Xtant Medical Holdings, Inc.

Good morning, everyone, and welcome to the Extant Medical fourth quarter and full year 2025 financial results. At this time, all participants are in a listen-only mode, and the floor will be open for questions and comments following the presentation. Please note that this conference is being recorded. I will now turn the conference over to your host, Kevin Gardner of LifeSci Advisors. Kevin, please go ahead.

Thank you, Operator, and welcome to Extant Medical's fourth quarter and full year 2025 financial results call. Joining me today are Sean Brown, President and Chief Executive Officer, and Scott Neals, Chief Financial Officer. Today's call is being webcast and will be posted on the company's website for playback. During the course of this call, management may make certain forward-looking statements regarding future events and the company's expected future performance. These forward-looking statements reflect XStand's current perspective on existing trends and information and can be identified by such words as expect, plan, will, may, anticipate, believe, should, intends, and other words with similar meaning. Such forward-looking statements are not guarantees of future performance and involve risks and uncertainties, including those noted in the risk factor section of the company's annual report on Form 10-K filed with the SEC and in subsequent SEC reports and press releases. Actual results may differ materially. The company's financial results press release and today's discussion include certain non-GAAP financial measures. Please refer to the non-GAAP to GAAP reconciliations, which appear in our press release and are otherwise available on our website. Note that the Form 8Ks that we file with our financial results press releases provide detailed narratives that describe our use of such measures. For the benefit of those who may be listening to a replay, this call was held and recorded on March 31, 2026 at approximately 8.30 a.m. Eastern Time. The company declines any obligation to update its forward-looking statements except as required by applicable law. Now I'd like to turn the call over to Sean Brown, CEO. Sean?

Thank you, Kevin, and good morning, everyone. Thank you for joining our fourth quarter update call. As has been our practice, I will begin with a few prepared remarks about our operations, and then Scott will provide a deeper dive into the financials. We'll then open the call to your questions. Okay, we again turned in solid financial performance during the fourth quarter update. highlighted by $32.4 million of revenue, representing growth of 3% over the fourth quarter of 2024. Now, I would note that the Companions Fine transaction closed in early December, roughly a month ahead of our original assumption, which cost us about $2 million of revenue in the quarter. Scott will provide the details, but I want to flag it up front so the headline number is properly contextualized. Importantly, we again generated positive cash flow, adjusted EBITDA, and net income, a continuation of the favorable trends we have seen over the past several quarters. Before covering the quarter in more detail, I want to briefly recap our recent sales. interlamorous stabilization assets and the international paradigm spine entities to companion spine, which closed in early December. The final purchase price was approximately 21.4 million. And I'm pleased to report that the transaction is now fully closed and settled. We use those proceeds to reduce our borrowings and strengthen our cash position. And we do not anticipate any need to raise additional outside capital in the foreseeable future. More strategically, this transaction was transformational for our company. It further sharpened our focus on our core high-margin biologics business, which is where our competitive differentiation lies and where we intend to grow. So for the full year of 2025, we generated total revenue of $133.9 million toward the upper end of our previously stated guidance of $131 to $135. Again, remember that guidance also included a full month of COFLEX and Paradigm Spine revenues. And this represented a growth of over 14% the full year of 2024. Adjusted EBITDA for the full year was $16.3 million compared to a loss of $1.9 million in 2024. A result we are very proud of, one that reflects the sustained operational discipline our team has demonstrated over the past two years. Our biologics product family, which has the greatest potential for growth both from a revenue and cash generation perspective, was essentially flat for the fourth quarter of last year. We've been direct with investors that our recent emphasis on self-sustainability, positive cash flows, tighter operating discipline, in-house manufacturing was intentional. And those goals are now achieved. The strategic initiatives we implemented are sharp and focused on higher margin biologics. Our emphasis on in-house manufacturing to improve quality and control costs and our more disciplined approach to operating expenses were all pursued with self-sustainability in mind. We are pleased to have delivered on each of them. With that foundation now firmly in place, we are turning our full attention to driving top-line growth, leveraging the strength of our Biologics product family. On the commercial side, we have been making measured but meaningful investments to expand our reach. In 2025 and into 2026, we have doubled the number of regional sales reps in the field. Those reps are now deployed, ramping up, and calling on accounts. This year, we plan to add significant resources to our national accounts team, which will expand our ability to drive institutional adoption at scale across hospital systems and large practice groups. Together, we believe these additions will have an accelerating impact on our biologics revenue as the year progresses. We continue to invest in R&D to bring innovations to surgeons and their patients, and we remain committed to the cadence of new product introductions that has characterized these past several years. So let's talk a little bit about new product launches. Innovation remains central to our strategy, and we continue to build out our portfolio during the quarter. In December, we announced the commercial launch of NanoStratta, our next-generation synthetic bone graft manufactured from hydroxycarbon apatite, a material with higher solubility than traditional hydroxyapatite, which is the most commonly used synthetic material. Increased solubility enhances the bioactivity of the graft, allowing for better integration and remodeling with surrounding bone tissue during the healing process. Early surgeon feedback has been excellent, and we are encouraged by Nanostrata's prospects. We also launched CollagenX, our bovine collagen particulate for surgical wound closure designed to promote healing, prevent dehiscence, and help mitigate surgical site infection risk. What makes CollagenX particularly compelling commercially is that it's a potential add-on to virtually every case type in our existing biologics portfolio, creating meaningful attach rate opportunity across our current procedure base, as well as an entry point into adjacent surgical disciplines we do not currently serve. Besides that addressable market opportunity is significant, we are very excited about what this product represents for both patients and for our business. As we have said before, but it bears repeating, we now offer and internally produce solutions across all five major orthobiologic categories, which includes demineralized bone, matrix, cellular allografts, synthetics, structural allografts, and growth factors. Additionally, with our amnio and collagen product lines, we're also well positioned to grow in the surgical repair and wound care markets. This breath positions us as the partner of choice in regenerative medicine. position that has been further reinforced by the very positive feedback we continue to receive from surgeons on these recent innovations. Turning now to guidance, our 2026 Revenue Outlook reflects the impact of the Companion's fine divestiture and the expiration of license revenue from our Q-code and amniotic membrane agreements, both non-recurring items that Scott will address in detail, Offsetting these headwinds is continued anticipated organic growth in our core biologics business, which we expect to accelerate as our expanded commercial team is fully deployed and our newest products gain traction in the field. With that context, we anticipate full year 2026 revenue in the range of 95 to 99 million. On a pro forma basis, this represents solid organic growth in our core business. We are committed to maintaining positive free cash flow at these revenue levels. And as I noted, we do not anticipate any need for any outside additional capital. Story heading into 2026 is straightforward. A focus on our core business, an expanding commercial footprint, an innovative and comprehensive product portfolio, and a clean balance sheet. We believe we have the right strategy, the right team, and the right foundation to deliver. Now with that, I'll turn the call over to Scott for a more detailed review of our financial results. Scott?