ATEC Reports Second Quarter 2025 Financial Results and Raises Full-Year Guidance
-
Surgical revenue grew
29% to$168 million -
Total revenue grew
$40 million 27.5% - Full-year revenue and profitability guidance increased
Second Quarter 2025 Financial Results
|
Quarter Ended
|
Total revenue |
|
GAAP gross margin |
|
Non-GAAP gross margin |
|
GAAP operating expenses |
|
Non-GAAP operating expenses |
|
GAAP net income / (loss) |
|
Non-GAAP net income / (loss) |
|
Adjusted EBITDA |
|
Adjusted EBITDA margin |
|
Ending cash balance |
|
Recent Highlights
-
Surgical revenue of
$168 million 29% on continued momentum of PTP™ and LTP™ -
Achieved
21% growth in new surgeon adoption, a key leading indicator of future growth -
Delivered adjusted EBITDA margin of
13% expanding by 880 bps YoY in the quarter through disciplined execution -
Trailing twelve months of adjusted EBITDA improved to
$62 million - Inflected to non-GAAP net income profitability
-
Generated
$5 million
“I’m proud of the ATEC Family for executing yet another strong quarter,” said Pat Miles, Chairman and Chief Executive Officer. “Six years of uninterrupted industry-leading growth has demonstrated that the spine market needs ATEC. While much of the industry wrestles with disruption and distraction, we continue to relentlessly architect procedural solutions that drive clinical distinction and more predictable surgical outcomes. The ecosystem we’ve invested in is only beginning to show its influence, but its impact is unmistakable: durable growth, at multiples of the market, leading to a clear financial inflection. At ATEC, we’re not just participating in this market; we’re revolutionizing it.”
Financial Outlook for the Full Year 2025
For the fiscal year ending December 31, 2025, the Company now expects total revenue to grow
Financial Results Webcast
ATEC will present these results via a live webcast today at 1:30 p.m. PT / 4:30 p.m. ET. The live webcast can be accessed by visiting 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.
Non-GAAP Financial Information
To supplement the Company’s financial statements presented in accordance with generally accepted accounting principles in
Non-GAAP Financial Measures
Free cash flow: Calculated by subtracting capital expenditures from cash flow provided by or used in operating activities. Management uses free cash flow to measure progress on its capital efficiency and cash flow initiatives.
Non-GAAP Gross Profit and Non-GAAP Gross Margin: Non-GAAP gross profit represents GAAP gross profit with adjustments to exclude the impact of certain items recorded to cost of goods sold. Such potential adjustments are described within the section below under "Non-GAAP Adjustments" and included in the non-GAAP reconciliation attached below. Non-GAAP gross margin represents non-GAAP gross profit as a percentage of GAAP net sales.
Non-GAAP Operating Expenses: Non-GAAP operating expenses represent GAAP operating expenses, such as sales, general, and administrative expense, and research and development expense, with adjustments to exclude the impact of certain items recorded in GAAP operating expenses. Such potential adjustments are described within the section below under "Non-GAAP Adjustments" and included in the non-GAAP reconciliation attached below.
Non-GAAP Net Income (Loss) and Non-GAAP EPS: Non-GAAP net income (loss) represents GAAP net loss with adjustments to exclude the impact of certain items recorded in GAAP net loss. Such potential adjustments are described within the sections below under "Non-GAAP Adjustments" and included in the non-GAAP reconciliation attached below. Non-GAAP EPS represents non-GAAP net income (loss) divided by weighted average shares outstanding.
EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin: EBITDA represents earnings before non-operating income/expense, taxes, depreciation and amortization. Adjusted EBITDA consists of EBITDA with adjustments to exclude certain items described within the section below under "Non-GAAP Adjustments" and included in the non-GAAP reconciliation attached below. Adjusted EBITDA margin represents adjusted EBITDA as a percentage of GAAP net sales.
Non-GAAP Adjustments
The Company's non-GAAP financial measures reflect the exclusion of the following items:
Amortization of acquired intangible assets: Represents amortization expense associated with intangible assets including, but not limited to customer relationships, intellectual property, and trade names acquired in business combinations and asset acquisitions. This adjustment does not include amortization from other intangibles.
Litigation-related expenses: We are involved in various litigation matters that from time-to-time result in settlements. Litigation matters can vary in their characteristics, frequency and significance to our operating results and core business operations. We review litigation matters from both a qualitative and quantitative perspective to determine whether such matters are a normal and recurring part of our business. We include in our GAAP financial statements litigation fees and settlement expenses that we determine to be normal, recurring and routine to our business. When we determine that certain litigation matters are not normal and recurring to our core business operations, we believe excluding these expenses will provide our management and investors with useful incremental information. Litigation fees and settlement expenses excluded from our non-GAAP financial measures in the periods presented relate primarily to patent litigation and other litigation matters that relate directly to the business transformation that we started in 2018 and are discussed more fully in our periodic reports filed with the Securities and Exchange Commission.
Purchase accounting adjustments on acquisitions: Includes non-cash expenses incurred as a result of fair value step-ups associated with tangible assets acquired in business combinations or asset acquisitions.
Restructuring expenses: From time-to-time, in order to realign the Company’s operations or to realize synergies from acquisitions, the Company may eliminate roles or restructure its operations and footprint. In such cases the Company may incur one-time severance and personnel costs associated with workforce reductions, or costs associated with exiting and/or relocating facilities. We exclude these costs as we do not consider such amounts to be part of the ongoing operations.
Stock-based compensation: Stock-based compensation is charged to cost of revenue and operating expenses. We exclude stock-based compensation from certain of our non-GAAP financial measures because we believe that excluding these non-cash expenses provides meaningful supplemental information regarding operational performance. Because of the variety of equity awards used by companies, the varying methodologies for determining stock-based compensation expense, the subjective assumptions involved in those determinations, and the volatility in valuations that can be driven by market conditions outside the Company’s control, the Company believes excluding stock-based compensation expense enhances the ability of management and investors to understand and assess the underlying performance of its business over time.
Transaction-related expenses: Represent one-time costs incurred in connection with business combinations, asset acquisitions, or debt financing and modification activities. These expenses may include, but are not limited to, legal and advisory fees, due diligence costs, contract termination charges, and other third-party expenses directly related to the planning or execution of these transactions. We exclude these costs because they can vary significantly from period to period and are not indicative of the underlying trends in our core business.
Foreign currency exchange impact: Gains and losses related to foreign currency transactions, which are recorded as other income (expense), net. Management excludes these items when evaluating the Company's operating results as they are primarily non-cash and non-operating in nature.
Loss on debt extinguishment: Represents charges recognized in connection with the early repayment, refinancing, or settlement of debt, including write-offs of unamortized debt discounts, premiums, or deferred financing costs, and any associated prepayment penalties. We exclude these items from non-GAAP results because they are non-recurring in nature, not indicative of ongoing operating performance, and can vary significantly from period to period based on financing activity.
Loss (gain) on derivative liability: Represents non-cash fair value adjustments associated with embedded derivative features related to our convertible debt. These mark-to-market changes are driven by fluctuations in our stock price and other valuation inputs, and do not reflect current operating performance. We exclude these amounts from non-GAAP results because they are non-cash, volatile, and unrelated to the company’s core business operations.
Non-cash interest expense: Consists primarily of interest expense related to the amortization of debt discounts, deferred financing costs, and other non-cash components associated with our convertible notes and other long-term debt instruments. We exclude this item from non-GAAP net income because it is non-cash in nature and does not reflect our core operating performance or current period cash expenditures.
Long-term income tax rate adjustment: The Company employs a structural long-term projected non-GAAP income tax rate of
Other non-recurring expenses: These represent items that are unusual or infrequent in nature and that we believe are not indicative of our ongoing operating performance. Examples may include discrete costs associated with tax strategy implementation or one-time expenses related to customer restructuring or reorganization events. We evaluate such items based on their nature and significance and disclose material adjustments in our non-GAAP reconciliations.
About Alphatec Holdings, Inc.
ATEC, through its wholly owned subsidiaries, Alphatec Spine, Inc., EOS imaging S.A.S. 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 InformatiX™ 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.
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. Forward-looking statements include, but are not limited to: references to the Company’s revenue, balance sheet, growth, and financial outlook and commitments; and the Company's ability to compel surgeon adoption and drive procedural growth. 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; 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
Alphatec Holdings, Inc. Condensed Consolidated Statements of Operations (in thousands, except per share amounts) |
||||||||||||||||
| Three Months Ended | Six Months Ended | |||||||||||||||
| June 30, | June 30, | |||||||||||||||
|
2025 |
|
|
2024 |
|
|
2025 |
|
|
2024 |
|
|||||
| (unaudited) | (unaudited) | |||||||||||||||
| Revenue from products and services | $ |
185,544 |
|
$ |
145,573 |
|
$ |
354,724 |
|
$ |
284,050 |
|
||||
| Cost of sales |
|
56,443 |
|
|
42,979 |
|
|
109,627 |
|
|
84,105 |
|
||||
| Gross profit |
|
129,101 |
|
|
102,594 |
|
|
245,097 |
|
|
199,945 |
|
||||
| Operating expenses: | ||||||||||||||||
| Research and development |
|
18,276 |
|
|
19,105 |
|
|
35,308 |
|
|
37,117 |
|
||||
| Sales, general and administrative |
|
118,507 |
|
|
112,731 |
|
|
245,524 |
|
|
226,341 |
|
||||
| Litigation-related expenses |
|
1,593 |
|
|
2,090 |
|
|
13,807 |
|
|
6,518 |
|
||||
| Amortization of acquired intangible assets |
|
3,803 |
|
|
3,836 |
|
|
7,456 |
|
|
7,690 |
|
||||
| Restructuring expenses |
|
7 |
|
|
139 |
|
|
378 |
|
|
927 |
|
||||
| Total operating expenses |
|
142,186 |
|
|
137,901 |
|
|
302,473 |
|
|
278,593 |
|
||||
| Operating loss |
|
(13,085 |
) |
|
(35,307 |
) |
|
(57,376 |
) |
|
(78,648 |
) |
||||
| Other expense, net: | ||||||||||||||||
| Cash interest expense, net |
|
(5,289 |
) |
|
(4,754 |
) |
|
(10,645 |
) |
|
(9,037 |
) |
||||
| Noncash interest expense, net |
|
(7,020 |
) |
|
(1,061 |
) |
|
(9,505 |
) |
|
(2,119 |
) |
||||
| Loss on debt extinguishment |
|
— |
|
|
— |
|
|
(17,576 |
) |
|
— |
|
||||
| (Loss) gain on derivative liability |
|
(16,780 |
) |
|
— |
|
|
620 |
|
|
— |
|
||||
| Other income (expense) , net |
|
993 |
|
|
156 |
|
|
1,330 |
|
|
274 |
|
||||
| Total other expense, net |
|
(28,096 |
) |
|
(5,659 |
) |
|
(35,776 |
) |
|
(10,882 |
) |
||||
| Net loss before taxes |
|
(41,181 |
) |
|
(40,966 |
) |
|
(93,152 |
) |
|
(89,530 |
) |
||||
| Income tax benefit |
|
(37 |
) |
|
(286 |
) |
|
(101 |
) |
|
(355 |
) |
||||
| Net loss | $ |
(41,144 |
) |
$ |
(40,680 |
) |
$ |
(93,051 |
) |
$ |
(89,175 |
) |
||||
| Net loss per share, basic and diluted | $ |
(0.27 |
) |
$ |
(0.29 |
) |
$ |
(0.63 |
) |
$ |
(0.63 |
) |
||||
| Weighted average shares outstanding, basic and diluted |
|
149,907 |
|
|
142,687 |
|
|
148,337 |
|
|
141,845 |
|
||||
| Stock-based compensation included in: | ||||||||||||||||
| Cost of sales | $ |
553 |
|
$ |
554 |
|
$ |
3,596 |
|
$ |
1,037 |
|
||||
| Research and development |
|
4,159 |
|
|
5,614 |
|
|
7,803 |
|
|
9,929 |
|
||||
| Sales, general and administrative |
|
10,912 |
|
|
10,792 |
|
|
26,543 |
|
|
23,316 |
|
||||
$ |
15,624 |
|
$ |
16,960 |
|
$ |
37,942 |
|
$ |
34,282 |
|
|||||
Alphatec Holdings, Inc. Condensed Consolidated Balance Sheets (in thousands) |
|||||||
| June 30, 2025 |
December 31, 2024 |
||||||
| (unaudited) | |||||||
| ASSETS | |||||||
| Current assets: | |||||||
| Cash and cash equivalents | $ |
157,063 |
$ |
138,840 |
|
||
| Accounts receivable, net |
|
95,919 |
|
82,987 |
|
||
| Inventories |
|
169,760 |
|
175,264 |
|
||
| Prepaid expenses and other current assets |
|
20,584 |
|
20,308 |
|
||
| Total current assets |
|
443,326 |
|
417,399 |
|
||
| Property and equipment, net |
|
139,729 |
|
156,394 |
|
||
| Right-of-use assets |
|
33,921 |
|
34,701 |
|
||
| Goodwill |
|
75,218 |
|
70,976 |
|
||
| Intangible assets, net |
|
95,593 |
|
93,518 |
|
||
| Other assets |
|
2,506 |
|
2,722 |
|
||
| Total assets | $ |
790,293 |
$ |
775,710 |
|
||
| LIABILITIES AND STOCKHOLDERS' EQUITY (DEFICIT) | |||||||
| Current liabilities: | |||||||
| Accounts payable | $ |
47,240 |
$ |
52,984 |
|
||
| Accrued expenses and other current liabilities |
|
87,013 |
|
81,466 |
|
||
| Contract liabilities |
|
11,497 |
|
10,467 |
|
||
| Short-term debt |
|
1,929 |
|
1,656 |
|
||
| Current portion of operating lease liabilities |
|
6,505 |
|
6,453 |
|
||
| Total current liabilities |
|
154,184 |
|
153,026 |
|
||
| Total long-term liabilities |
|
588,735 |
|
613,250 |
|
||
| Redeemable preferred stock |
|
23,603 |
|
23,603 |
|
||
| Stockholders' equity (deficit) |
|
23,771 |
|
(14,169 |
) |
||
| Total liabilities and stockholders' equity (deficit) | $ |
790,293 |
$ |
775,710 |
|
||
Alphatec Holdings, Inc. Reconciliation of Non-GAAP Financial Measures (in thousands) |
||||||||||||||||
| Three Months Ended | Six Months Ended | |||||||||||||||
| June 30, | June 30, | |||||||||||||||
|
2025 |
|
|
2024 |
|
|
2025 |
|
|
2024 |
|
|||||
| (unaudited) | ||||||||||||||||
| Gross profit, GAAP | $ |
129,101 |
|
$ |
102,594 |
|
$ |
245,097 |
|
$ |
199,945 |
|
||||
| Add: amortization of intangible assets |
|
64 |
|
|
307 |
|
|
114 |
|
|
614 |
|
||||
| Add: stock-based compensation |
|
553 |
|
|
554 |
|
|
3,596 |
|
|
1,037 |
|
||||
| Add: purchase accounting adjustments on acquisitions |
|
— |
|
|
197 |
|
|
— |
|
|
197 |
|
||||
| Non-GAAP gross profit | $ |
129,718 |
|
$ |
103,652 |
|
$ |
248,807 |
|
$ |
201,793 |
|
||||
| Gross margin, GAAP |
|
69.6 |
% |
|
70.5 |
% |
|
69.1 |
% |
|
70.4 |
% |
||||
| Add: amortization of acquired intangible assets |
|
0.0 |
% |
|
0.2 |
% |
|
0.0 |
% |
|
0.2 |
% |
||||
| Add: stock-based compensation |
|
0.3 |
% |
|
0.4 |
% |
|
1.0 |
% |
|
0.4 |
% |
||||
| Add: purchase accounting adjustments on acquisitions |
|
0.0 |
% |
|
0.1 |
% |
|
0.0 |
% |
|
0.1 |
% |
||||
| Non-GAAP gross margin |
|
69.9 |
% |
|
71.2 |
% |
|
70.1 |
% |
|
71.0 |
% |
||||
| Three Months Ended | Six Months Ended | |||||||||||||||
| June 30, | June 30, | |||||||||||||||
|
2025 |
|
|
2024 |
|
|
2025 |
|
|
2024 |
|
|||||
| (unaudited) | ||||||||||||||||
| Operating expenses, GAAP | $ |
142,186 |
|
$ |
137,901 |
|
$ |
302,473 |
|
$ |
278,593 |
|
||||
| Adjustments: | ||||||||||||||||
| Stock-based compensation |
|
(15,071 |
) |
|
(16,406 |
) |
|
(34,346 |
) |
|
(33,245 |
) |
||||
| Litigation-related expenses |
|
(1,593 |
) |
|
(2,090 |
) |
|
(13,807 |
) |
|
(6,518 |
) |
||||
| Amortization of acquired intangible assets |
|
(3,803 |
) |
|
(3,836 |
) |
|
(7,456 |
) |
|
(7,690 |
) |
||||
| Transaction-related expenses |
|
— |
|
|
— |
|
|
— |
|
|
117 |
|
||||
| Restructuring expenses |
|
(7 |
) |
|
(139 |
) |
|
(378 |
) |
|
(927 |
) |
||||
| Other non-recurring expenses |
|
— |
|
|
(1,608 |
) |
|
— |
|
|
(1,608 |
) |
||||
| Non-GAAP operating expenses | $ |
121,712 |
|
$ |
113,822 |
|
$ |
246,486 |
|
$ |
228,722 |
|
||||
Alphatec Holdings, Inc. Reconciliation of Non-GAAP Financial Measures (in thousands) |
||||||||||||||||
| Three Months Ended | Six Months Ended | |||||||||||||||
| June 30, | June 30, | |||||||||||||||
|
2025 |
|
|
2024 |
|
|
2025 |
|
|
2024 |
|
|||||
| (unaudited) | ||||||||||||||||
| Net loss, GAAP | $ |
(41,144 |
) |
$ |
(40,680 |
) |
$ |
(93,051 |
) |
$ |
(89,175 |
) |
||||
| Cash interest expense, net |
|
5,289 |
|
|
4,754 |
|
|
10,645 |
|
|
9,037 |
|
||||
| Noncash interest expense, net |
|
7,020 |
|
|
1,061 |
|
|
9,505 |
|
|
2,119 |
|
||||
| Loss on debt extinguishment |
|
— |
|
|
— |
|
|
17,576 |
|
|
— |
|
||||
| Gain on derivative liability |
|
16,780 |
|
|
— |
|
|
(620 |
) |
|
— |
|
||||
| Other expense (income), net |
|
(993 |
) |
|
(156 |
) |
|
(1,330 |
) |
|
(274 |
) |
||||
| Income tax benefit |
|
(37 |
) |
|
(286 |
) |
|
(101 |
) |
|
(355 |
) |
||||
| Depreciation |
|
15,012 |
|
|
15,735 |
|
|
30,766 |
|
|
29,459 |
|
||||
| Amortization expense |
|
4,316 |
|
|
4,143 |
|
|
8,469 |
|
|
8,304 |
|
||||
| EBITDA |
|
6,243 |
|
|
(15,429 |
) |
|
(18,141 |
) |
|
(40,885 |
) |
||||
| Add back significant items: | ||||||||||||||||
| Stock-based compensation |
|
15,624 |
|
|
16,960 |
|
|
37,942 |
|
|
34,282 |
|
||||
| Purchase accounting adjustments on acquisitions |
|
— |
|
|
197 |
|
|
— |
|
|
197 |
|
||||
| Litigation-related expenses |
|
1,593 |
|
|
2,090 |
|
|
13,807 |
|
|
6,518 |
|
||||
| Transaction-related expenses |
|
— |
|
|
— |
|
|
— |
|
|
(117 |
) |
||||
| Restructuring expenses |
|
7 |
|
|
139 |
|
|
378 |
|
|
927 |
|
||||
| Other non-recurring expenses |
|
— |
|
|
1,608 |
|
|
— |
|
|
1,608 |
|
||||
| Adjusted EBITDA | $ |
23,467 |
|
$ |
5,565 |
|
$ |
33,986 |
|
$ |
2,530 |
|
||||
| Adjusted EBITDA margin |
|
12.6 |
% |
|
3.8 |
% |
|
9.6 |
% |
|
0.9 |
% |
||||
| Adjusted EBITDA margin expansion |
|
880 |
|
bps |
|
870 |
|
bps | ||||||||
| Three Months Ended | Six Months Ended | |||||||||||||||
| June 30, | June 30, | |||||||||||||||
|
2025 |
|
|
2024 |
|
|
2025 |
|
|
2024 |
|
|||||
| (unaudited) | ||||||||||||||||
| Net loss, GAAP | $ |
(41,144 |
) |
$ |
(40,680 |
) |
$ |
(93,051 |
) |
$ |
(89,175 |
) |
||||
| Stock-based compensation |
|
15,624 |
|
|
16,960 |
|
|
37,942 |
|
|
34,282 |
|
||||
| Amortization of acquired intangible assets |
|
3,867 |
|
|
4,143 |
|
|
7,570 |
|
|
8,304 |
|
||||
| Restructuring expenses |
|
7 |
|
|
139 |
|
|
378 |
|
|
927 |
|
||||
| Transaction-related expenses |
|
— |
|
|
— |
|
|
— |
|
|
(117 |
) |
||||
| Litigation-related expenses |
|
1,593 |
|
|
2,090 |
|
|
13,807 |
|
|
6,518 |
|
||||
| Loss on debt extinguishment |
|
— |
|
|
— |
|
|
17,576 |
|
|
— |
|
||||
| Loss (gain) on derivative liability |
|
16,780 |
|
|
— |
|
|
(620 |
) |
|
— |
|
||||
| Non-cash interest expense |
|
7,020 |
|
|
1,061 |
|
|
9,505 |
|
|
2,119 |
|
||||
| Foreign currency exchange impact |
|
(308 |
) |
|
(44 |
) |
|
(619 |
) |
|
(163 |
) |
||||
| Long-term income tax rate adjustment |
|
(848 |
) |
|
4,606 |
|
|
2,080 |
|
|
10,054 |
|
||||
| Non-GAAP net income (loss) | $ |
2,591 |
|
$ |
(11,725 |
) |
$ |
(5,432 |
) |
$ |
(27,251 |
) |
||||
| Non-GAAP net income (loss) per share | $ |
0.02 |
|
$ |
(0.08 |
) |
$ |
(0.04 |
) |
$ |
(0.19 |
) |
||||
| Weighted average shares outstanding, basic and diluted |
|
149,907 |
|
|
142,687 |
|
|
148,337 |
|
|
141,845 |
|
||||
View source version on businesswire.com: https://www.businesswire.com/news/home/20250731113773/en/
Investor/Media Contact:
Robert Judd
Investor Relations
(760) 494-6790
investorrelations@atecspine.com
Company Contact:
J. Todd Koning
Chief Financial Officer
investorrelations@atecspine.com
Source: Alphatec Holdings, Inc.
