION WHILE CONTINUING TO IN VEST FOR GROWTH Total revenue; 13% growth $862M $137M Adjusted EBITDA; 16% margin | 47% growth $10M FREE CASH FLOW Investing in growth and generating cash DOUBLE -DIGIT GROWTH SIGNIFICANT LEVERAGE 8
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OUR STRATEGY REMAINS STEADFAST COMPEL SURGEON ADOPTION CREATE CLINICAL DISTINCTION 2 1 EXPAND, ELEVATE & ENABLE SALES FORCE3 DELIVERING ON THE FUNDAMENTALS OF OUR LONG - TERM GROWTH ALGORITHM Architect unparalleled procedural solutions that improve patient outcomes Earn loyalty through differentiated training, technology, and clinical value Build a high-performing, aligned sales force designed to scale and win 99
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ACDF PCF POSTERIOR FIXATION PLIF TLIF ALIF LTP PTP CLINICAL DISTINCTION EARNS TRUST AND COMPOUNDS ADOPTION CONFIDENCE IN ONE PROCEDURE EXPANDS INTO MORE OF THE SURGEON’S P RACTICE 1010
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EOS CREATES STRATEGIC ACCESS, INFLUENCING THE NEXT GENERATION OF SPINE SURGEONS MARKET SHARE ACROSS ACADEMIC INSTITUTIONS >70% 1111
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EOS INSIGHT TURNS DATA INTO ADVANTAGE TRANSFORMING A GROWING DATASET INTO ACTIONABLE CLINICAL INTELLIG ENCE 1212
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BECOMING INDISPENSABLE IN THE O.R. INTEGRATING INTELLIGENCE INTO THE PROCEDURE AT A FRACTION OF THE PHYSICAL FOOTPRINT 1313
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2026 FINANCIAL OUTLOOK MAINTAINING STRONG ADJUSTED EBITDA DESPITE LOWER REVENUE OUTLOOK EXPANDING PROFITABILITY + CASH GENERATION WHILE CONTINUING TO IN VEST FOR GROWTH Total revenue; 13% growth $862M $137M Adjusted EBITDA; 16% margin | 47% growth 14 $10M FREE CASH FLOW Investing in growth and generating cash DOUBLE -DIGIT GROWTH SIGNIFICANT LEVERAGE 14
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THE PREFERRED DESTINATION IN SPINE.
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APPENDIX 16