SI-BONE, Inc.
For the period ended Sep 30, 2026. Filed Nov 3, 2026.
View on SEC.govAbout this filing
A company's report for each of its first three quarters. The financial statements are not audited. It shows how the business has moved since the last annual report, and what management says changed.
Sep 30, 2026 · Filed Nov 3, 2026
SIBN$24.24-0.1%Stored close · as of Nov 6, 2026
What changed in Management’s Discussion and Analysis?
Read the current filingPrevious report: 10-Q
Period ended 2026-06-30; filed 2026-08-04.
0001459839-26-000069
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of OperationsCurrent report: 10-Q
Period ended 2026-09-30; filed 2026-11-03.
0001459839-26-000086
Item 2. Management’s Discussion and Analysis of Financial Condition and Results of OperationsThe baseline is this issuer’s latest earlier reporting period of the same form that was filed before the current report. A previous 10-Q is a different quarter, not a year-over-year comparison. Amendments are excluded.
Compared 106 previous paragraphs and 104 current paragraphs.
64 unchanged; 32 reworded; 8 added; 9 removed; 1 previous and 0 current paragraphs rearranged.
Tables are not compared: 10 previous and 10 current tables excluded. Dates, whitespace, punctuation and numbering changes are ignored; changes to financial figures remain significant.
A changed paragraph is not evidence that risk increased or decreased. An unchanged paragraph does not establish that risk stayed the same.
Added paragraphs (8)
Current report
General and Administrative Expenses. The general and administrative expenses for the three months ended September 30, 2026 is consistent with general and administrative expense for the three months ended September 30, 2025.
Current report
Comparison of the Nine Months Ended September 30, 2026 and 2025
Current report
As of September 30, 2026, we had cash and marketable securities of $146.3 million as compared to $147.8 million as of December 31, 2025. We generated cash from operations of $4.4 million for the nine months ended September 30, 2026.
Current report
Our outstanding debt is related to a Loan and Security Agreement with Silicon Valley Bank (“First Citizens”), originally entered into in January 2024 and as subsequently amended in November 2024, September 2025 and September 2026 (the “Loan Agreement”). As of September 30, 2026, we had $36.0 million in aggregate principal amount outstanding under the Loan Agreement. Our term loan matures on September 1, 2029, and the principal repayments are scheduled to commence on October 1, 2027, which date will become October 1, 2028 upon achievement of the applicable performance milestone. Interest on the term loan is payable monthly at a floating rate per annum equal to the greater of 4.25% and the prime rate published in The Wall Street Journal minus 0.5%.
Current report
The Loan Agreement contains affirmative and negative covenants, including restrictions on transferring collateral, pledging our intellectual property, engaging in mergers or acquisitions, paying dividends or making other distributions, incurring indebtedness, transacting with affiliates and making certain investments, in each case subject to certain exceptions. For additional information regarding our term loan and the Loan Agreement, see Note 7, “Borrowings,” to our unaudited condensed consolidated financial statements included in Part I, Item 1 of this Quarterly Report on Form 10-Q.
Current report
Cash requirements
Current report
During the nine months ended September 30, 2026, net cash provided by operating activities was $4.4 million, compared to our net loss of $12.0 million. The differences were primarily due to $22.5 million of non-cash charges included in net loss, offset by $6.1 million of cash used in operating activities resulting from changes in net operating assets.
Current report
During the nine months ended September 30, 2025, net cash used in operating activities was $2.4 million, compared to our net loss of $17.3 million. The differences were primarily due to $25.1 million non-cash charges included in net loss, offset by $10.2 million cash used in operating activities resulting from changes in net operating assets.
Removed paragraphs (9)
Previous report
We conduct instructor-led trainings designed to build people leadership capabilities and train managers on delivering actionable feedback. We have also adopted a goal for each of our managers to have regular check-ins with employees to discuss their personal goals and career plans in furtherance of our commitment to career and professional development.
Previous report
Comparison of the Six Months Ended June 30, 2026 and 2025
Previous report
Our outstanding debt is related to a Loan and Security Agreement (the "Original Loan Agreement") dated August 12, 2021 (the "Effective Date"), entered into by us and Silicon Valley Bank, a California corporation ("SVB"). Pursuant to the Original Loan Agreement, we borrowed a term loan in the aggregate principal amount of $35.0 million (the "Original Term Loan").
Previous report
On January 6, 2023, we entered into a First Amendment to Loan and Security Agreement with SVB to amend our Original Loan Agreement (the "First Amendment" and together with the Original Loan Agreement, collectively the "Amended Loan Agreement"). Upon entry into the Amended Loan Agreement, we borrowed a new term loan in the aggregate principal amount of $36.0 million (the "First Amendment Term Loan"), which was substantially used to repay in full the $35.0 million Original Term Loan outstanding under the Original Loan Agreement, and we also obtained a secured revolving credit facility in an aggregate principal amount of up to $15.0 million (the "Revolving Line"). The First Amendment also provided for a final payment fee payable to SVB of 2% of the original principal amount of the First Amendment Term Loan due upon the earlier of the First Amendment Term Loan Maturity Date, termination of the Amended Loan Agreement, acceleration by the Lender following an event of default, or prepayment of the First Amendment Term Loan.
Previous report
On January 25, 2024, we entered into a Second Amendment to Loan and Security Agreement with Silicon Valley Bank, a division of First-Citizens Bank & Trust Company, as successor in interest to SVB ("First-Citizens") to further amend our Amended Loan Agreement (the "Second Amendment" and together with the Amended Loan Agreement, collectively, the "Second Amended Loan Agreement"). The Second Amendment revised certain provisions related to financial covenants and the periods in which such covenants applied.
Previous report
On November 8, 2024, we entered into a Third Amendment to Loan and Security Agreement with First-Citizens to further amend our Second Amended Loan Agreement (the "Third Amendment" and together with the Second Amended Loan Agreement, collectively, the "Third Amended Loan Agreement"). Upon entry into the Third Amended Loan Agreement, we borrowed a new term loan in the aggregate principal amount of $36.0 million (the “Third Amendment Term Loan”), which was substantially used to refinance and repay in full the then-outstanding $36.0 million First Amendment Term Loan. We also paid a certain final payment fee related to such prior First Amendment Term Loan. The Third Amendment set the maturity date for the Third Amendment Term Loan to September 1, 2029 (the "Third Amendment Term Loan Maturity Date"), and set the first principal repayment due date for the Third Amendment Term Loan to October 1, 2027, which date will, upon the achievement of the Performance Milestone (as defined in the Third Amendment) become October 1, 2028. Interest on the outstanding principal balance of the Third Amendment Term Loan is payable monthly at a floating rate per annum equal to the greater of 4.25% and the WSJ prime rate minus 0.5%. The Company may elect to prepay the Third Amendment Term Loan in whole prior to the Third Amendment Term Loan Maturity Date, subject to a prepayment fee equal to 1.5% of the original principal amount of the Third Amendment Term Loan if the loan is prepaid within 18 months following the closing of the Third Amendment. The Third Amendment revised certain provisions related to financial covenants and the periods in which such covenants apply, and First-Citizens and the Company also agreed to terminate the Revolving Line and an uncommitted accordion term loan provision.
Previous report
On September 25, 2025, we entered into a Fourth Amendment to Loan and Security Agreement with First-Citizens to further amend our Third Amended Loan Agreement (the “Fourth Amendment” and together with the Third Amended Loan Agreement, collectively, the “Fourth Amended Loan Agreement”). The Fourth Amendment revised the periods in which the financial covenants applied.
Previous report
Cash requirement
Previous report
During the six months ended June 30, 2026, net cash used in operating activities was $1.6 million, consisting of a net loss of $8.4 million and an increase in net operating assets of $8.5 million, partially offset by non-cash charges of $15.4 million. During the six months ended June 30, 2025, net cash used in operating activities was $4.7 million, consisting of a net loss of $12.7 million and an increase in net operating assets of $8.7 million, partially offset by non-cash charges of $16.6 million.
Reworded paragraphs (32)
Previous wording
We are a leader in developing and commercializing differentiated solutions targeting surgical and interventional procedures for patients with compromised bone. Since building solutions targeting the sacroiliac joint, we have expanded our platform to address adjacent indications, including spinopelvic fixation and pelvic trauma, leveraging our expertise in biomechanical design and anatomy-specific innovation.
Current wording
We are a leader in developing and commercializing differentiated solutions targeting surgical and interventional procedures for patients with compromised bone. Since building solutions targeting the sacroiliac joint, we have expanded our platform to address adjacent indications, including spinopelvic fixation, and trauma, leveraging our expertise in biomechanical design and anatomy-specific innovation.
Previous wording
We market our products primarily with a direct sales force as well as a number of third-party sales agents in the United States, and with a combination of a direct sales force and sales agents in other countries. As of June 30, 2026, over 150,000 procedures have been performed using our technologies since initial commercialization.
Current wording
We market our products primarily with a direct sales force as well as a number of third-party sales agents in the United States, and with a combination of a direct sales force and sales agents in other countries. As of September 30, 2026, over 160,000 procedures have been performed using our technologies since initial commercialization.
Previous wording
We believe we are the industry leader in pioneering anatomy-specific solutions that are grounded in our biomechanical design expertise and backed by strong clinical evidence. Our product development strategy focuses on addressing unmet clinical needs while leveraging our existing platform technologies, enabling us to expand physician adoption and increase procedure volumes over time. As pioneers of minimally invasive treatment for sacroiliac joint dysfunction and degeneration, we developed a deep competency in addressing the challenges of low-density bone in the sacrum. Over the years, we have expanded our platform of solutions to address spinopelvic fixation and pelvic trauma. Our focus on innovation has resulted in three of our platform technologies being designated as breakthrough devices by the FDA.
Current wording
We believe we are the industry leader in pioneering anatomy-specific solutions that are grounded in our biomechanical design expertise and backed by strong clinical evidence. Our product development strategy focuses on addressing unmet clinical needs while leveraging our existing platform technologies, enabling us to expand physician adoption and increase procedure volumes over time. As pioneers of minimally invasive treatment for sacroiliac joint dysfunction and degeneration, we developed a deep competency in addressing the challenges of low-density bone in the sacrum. We are continuing to leverage this expertise to expand the application of our platform of solutions across other indications in spinopelvic fixation and trauma. Our focus on innovation has resulted in three of our platform technologies being designated as breakthrough devices by the FDA.
Previous wording
We continue to invest in research and development initiatives to bring new and differentiated solutions to the market. Robust clinical evidence is central to drive adoption and favorable reimbursement, and we remain focused on continuing to set the industry standard in delivering evidence-based care through best-in-class clinical trials that demonstrate the efficacy, safety, and economic benefit of our solutions. During the six months ended June 30, 2026, we spent $9.4 million on research and development, equating to 8.7% of our revenue. During the six months ended June 30, 2025, we spent $8.8 million on research and development, equating to 9.2% of our revenue.
Current wording
We continue to invest in research and development initiatives to bring new and differentiated solutions to the market. Robust clinical evidence is central to drive adoption and favorable reimbursement, and we remain focused on continuing to set the industry standard in delivering evidence-based care through best-in-class clinical trials that demonstrate the efficacy, safety, and economic benefit of our solutions. During the nine months ended September 30, 2026, we spent $14.0 million on research and development, equating to 8.5% of our revenue. During the nine months ended September 30, 2025, we spent $13.1 million on research and development, equating to 9.1% of our revenue.
Previous wording
Our commercial growth is driven by expansion of our sales organization, increased surgical capacity, and broader site-of-service adoption. As of June 30, 2026, our U.S. commercial organization comprised of more than 175 sales team members, including territory sales managers and clinical support specialists, and more than 350 third-party sales agents. As of June 30, 2025, our U.S. commercial organization comprised of more than 160 sales team members, including territory sales managers and clinical support specialists, and 295 third-party sales agents.
Current wording
Our commercial growth is driven by expansion of our sales organization, increased surgical capacity, and broader site-of-service adoption. As of September 30, 2026, our U.S. commercial organization comprised of more than 180 sales team members, including territory sales managers and clinical support specialists, and more than 375 third-party sales agents. As of September 30, 2025, our U.S. commercial organization comprised of more than 170 sales team members, including territory sales managers and clinical support specialists, and more than 300 third-party sales agents.
Previous wording
As of June 30, 2026, our international commercial organization included 10 direct sales representatives and 31 third-party sales agents and resellers, compared to 10 direct sales representatives and 29 third- party sales agents and resellers as of June 30, 2025.
Current wording
As of September 30, 2026 and September 30, 2025, our international commercial organization included 10 direct sales representatives and 30 third-party sales agents and resellers.
Previous wording
Our expanded platform allows us to serve our physicians across all sites of care. Over 35 percent of U.S. sacroiliac joint procedures were performed in ambulatory surgical center (“ASC”) and office-based lab (“OBL”) settings during the quarter.
Current wording
Our expanded platform allows us to serve our physicians across all sites of care. Over 40 percent of U.S. sacroiliac joint procedures were performed in ambulatory surgical center (“ASC”) and office-based lab (“OBL”) settings during the quarter.
Previous wording
We are focused on increasing our territory sales managers’ capacity, efficiency and productivity. We may do this by adding more clinical support specialists and third-party sales agents as part of hybrid arrangements for case coverage, and by consigning instrument trays and implants at selective sites of service. As of June 30, 2026, our trailing twelve month average revenue per territory sales manager has increased to approximately $2.2 million from $2.1 million as of June 30, 2025.
Current wording
We are focused on increasing our territory sales managers’ capacity, efficiency and productivity. We may do this by adding more clinical support specialists and third-party sales agents as part of hybrid arrangements for case coverage, and by consigning instrument trays and implants at selective sites of service. As of September 30, 2026, our trailing twelve month average revenue per territory sales manager has increased to approximately $2.3 million from $2.1 million as of September 30, 2025.
Previous wording
We have made significant investments in instrument trays and implants to support procedural growth. We continue to focus on improving capital efficiency through optimized inventory management and maximize our asset utilization by having our instrument trays used in more surgeries in any given time period. We routinely work with our suppliers to improve supply chain efficiency, lower manufacturing costs and reduce our cash investment in inventory.
Current wording
We have made significant investments in instrument trays and implants to support procedural growth. We continue to focus on improving capital efficiency through optimized inventory management and maximizing our asset utilization by having our instrument trays used in more surgeries in any given time period. We routinely work with our suppliers to improve supply chain efficiency, lower manufacturing costs and reduce our cash investment in inventory.
Previous wording
Interest expense is primarily related to borrowings, amortization of debt issuance costs, and accretion of final fees on the First-Citizens Fourth Amended Loan Agreement.
Current wording
Interest expense is primarily related to borrowings, amortization of debt issuance costs, and accretion of final fees on the First-Citizens Fifth Amended Loan Agreement.
Previous wording
Revenue. The increase in revenue for the three months ended June 30, 2026 as compared to the three months ended June 30, 2025 was primarily driven by a $6.8 million increase in U.S. revenue due to 14.9% increase in procedure volumes, increased sales channel coverage, and continued growth in ASC and OBL settings.
Current wording
Revenue. The increase in revenue for the three months ended September 30, 2026 as compared to the three months ended September 30, 2025 was primarily driven by a $6.4 million increase in U.S. revenue due to increased sales channel coverage, and 19.5% increase in procedure volumes, including strong growth in demand from interventional spine physicians in the ASC and OBL settings.
Previous wording
Gross Profit and Gross Margin. Gross profit increased $5.7 million for the three months ended June 30, 2026 as compared to the three months ended June 30, 2025, mainly driven by higher revenue. The gross margin was 79.5% for the three months ended June 30, 2026 compared to a gross margin of 79.8% for the three months ended June 30, 2025 due to changes in product mix.
Current wording
Gross Profit and Gross Margin. Gross profit increased $5.3 million for the three months ended September 30, 2026 as compared to the three months ended September 30, 2025, mainly driven by higher revenue. The gross margin was 79.3% for the three months ended September 30, 2026 compared to a gross margin of 79.8% for the three months ended September 30, 2025 due to changes in site of care and procedure mix.
Previous wording
Sales and Marketing Expenses. The increase in sales and marketing expenses for the three months ended June 30, 2026 as compared to the three months ended June 30, 2025 was primarily due to a $2.5 million increase in commissions and personnel cost driven by higher revenues and increase in headcount, and a $1.1 million increase related to travel, training and marketing activities, partially offset by a decrease of $0.4 million related to stock-based compensation.
Current wording
Sales and Marketing Expenses. The increase in sales and marketing expenses for the three months ended September 30, 2026 as compared to the three months ended September 30, 2025 was primarily due to a $2.8 million increase in commissions and personnel cost driven by higher revenues and increase in headcount, and a $1.3 million increase related to travel, training and marketing activities, partially offset by a decrease of $0.3 million related to stock-based compensation.
Previous wording
Research and Development Expenses. The increase in research and development expenses for the three months ended June 30, 2026 as compared to the three months ended June 30, 2025 was primarily due to a $0.9 million increase in next generation product development activities, clinical and regulatory initiatives.
Current wording
Research and Development Expenses. The increase in research and development expenses for the three months ended September 30, 2026 as compared to the three months ended September 30, 2025 was primarily due to a $0.3 million increase in next generation product development activities, clinical and regulatory initiatives.
Previous wording
Interest Expense. The decrease in interest expense for the three months ended June 30, 2026 as compared to the three months ended June 30, 2025 was due to lower interest rates associated with the First-Citizens Fourth Amended Loan Agreement.
Current wording
Interest Expense. The decrease in interest expense for the three months ended September 30, 2026 as compared to the three months ended September 30, 2025 was due to lower interest rates associated with the First-Citizens Fifth Amended Loan Agreement.
Previous wording
Revenue. The increase in revenue for the six months ended June 30, 2026 as compared to the six months ended June 30, 2025 was primarily driven by an $11.3 million increase in U.S. revenue driven by 12.3% increase in procedure volumes, supported by expanded adoption of our product portfolio, increased sales channel coverage, and continued growth in ASC and OBL settings.
Current wording
Revenue. The increase in revenue for the nine months ended September 30, 2026 as compared to the nine months ended September 30, 2025 was primarily driven by a $17.7 million increase in U.S. revenue driven by 14.7% increase in procedure volumes, supported by expanded adoption of our product portfolio and increased sales channel coverage.
Previous wording
Gross Profit and Gross Margin. Gross profit increased $10.0 million for the six months ended June 30, 2026 as compared to the six months ended June 30, 2025, mainly driven by higher revenue. The gross margin was 79.6% for the six months ended June 30, 2026 as compared to 79.8% for the six months ended June 30, 2025. Gross margin change in the six months ended June 30, 2026 as compared to the six months ended June 30, 2025, was primarily due to changes in product mix.
Current wording
Gross Profit and Gross Margin. Gross profit increased $15.3 million for the nine months ended September 30, 2026 as compared to the nine months ended September 30, 2025, mainly driven by higher revenue. The gross margin was 79.5% for the nine months ended September 30, 2026 as compared to 79.8% for the nine months ended September 30, 2025. Gross margin change in the nine months ended September 30, 2026 as compared to the nine months ended September 30, 2025, was primarily due to changes in site of care and procedure mix.
Previous wording
Sales and Marketing Expenses. The increase in sales and marketing expenses for the six months ended June 30, 2026 as compared to the six months ended June 30, 2025 was primarily due to a $3.3 million increase in commissions and personnel costs driven by higher revenues, a $2.7 million increase in travel, training and marketing activities, partially offset by a decrease of $0.8 million related to stock-based compensation.
Current wording
Sales and Marketing Expenses. The increase in sales and marketing expenses for the nine months ended September 30, 2026 as compared to the nine months ended September 30, 2025 was primarily due to a $6.2 million increase in commissions and personnel costs driven by higher revenues, a $3.9 million increase in travel, training and marketing activities, partially offset by a decrease of $1.1 million related to stock-based compensation.
Previous wording
Research and Development Expenses. The increase in research and development expenses for the six months ended June 30, 2026 as compared to the six months ended June 30, 2025 was primarily due to $0.6 million increase in next generation product development activities, clinical and regulatory initiatives.
Current wording
Research and Development Expenses. The increase in research and development expenses for the nine months ended September 30, 2026 as compared to the nine months ended September 30, 2025 was primarily due to $0.9 million increase in next generation product development activities, clinical and regulatory initiatives.
Previous wording
General and Administrative Expenses. The decrease in general and administrative expenses for the six months ended June 30, 2026 as compared to the six months ended June 30, 2025 was primarily due to a $0.9 million decrease in professional service costs, partially offset by $0.4 million increase in personnel costs and stock-based compensation.
Current wording
General and Administrative Expenses. The decrease in general and administrative expenses for the nine months ended September 30, 2026 as compared to the nine months ended September 30, 2025 was primarily due to a $0.9 million decrease in professional service costs, partially offset by $0.4 million increase in personnel costs.
Previous wording
Interest Income. The decrease in interest income for the six months ended June 30, 2026 as compared to the six months ended June 30, 2025 was primarily due to lower interest earned on our investments in marketable securities, primarily as a result of lower interest rates.
Current wording
Interest Income. The decrease in interest income for the nine months ended September 30, 2026 as compared to the nine months ended September 30, 2025 was primarily due to lower interest earned on our investments in marketable securities, primarily as a result of lower interest rates.
Previous wording
Interest Expense. The decrease in interest expense for the six months ended June 30, 2026 as compared to the six months ended June 30, 2025 was primarily due to lower interest rates associated with the First-Citizens Fourth Amended Loan Agreement.
Current wording
Interest Expense. The decrease in interest expense for the nine months ended September 30, 2026 as compared to the nine months ended September 30, 2025 was primarily due to lower interest rates associated with the First-Citizens Fifth Amended Loan Agreement.
Previous wording
Other Income (Expense), Net. The change in other income (expense), net for the six months ended June 30, 2026 as compared to the six months ended June 30, 2025 was primarily due to foreign currency fluctuations.
Current wording
Other Income (Expense), Net. The change in other income (expense), net for the nine months ended September 30, 2026 as compared to the nine months ended September 30, 2025 was primarily due to foreign currency fluctuations.
Previous wording
As of June 30, 2026, we had cash and marketable securities of $145.9 million as compared to $147.8 million as of December 31, 2025. We have financed our operations primarily through the sale of our common stock in our public offerings and debt financing arrangements. As of both June 30, 2026 and December 31, 2025, we had $35.6 million in outstanding debt.
Current wording
We have financed our operations primarily through the sale of our common stock in our public offerings and debt financing arrangements. As of September 30, 2026, we had $35.7 million in outstanding debt as compared to $35.6 million as of December 31, 2025.
Previous wording
As of June 30, 2026, we had an accumulated deficit of $458.7 million as compared to $450.3 million as of December 31, 2025. During the six months ended June 30, 2026, we incurred a net loss of $8.4 million. During the years ended December 31, 2025 and 2024, we incurred a net loss of $18.9 million and $30.9 million, respectively, and expect to incur additional losses in the future. We have not achieved positive cash flow from operations for the six months ended June 30, 2026.
Current wording
As of September 30, 2026, we had an accumulated deficit of $462.3 million as compared to $450.3 million as of December 31, 2025. During the nine months ended September 30, 2026, we incurred a net loss of $12.0 million. During the years ended December 31, 2025 and 2024, we incurred a net loss of $18.9 million and $30.9 million, respectively, and expect to incur additional losses in the future.
Previous wording
Based upon our current operating plan and improved cash flow from operations, we believe that our existing cash and marketable securities will enable us to fund our operating expenses and capital expenditure requirements over the next 12 months from the filing of this Form 10-Q. However, the financial impact of a potential economic downturn or capital market disruptions pose risks to uncertainties in our future available capital resources. We may face challenges and uncertainties and, as a result, may need to raise additional capital as our available capital resources may be consumed more rapidly than currently expected due to, but not limited to (a) decreases in sales of our products and the uncertainty of future revenues from new products; (b) changes we may make to the business that affect ongoing operating expenses; (c) changes we may make in our business strategy; (d) regulatory and reimbursement developments affecting our existing products; (e) changes we may make in our research and development spending plans; and (f) other items affecting our forecasted level of expenditures and use of cash resources. In addition, as we seek to deploy new product offerings, the need for additional capital to fund the purchase of inventories of implants and instrument trays may become more acute and may limit the number of revenue opportunities that we pursue. Each new product family introduced typically requires the purchase of consumable implant inventory as well as investment in a fleet of instrument trays required to support procedures nationwide.
Current wording
Based upon our current operating plan and improved cash flow from operations, we believe that our existing cash and marketable securities will enable us to fund our operating expenses and capital expenditure requirements over the next 12 months from the filing of this Form 10-Q. However, the financial impact of a potential economic downturn or capital market disruptions poses risks and uncertainties to our future available capital resources. We may face challenges and uncertainties and, as a result, may need to raise additional capital as our available capital resources may be consumed more rapidly than currently expected due to, but not limited to (a) decreases in sales of our products and the uncertainty of future revenues from new products; (b) changes we may make to the business that affect ongoing operating expenses; (c) changes we may make in our business strategy; (d) regulatory and reimbursement developments affecting our existing products; (e) changes we may make in our research and development spending plans; and (f) other items affecting our forecasted level of expenditures and use of cash resources. In addition, as we seek to deploy new product offerings, the need for additional capital to fund the purchase of inventories of implants and instrument trays may become more acute and may limit the number of revenue opportunities that we pursue. Each new product family introduced typically requires the purchase of consumable implant inventory as well as investment in a fleet of instrument trays required to support procedures nationwide.
Previous wording
(1)Represents the principal obligations of our First-Citizens Fourth Amended Loan Agreement.
Current wording
(1)Represents the principal obligations of our First-Citizens Fifth Amended Loan Agreement.
Previous wording
(2)Represents the future interest obligations on our First-Citizens Fourth Amended Loan Agreement estimated using an interest rate of 6.25% as of June 30, 2026.
Current wording
(2)Represents the future interest obligations on our First-Citizens Fifth Amended Loan Agreement estimated using an interest rate of 6.50% as of September 30, 2026.
Previous wording
Significant changes in net operating assets during the six months ended June 30, 2026 included higher inventory levels to support new product introductions, higher accounts receivable due to timing of sales and cash collections, and lower accrued liabilities and higher accounts payable balance due to the timing of payments. Non-cash charges consisted primarily of stock-based compensation and depreciation.
Current wording
Significant changes in net operating assets during the nine months ended September 30, 2026 included higher inventory levels to support new product introductions, higher accounts receivable due to timing of sales and cash collections, and lower accrued liabilities and higher accounts payable balance due to the timing of payments. Non-cash charges consisted primarily of stock-based compensation and depreciation.
Previous wording
Net cash used in investing activities in the six months ended June 30, 2026 was $9.0 million as compared to cash provided by investing activities of $1.2 million in the six months ended June 30, 2025. Net cash used in investing activities for the six months ended June 30, 2026 consisted of a $6.3 million cash outflow from purchase of our marketable securities net of maturities, and $2.6 million purchases of property and equipment primarily related to individual components in instrument sets to support revenue growth and leasehold improvement assets for our new corporate office. Net cash provided by investing activities for the six months ended June 30, 2025 consisted of a $5.3 million cash inflow from maturities of our marketable securities net of purchases, and $4.2 million purchases of property and equipment primarily related to individual components in instrument sets to support revenue growth.
Current wording
Net cash used in investing activities in the nine months ended September 30, 2026 was $13.1 million as compared to net cash used in investing activities of $8.9 million in the nine months ended September 30, 2025. Net cash used in investing activities for the nine months ended September 30, 2026 consisted of a $4.1 million cash outflow from purchase of our marketable securities net of maturities, and $9.0 million purchases of property and equipment primarily related to individual components in instrument sets to support revenue growth and leasehold improvement assets for our new corporate office. Net cash used in investing activities for the nine months ended September 30, 2025 consisted of a $1.7 million cash outflow from purchase of marketable securities net of maturities, and $7.1 million purchases of property and equipment primarily related to individual components in instrument sets to support revenue growth.
Previous wording
Cash provided by financing activities in the six months ended June 30, 2026 and 2025 was $1.7 million and $2.3 million, respectively, resulting from the issuance of common stock under our stock-based incentive compensation plans.
Current wording
Cash provided by financing activities in the nine months ended September 30, 2026 and 2025 was $2.0 million and $2.3 million, respectively, resulting from the issuance of common stock under our stock-based incentive compensation plans.
Previous wording
Our critical accounting policies and estimates are described in “Management's Discussion and Analysis of Financial Condition and Results of Operations - Critical Accounting Policies, Significant Judgments, and Use of Estimates” in our 2025 Annual Report. There had been no material changes to the descriptions of these accounting policies, judgments and estimates.
Current wording
Our critical accounting policies and estimates are described in “Management's Discussion and Analysis of Financial Condition and Results of Operations - Critical Accounting Policies, Significant Judgments, and Use of Estimates” in our 2025 Annual Report. There have been no material changes to the descriptions of these accounting policies, judgments and estimates.
Rearranged previous paragraphs (1)
Previous report — wording carried elsewhere
General and Administrative Expenses. The decrease in general and administrative expenses for the three months ended June 30, 2026 compared to the three months ended June 30, 2025 was primarily due to a $0.3 million decrease in personnel costs and stock-based compensation and a $0.3 million decrease in professional service costs.