ATEC · Alphatec Holdings, Inc.

Alphatec Holdings, Inc. (ATEC) executed a transformative refinancing on May 1, 2026, replacing prior asset-based lending (ABL Credit Agreement with MidCap) and term loan facilities (2023 Term Loan Agreement with Wilmington Trust) with a $300 million syndicated bank facility led by JPMorgan Chase Bank, N.A. This inaugural term loan A ($175M) and revolver ($125M) structure simplifies the capital stack, cuts borrowing costs (SOFR + 275 bps vs. prior facilities), and extends maturities to 2031, saving over $6M in annual interest with $35M potential lifetime benefits. The transaction reflects ATEC's operating maturation, enabling an incremental $150M accordion for growth. Key covenants include a 3.00x net leverage test (step-up to 3.50x post large acquisitions) and 2.00x fixed charge coverage from Q3 2026, with security over substantially all assets.

Concurrently, Q1 2026 earnings showcased robust surgical momentum: $178M revenue (+17% YoY, 21% case volume growth), total revenue $192M (+14%), and adjusted EBITDA $21M (11% margin, +460 bps YoY expansion). Net new surgeon users rose 23% YoY, validating the procedural ecosystem. GAAP net loss was $34M amid non-cash and one-time items, with non-GAAP breakeven. Balance sheet strengthened to $140M cash, trailing 12-month free cash flow turned positive at $7M.

FY2026 guidance holds at $882M revenue (15% growth, surgical $805M), $134M adjusted EBITDA (15% margin), and ≥$20M free cash flow, despite EOS adjustment to $77M. CEO Pat Miles emphasized volume-driven growth and procedural differentiation, positioning ATEC for scalable profitability amid spine market expansion. This dual disclosure materially enhances liquidity, cost efficiency, and growth optionality for investors.