SIBN · SI-BONE, Inc.

SI-BONE's first quarter 2026 results demonstrate strong operational execution and accelerating commercial momentum. Worldwide revenue of $52.6 million grew 11.2% year-over-year, driven by 10.0% growth in the U.S. ($49.3 million) and a 33.9% surge in international revenue ($3.3 million), reflecting robust demand for the iFuse TORQ platform. Gross margin remained stable at 79.8%, while operating expenses increased only 4.1% to $47.0 million, demonstrating operating leverage. As a result, operating loss improved 31.9% to $5.1 million, and net loss narrowed 33.8% to $4.3 million ($0.10 per share). Adjusted EBITDA turned positive at $2.5 million, a dramatic improvement from $0.5 million in the prior year period, underscoring the company's path to profitability.

Management highlighted record physician engagement with over 1,650 active U.S. physicians (up 17% YoY) and a 11% increase in trailing 12-month average revenue per territory to $2.2 million. Key operational milestones included the U.S. launch of INTRA Ti, a trauma partnership with Smith+Nephew, and international expansion of iFuse TORQ TNT in Europe and iFuse TORQ in Australia. The company also noted a positive CMS proposal for a new MS-DRG family that could support higher reimbursement for complex spinal fusion procedures incorporating iFuse Bedrock Granite.

Looking ahead, SI-BONE raised its full-year 2026 revenue guidance to $230-$233 million (implying ~14-16% growth) and increased gross margin guidance to ~79%, reflecting confidence in continued adoption and operational improvements. The company ended the quarter with $144.7 million in cash and equivalents, providing ample runway to fund growth initiatives. The strong Q1 performance and upward guidance revision signal accelerating growth and improving profitability, positioning SI-BONE well for the remainder of 2026.