Orthofix Medical Inc.

mute to prevent any background noise. After the speaker's remarks, there will be a question and answer session. If you'd like to ask a question during this time, simply press star followed by the number one on your telephone keypad. If you'd like to withdraw your question, again, press the star and one. I would now like to turn the call over to Julie Dewey. You may begin.

Thank you, operator, and good morning, everyone. Welcome to OrthoFix's second quarter 2025 earnings call. We appreciate you joining us. I'm Julie Dewey, OrthoFix's Chief IR and Communications Officer. Joining me on the call today are President and Chief Executive Officer Masimo Calafiore and Chief Financial Officer Julie Andrews. Before we get started, please note that our earnings release and the supplemental presentation accompanying this call are available on the events and presentations page of the Investor section of our corporate website at orthofix.com. Also, this call is being broadcast live over the internet to all interested parties, and an archived copy of this webcast will be available in the Investor section of our corporate website shortly after the conclusion of this call. During this call, we'll be making forward-looking statements that involve risks and uncertainties. All statements other than those of historical facts are forward-looking statements. We do not undertake any obligation to revise or update such forward-looking statements. Factors that could cause actual results to differ materially are discussed in our most recent filings with the SEC and may be included in our future filings with the SEC. In addition on today's call, we will refer to various non-GAAP financial measures. Please refer to today's news release announcing our second quarter 2025 results for information regarding our non-GAAP results, including our reconciliations of these non-GAAP financial measures to our US GAAP results. Additionally, and unless otherwise stated, all net sales percentage changes discussed will be on a pro forma constant currency year over year basis excluding the impact from the discontinuation of the M6 artificial disk product lines, and all results of operations that we will refer to will be on a non-GAAP as adjusted basis. As we announced on our Q4 earnings call, we are discontinuing the M6 artificial disk product lines. We have posted a pro forma P&L excluding M6 on our website to assist you with updating your models. We will update it on a quarterly basis for the remainder of 2025. Moving to today's agenda, Massimo will open with comments on our performance and business updates. Julie Andrews will then review the specifics of our second quarter results and our 2025 financial guidance. With that, I'll now turn the call over to Massimo.

Thank you, Julie. Good morning, everyone, and thank you for joining us for our second quarter earnings call. I'll spend some time providing business updates and information about our key initiatives before I turn it over to Julie Andrews to cover the specifics of our Q2 results and 2025 guidance. During the second quarter, we continue to execute the priorities that we outlined in our three-year plan to transform our business and deliver on our commitment to drive profitable growth. Our second quarter pro forma net sales of $200.7 million represents -over-year constant currency growth of 4%. Our disciplined approach led to strong adjusted EBITDA margin growth and positive free cash flow generation, underscoring our ability to grow the business responsibly. Strategic initiatives like accelerating spine distributor transition in certain under-penetrated USA territories are gaining traction and creating a powerful foundation for a stronger, more scalable commercial organization to drive our next phase of growth. We expect to benefit from our recent product launches and deliver meaningful product innovation that improves outcomes and efficiencies for our surgeons and their patients. I'm confident the companies were positioned to deliver sustainable long-term shareholder value throughout the second half of 2025 and beyond. Now, I would like to provide additional detail for each of our businesses. Our USA spinal fixation net sales grew .4% and procedure volume grew 7%, both of which were consistent with our expectation. Importantly, we are off to a strong start accelerating targeted distributor transition in certain USA territories that we announced last quarter. Collectively, these distributors represent a potentially sizable book of business which we believe will support the above market cager of 6.5 to .5% reflected in our three-year financial plan. We expect this distributor transition will result in a more robust and scalable commercial organization paving the way for future growth. In addition to this distributor transition, we continue to gain share in our US anterior lumbar and cervical fusion portfolios which both grew in excess of 15%, significantly outperforming the market. We launched