REMI Robotic Navigation System to advance ATEC's procedural strategy by integrating navigation and robotics into spine workflow
First quarter 2023 total revenue expected to grow more than 52% to over $108 million
Full-year total revenue guidance raised to $450 million
Reaffirms break-even adjusted EBITDA in 2023 and break-even free cash flow in 2025
Webcast today at 2:00pm PT/ 5:00pm ET

Alphatec Holdings, Inc. (NASDAQ:ATEC), a provider of innovative solutions dedicated to revolutionizing the approach to spine surgery, announced today that it has acquired all assets related to the REMI Robotic Navigation System from Fusion Robotics, LLC, a privately held medical technology company, for a purchase price of $55 million.

The REMI (Robotic-Enabled Minimally Invasive) System is an intra-operative platform developed by spine experts with deep navigation and robotics know-how that integrates navigation and robotics into spine procedures utilizing either a 3D imaging scan or 2D fluoroscopic images of the patient. REMI's small, table-mounted navigation system guides instrumentation and implants to a precise destination during surgery. The incorporation of REMI into ATEC's procedural strategy will improve surgical predictability, reduce radiation exposure and enhance intra-operative precision.

"ATEC's intention is to further clinical distinction by integrating actionable information into spine's procedural workflow," remarked Pat Miles, Chairman and Chief Executive Officer. "With our SafeOp and EOS systems, we have demonstrated prowess in identifying informational technologies and know-how that can integrate information into spine surgery's procedural workflow. We are excited to add the Fusion Robotics platform's navigation and robotic precision capabilities to ATEC's intra-operative informational ecosystem and advance our commitment to control clinical variables in the operating room."

"We founded Fusion Robotics with the vision of applying years of experience and extensive know-how in image-guided surgery to designing and developing a more efficient, integrated navigation and robotics solution for spine," added Kevin Foley, M.D., co-founder of Fusion Robotics, LLC. "We are thrilled that the Fusion team will be able to apply its prowess to accelerating the evolution of the REMI platform as part of ATEC's innovation machine."

Preliminary, Unaudited First Quarter 2023 Financial Update

ATEC's preliminary total revenue grew over 52% year-over-year in the first quarter. Continued strong momentum fueled preliminary surgical revenue growth of over 53%, led by surgical volume growth of at least 39% compared to the prior year period.

	First Quarter Ended March 31, 2023
Surgical revenue	$93.2M to $94.3M
EOS revenue	$14.8M to $15.2M
Total revenue	$108.0M to $109.5M

The select, preliminary financial results announced today are based on the Company's current expectations and may be adjusted as a result of, among other things, completion of customary quarter-end close review procedures and further financial review.

Financial Outlook for the Full-Year 2023

The Company now anticipates full-year 2023 total revenue of $450 million, reflecting growth of approximately 28% year-over-year. This includes surgical revenue of approximately $393 million and approximately $57 million of EOS revenue. The Company continues to expect to achieve non-GAAP adjusted EBITDA break-even for the full-year 2023.

	Previous Full-Year 2023 Guidance	Updated Full-Year 2023 Guidance
Surgical revenue	$383M	$393M
EOS revenue	$55M	$57M
Total revenue	$438M	$450M

Further detail will be provided when the Company reports first quarter 2023 financial results on Thursday, May 4, 2023, after the market close.

Webcast

The Company will host a live webcast today at 2:00 p.m. PT / 5:00 p.m. ET. To access the live webcast, please visit the Investor Relations Section of ATEC's Corporate Website. To dial into the live webcast, please register at this link. Access details will be shared via email.

A replay of the webcast will remain available through the Investor Relations Section of ATEC's Corporate Website for twelve months. In addition, a dial-in replay will be available beginning two hours after the webcast's completion through April 26, 2023 . Access the replay by dialing (800) 770-2030 and referencing conference ID number 78538.

Inducement Awards Granted

As an inducement material to accepting employment with the Company, and in accordance with Nasdaq Listing Rule 5635(c)(4), ATEC today announced that the independent Compensation Committee of the Board of Directors has approved aggregate grants to eighteen new employees (who are not executive officers) of, collectively, 22,741 restricted stock units ("RSUs") under the Company's 2016 Employment Inducement Award Plan. The RSUs will vest in equal annual installments on each of the first four anniversaries of the grant date, provided that the recipient remains continuously employed by ATEC as of such vesting date. In addition, the RSUs will vest fully upon a change of control of ATEC.

About ATEC

ATEC, through its wholly owned subsidiaries, Alphatec Spine, Inc., EOS imaging S.A. and SafeOp Surgical, Inc., is a medical device company dedicated to revolutionizing the approach to spine surgery through clinical distinction. ATEC's Organic Innovation Machine™ is focused on developing new approaches that integrate seamlessly with the Company's expanding AlphaInformatiX Platform to better inform surgery and more safely and reproducibly achieve the goals of spine surgery. ATEC's vision is to be the Standard Bearer in Spine. For more information, visit us at www.atecspine.com.

About Fusion Robotics

Fusion Robotics, LLC is a privately held medical device manufacturer headquartered in Boulder, CO. It is focused on the research, development and commercialization of robotics technologies for spinal surgical applications. The company's mission is to provide pragmatic and economical navigation and robotics solutions for broad clinical use in spine surgery. Fusion Robotics is a subsidiary of Accelus Inc.

Forward Looking Statements

This press release 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. The words "may," "might," "will," "could," "would," "should," "expect," "plan," "anticipate," "intend," "believe," "expect," "estimate," "seek," "predict," "future," "project," "potential," "continue," "target" and similar words or expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. Forward-looking statements include, but are not limited to: the potential benefits and synergies of the announced acquisition, including the expected impact on future financial and operating results, post-acquisition plans, and intentions, strategy and procedural integration; the Company's expectations with respect to future revenue, growth and financial outlook; planned commercial launches, introductions, integration, regulatory submissions or clearances; the Company's ability to create clinical distinction, compel surgeon adoption and earn market share; and the Company's expectations with respect to future revenue, growth and financial outlook. 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 effect of the announcement of the acquisition on the Company's ability to retain and hire key personnel and maintain relationships with customers and suppliers; risks related to potential litigation in connection with acquisition; the risk that the assets acquired will not be integrated successfully or that the benefits and synergies from the acquisition may not be fully realized or may take longer to realize than expected; 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; 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; the Company's ability to compete with other products or with emerging technologies; product liability exposure; an unsuccessful outcome in any litigation; and changes to our financial results for the quarter due to the completion of financial closing procedures. 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 Securities and Exchange Commission. Forward-looking statements represent the Company's views only as of today and should not be relied upon as representing its views as of any subsequent date. 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. No representations or warranties (expressed or implied) are made about the accuracy of any such forward-looking statements.

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ATEC Acquires Navigation-Enabled Robotics Platform; Raises 2023 Revenue Guidance on Strength of Preliminary First Quarter Revenue Results