All right, welcome back, everybody. For our next panel session here, we have Nevro and senior leadership from Nevro, CEO Kevin Thornal and CFO Rod MacLeod. Welcome to both of you, and thanks for participating this year. Thanks for having us. So, a lot of questions to get into, and just as a reminder, as we've been saying all along, if anyone has a question from the audience, you can come up to the microphone and ask your question, or you can scan the QR code on the presentation screen, and I can read whatever you want to ask on your behalf. So, Kevin, it's been about a year since you took the reins. Maybe a good place to start, tell us how you see the world today versus what it looked like 12 months ago. What's going well? Where's the wood to chop? Yeah, so I'll start with what's going well. I think, you know, in the history of the company, we've done a couple of things over the last 12 months. One is we refinanced our debt thanks to a partnership at Braidwell. We kicked that out. We also did the first acquisition in the history of the company to help diversify us into other areas of pain management. We were in, obviously, neuropathic pain. Now we're in mechanical back pain with the acquisition of Vyrsa for SI joint fusion devices. We also restructured a couple of times and took out over $30 million of run rate of expense into the business without affecting our sales and marketing team, so it allows us to be able to keep going there. And we brought in about half of a new leadership team. So I feel good about we have the right team. I feel good that we made the right decisions to just do the blocking and tackling we need to do in the company. I don't think any of us would have ever predicted over a year ago that all of small and mid-cap healthcare stocks were going to get punished right now, and companies that are beating and raising and growing 28% are down 35% the next day. I mean, none of us would have predicted that, and obviously, there's a lot of discussions around what's the cyclical nature of healthcare stocks, and we're a generalist investing and things like that. So that's something I wouldn't have predicted, but, you know, what we can concentrate on is the fundamentals, which is commercial execution, diversifying our business, and ensuring that we get our path towards profitability where it needs to be. That's great. Yeah, definitely went through a lot. New leadership, M&A, restructurings, you guys have been busy for sure. Maybe let's go into each of those in a second. I want to talk first about the spinal cord stimulation SCS market. You know, what's the growth algorithm for getting the market back to 6%-9%, which I think is where you see normalized market rate as still achievable eventually? Where does Nevro sit in that 6%-9% rate when we get there, and where's the market today, and where do you stand today? Are you above, below, in line with the market? Yeah, so the only thing we really can talk about is last quarter, and now that all four of us that are public companies have announced, you know, you had Boston down 3% globally, negative 5% in the U.S. You had Medtronic that was low single digits, which I guess that's 1%, 2%. If you were 3%, you probably would say mid. And so they struggled a bit. Abbott grew double digits, and we grew 6%. So all we can say is that we did better than the majority of the market there. However, obviously, if one of the market leaders, if you take Medtronic and Boston together, it's over 50% of the market, they were flattish to down. That is, we are seeing some pressure in the SCS market. We do believe that that's going to return because patients obviously still have back pain. They're still failing fusions. They're still failing other surgical interventions, and now we have nonsurgical back pain. I think for Nevro, the thing that we have is PDN, and PDN is one of those good growth drivers for us now and well into the future. We're less than 1% penetrated. The clinical results are outstanding, and 10 kHz is making a big difference in that patient population. So I think we're still on the very early innings of that. It's tough because you're creating a market from scratch, but we do have that growth driver for the future. And then on the last earnings call, I brought up something that we haven't brought up before, which is, you know, we've never been able to enjoy sort of a replacement cycle for our batteries because, you know, it's about 10 years that batteries for rechargeables are available to sort of say that your end of life is coming. And so all of our competitors, maybe some years enjoy 20%-30% of their total revenue is for replacements. We've never had that before. So we're in the very early stages of those people that were first implanted eight and a half, nine years ago. And so we'll start to see that as a possible tailwind over the next few years in our business that we've not enjoyed. I mean, it sounds like you're at the low end of a normalized market growth level already. That was a worldwide number. Do you remind me? Oh, 6% was worldwide, correct. Yeah, so a little lower in the U.S., obviously. Yeah, there was about the same U.S. and international. It was, okay. So we're not that far off for you growing in line with the market that you're saying the market should be getting back to. I think you've always wanted to grow above the market. You're growing above the market now. So is that the way we should think of kind of where you see yourself when you think about the potential for incremental momentum from a replacement cycle and where, you know, your product innovation is going to take you and sales force, et cetera? Should we think of you growing above that level over time, or you want to grow in line with that market rate, and then you'll layer on top of that the other growth drivers that you're starting to build, like Vyrsa? Yeah, I mean, we always aspire to be better than our competition, but we also have always talked about over the last year is the recovery is going to be lumpy. So, you know, every quarter it may be up or down or what have you, but we always compare ourselves against our competition and say, how did we do? And so we liked where we ended up in the first quarter, and we'll see where we end up in the quarters moving forward. Definitely some pressure in the market when you see two of your, you know, these are good companies. I mean, Boston and Medtronic are unbelievable operators. Their businesses are doing really well. So to see them put up some pretty scary numbers, it was like, that's interesting. You know, I guess we did okay in the first quarter. I'd rather everybody do really well right now. But I think that's just, again, we've been talking about the SCS market being a little bit lumpy right now as patients still have to go through a huge care continuum before they finally get to it's time to do a spinal cord stimulation implant. And so we'll always watch the trends and what's going on. I think that, you know, there's new product launches all the time that we always work on. That's always a catalyst in the market because you get price and you also hopefully can take some share during that. So we'll be going to continue to, you know, pump out things on our R&D pipeline and, as I said all along, diversify our business and to get into other revenue streams so it's not just one particular part. So we have new indications like PDN and nonsurgical back pain. We also have new acquisitions in SI joint. And then we've also talked about our R&D pipeline. Whenever it becomes into the market, we'll also get us into new markets that we're not into today. I think that's the long-term story of Nevro is diversification within SCS and also with tangential businesses that allow us to leverage our biggest asset, which is our sales force. Maybe one more on SCS, and then I want to switch to some of those other growth areas, particularly Vyrsa. You know, there are some new innovations from competitors coming out, you know, new players getting the indications that you have now. So their SCS indication sets are a little more holistic. You also have closed-loop and, you know, Medtronic with ECAP. So I'd love to, especially on the latter, hear your views on kind of those product cycles that are hitting the market now. What are you seeing in the field, if anything? And, you know, what's the rebuttal from Nevro on closed-loop? Yeah, the easy rebuttal is we put closed-loop out of business 10 years ago when we came to the market. So closed-loop, all it is, is when you do paresthesia-based mapping, you have to worry about how close your lead is to the spinal cord. If it's too close, you zap it. If it's too far away, you lose the efficacy of the device. We don't do paresthesia at all. We don't need closed-loop. So we've never needed that. You can drive a car, you can play golf, you can do whatever you want to do with a Nevro device implanted. So we would never, it's almost like I've used this analogy before. Actually, Rod came up with this pretty good for a CFO, but he's like, it's like asking Elon Musk when he's going to put a gasoline tank in a Tesla. It's an electric car. Why would you do that? We don't need closed-loop because it wouldn't do anything because we don't do paresthesia. So we've not done paresthesia since we came out on the market 10 years ago. So we've always had a rebuttal against that. They're solving a problem that they have inherently in low-frequency. We've never had that problem. So that's the reason why we have a rebuttal. Most of our physicians, if you've put in high frequency for most of your career or you've done it for the last 10 years, you're not going to go back to paresthesia-based mapping because you have to wake up the patient. There's a lot of things that happen during that, which you never have to do with Nevro. And then as far as innovation, yeah, I mean, what you see, and it's great for the whole market, when other people got the indications, I was hopeful that our competitors would flood a ton of money into showing that this is a great device for diabetic patients that are suffering from ulcers and going down towards amputation. The reason why they're probably not is because they know that high frequency is such a difference maker in these patient groups. Because it's, again, think about people that have painful diabetic neuropathy. The reason why they're in pain is because their feet and their legs tingle. Why would you want to put someone in paresthesia and cause more tingling when you're trying to solve for that tingling? And that's where we believe we still have a big competitive advantage regardless of what people might get FDA approval for. You know, you talked about the lumpiness of the recovery of SCS, and I think the interventional pain market from a macro level is probably one of the most impacted during COVID and has been one of the slower to recover post-COVID. When do you think patients started to reengage with that channel post-COVID, and do you have a sense of what the average time for a patient once they reengage with the doctor to getting to an SCS implant is? Yeah, so I'll talk about it in two of the goods and the bads of the market. So we'll start with the bad. So don't forget, most patients that go to a pain physician is because they've tried everything else, and they're just like, I just can't sleep. I have so much pain. I need something more. A lot of those patients came through failed back surgery, right? They get a fusion. They're trying to fix the structural issues, and they realize there's still neuropathic pain. So it takes some time for those patients after COVID to go back to get their spinal surgeries, and then if the spinal surgeries don't work, they end up in the interventional pain doctor's office. And don't forget, you have to do bracing first. Then you do epidural injections. Then you might do RF nerve ablation. You might do, you know, an SI joint procedure, which is why we got into that business. And then finally, you get to SCS. That's why the delay is happening. Now, also from a positive side, say there's a lot of great markets that are growing big time in the interventional pain space. So you take, you know, one of the public companies that are in the SI joint space is growing 18%-19%. Those are the same patients that interventional pain doctors see because they're having SI joint pain. Again, why we got into the SI joint market. There's also peripheral nerve stimulation that's growing rapidly in the space. You also saw Relievant get purchased by Boston Scientific this year, which is also growing space in interventional pain. So there are other areas that are doing really, really well, and those are sort of earlier in the care continuum that those patients will also eventually need a spinal cord stimulation as well. You can solve all the mechanical issues you want. If you have neuropathic pain, you still need to treat that, and the only thing that treats that is spinal cord stimulation. Great. Maybe shifting to Vyrsa, how's the ramp progressing there kind of relative to what you originally would have anticipated when you purchased the asset? Yeah, so I think what's going well is the amount of physicians that are interested. You know, we talked last quarter, 245 physicians came to a training, which they take up, you know, usually leave a Thursday or Friday out of their practice, come to a cadaver lab on the weekends and spend their time learning. That's going really well. We had more people wanting to come to a training course than we had opportunities to do that. We're now doing those more regionally based, and so we can get closer to the physician. So really excited about that. Now, those physicians need to go back and start building this practice in their, because typically they would just refer those into a neuro or orthopedic spine surgeon, and now they need to set their practice up to be able to do those procedures there. And so that's underway right now. You have to do Value Analysis Committees to make sure you can get the implant on the approved list. There's some of those things that we're still working through. From a little bit of a surprise standpoint, which I've talked about, you know, we had to build up the manufacturing of the trays that you need to have the devices to do the procedure. That took a little bit longer than what we had thought because, you know, smaller suppliers, you have to ramp them up. And I mean, we have 400 people out in the field. If everybody had a tray, I mean, there was like 30 trays before. We wanted 400 overnight. That takes some time to be able to do that. And then you have the busy offices that want to have one of those trays actually left behind so that they have in their facility all the time. So we're continuing to ramp that up, and that's taken a little bit longer, but we feel good about sort of the, you know, the interest level from physicians wanting to learn how to do this procedure if they've never done it before. Do you see Vyrsa helping you kind of win in the SI joint market versus SI-BONE, or do you see this more as participating in this growth market and you'll expand it? And, you know, depending on how you answer that, do you see risk of training interventional pain docs and then they learn on your system and then they go with SI-BONE? So SI joints are still one of the most, it's not as bad as PDN, which we're only 1% penetrated, but every year there's millions of patients that present with SI joint problems. The only thing that's going to really solve it after you do epidural injections and all that is actually fusing the ilium and the sacrum together. That's what our device does, and that's what our competitor's device do. We believe that we are going to, you know, all boats rise with the rising tide. We believe we can be helpful with that. As far as training the physicians, there's two distinctive differences between us and our competitor on the market is really the approach. So they utilize a lateral approach, which you come in from the side and you put three screws through and fuse the ilium and the sacrum, which we use the posterior approach where you go through and you have a straight shot between the ilium and the sacrum. I have the device here in my hand. You put this, looks like an interbody cage design, and you put it in between the ilium and the sacrum, and you turn the screw and it shoots out wings that go into the ilium and the sacrum and actually creates that environment for fusion to occur, transfixation to occur. And so once you've learned on one of the approaches, you're probably more comfortable in that approach and you probably stick with it. We believe we need to get more physicians that are more educated for this type of procedure because there's a lot of patients that are dealing with this issue. We believe that all companies can do really well getting into this market right now, that are in the market right now. The lateral approach is, it's a much more cumbersome approach than this posterior approach. And to Kevin's point, we think that they'll stick with that once they've learned it. And, you know, just thinking about some of the dynamics that I think you've called out on the 1Q call and relative to the way you left your guidance unchanged despite some 1Q outperformance implies a little bit of a, not a step back, but decel from a stronger than expected 1Q. And I think some of that was attributed to, you know, Vyrsa focus and the sales organization. Can you talk to that dynamic? Am I characterizing that appropriately first and foremost? And then, you know, how should we expect, you know, going forward, you know, we're modeling Vyrsa improving sequentially each quarter. When will that stop being zero sum? Yeah, so really it was less about the sales reps not being in the field to get trained on the device than it was the physician. So we took a different approach with our first launch. So eventually we're excited about getting into SI joint because we believe once we're in the OR with that physician, we're going to start talking about if they're not using Nevro spinal cord stim, that's going to come up in a conversation. Any good rep is going to say, hey, thank you for using me for this. You see your patients are doing well. Can I get a couple of those SCS cases? Let me show you what 10 kHz does different than what you're using, right? So that will help us with hopefully helping us with SCS. Where we started those because we had so many loyal Nevro doctors that wanted to get trained for SI joint, we started there. Give them the loyalty because they've stuck with this for a really long time. So we've not really used SI joint because we had the supply challenges. So we only had X amount of procedures we can do every quarter. So we started out with our most friendly doctors that wanted to be trained. And so what we've seen there is that those doctors, when they came to those trainings, we didn't have the regional training set up yet because we needed cadaver labs. We had one in Vegas and one in Dallas that we had, you could get cadavers in. And so they took two days off of their practice to come get trained. That's a couple of trials that they miss. It's a couple of implants that they may miss to do it. So that continues into Q2 right now because we know that that's going to set up the foundation for the growth for the future in SI joint. So it will be a good positive uplift. Then now we're just now getting into, okay, we can start to train competitive SCS doctors on our device. So that's when it starts to get really fun. If you're a really good sales rep, you're like, hey doctor, I'm not trying to take your SCS business. Don't worry about that. I'm going to try to sell you something or something good for your patients that's SI joint. Just come learn that. Then you get into the OR, you're there more often, you're in the facility more often. That's how a good salesperson will say, hey, let me tell you about the benefits of 10 kHz SCS. And we haven't done that yet. That'll be toward the end of this year. Okay. So I guess, you know, we should think of, sorry if I keep oversimplifying it to zero sum and not. Yeah, yeah, that's right. You know, 2Q is still a zero-sum quarter. You embedded that in your outlook by not raising your guidance and the stronger expected 1Q. Maybe in the back half, or would you even say 4Q is when it becomes less zero-sum? Yeah, I think we're obviously not talking about future quarters here or anything like that. Whenever it becomes a material part of our business, we'll be forced to talk about it. Right now for competitive reasons, we're not talking about it. And we are in the beginning parts of this ramp. We still have manufacturing to, we're moving facilities to try to get the basis for manufacturing set up for the long term. So it'll still be a little low for the remainder of the year, but we hope that as we go into 2025, it'll be a good growth driver and we'll start talking about it a little bit more into the numbers perspective. And just as a reminder, we were really thinking about when we put our, you know, initial Q1 thoughts; we were really thinking largely about the first half of the year. We're basically holding the first half of the year right where we thought it would be. You know, you can get a little bit of swing from quarter- to- quarter. You finished Q1 a little bit hot, that some of those procedures you thought were going to come in Q2. So we're still, you know, really right on for the first half of the year. Yeah, I think just for an analogy, since I've, you know, worked at two different companies for 10 years apiece, you know, this isn't a run rate business where there's X amount of surgeries and they automatically order your cement mixer or your togas or your blades or what have you. This is every procedure is a $24,000 device. So for move between quarters, that's $100,000. You get 16 of those moving. Now you're, there's $400,000. And so you can see a lot of movement just in that last week. Oh, they did the surgery on a Wednesday. That was into the month versus the Thursday. We got it in Q1 versus Q2. It doesn't take a lot to move those between quarters right now. You probably have, especially with your experience at Stryker, you know, changed the compensation structure a bit. Do you think there's anything that would have potentially facilitated some of those quarter-end shifts based on the changes you made there? No, it's really a yearly comp plan that everybody's going after their yearly number. If you hit your yearly number, you get a big bonus on top of your commissions that you have. We wouldn't pay you differently at the last week of the quarter than the beginning of the next quarter. It's still the same flat or same commission rate based upon X% times however many dollars that procedure was. You get paid the same regardless. Got it. Oh, maybe one last one on one Q puts and takes. Was there any impact from, you know, Medtronic trialing that you were seeing with the new ECAP device? Was there anything on the competitive front that maybe gave you pause to, you know, being a little more aggressive with the first half outlook, you know? I mean, most of the physicians that we have are, you know, they're Nevro physicians and we're there with them every day. And if you've used 10 kHz before, you're probably not going to go backwards. You're probably, some doctors may try out something new, but they've had the capability to try an ECAP system for the last two years with one of the private companies that's out there. So a lot of them, if they've already tested it and tried it, I think they're going to do extremely well with their loyal base. And don't forget, like I said earlier, one thing that we don't have, which is an installed base. They have a lot of patients that are coming up on their 10-year mark probably for the rechargeable batteries that those patients were probably. Why would you get the old body style of a car if the new one's coming out next week? Let's wait for the new one to come out before you do it. So we think, and Larry Biegelsen does a good job of putting out sort of the SCS market. He has them growing over the next four quarters because they will start to go back to their installed base and implant those patients that need a new upgrade. And I probably will see another one of those that enjoyed a lot of great quarters last year go against some harder comps and probably go down a little bit. So you'll see a little bit of noise in the market with new product launches, but it's good for the market because we believe that the market can still be, you know, low- to mid-single-digits total growth in a dollar amount perspective because of those new launches that are out there. Got it. Rod, just on the profitability front, you know, two restructurings kind of back- to- back, I guess, can you talk about the rationale and differences between the two and kind of, you know, where you see the profit profile going over the 2024 time horizon and beyond? Yeah, so a couple of things. One, as Kevin mentioned, we pulled over $30 million out on an annualized basis. So we'll see the impact of that as we go forward. Two, we just really want to control move materially towards controlling our own destiny. And what that means is that, you know, we're driving the business to get to a place where we are a cash flow break even or even positive. If you just do the math on where we finished in Q1 and where we guided to on the year, that basically means that we're running for the last nine months of the year in an Adjusted EBITDA positive sort of territory. And, you know, it's just, you know, we've, you know, Kevin and I have been, you know, in these businesses that are, you know, med device businesses for a long time. And, you know, it's about getting the leverage and the financial health of the business in a different place. But also a lot of times you actually find a way when you flatten out an organization, you actually find out that you can actually move faster. And I think we're finding that definitely in different parts of the business. As Kevin mentioned, we really focused more kind of away from the commercial organization because we didn't want to impact that, but we felt like we had some areas where we could lean out the organization, get a little bit more focus and, you know, really drive the business faster. Great. I think we're right at the time mark here, but thank you both. Really appreciate you taking the time to come to the conference.[crosstalk].