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Surgical revenue growth of 17% was driven by a 23% increase in new surgeon users, validating the company's 'adoption story' over simple utilization.

Management attributed EOS revenue lumpiness to installation timing and construction-related delays rather than a lack of demand, while surgical revenue was impacted by weather, lower biologics attachment, and slower growth in traditional procedures.

Revenue per case declined 3% year-over-year due to a higher mix of lower-ASP cervical procedures, international growth, and lower-than-expected biologics attachment.

The EOS Insight platform is evolving into a 'hunting license' for prestigious institutions, providing access to accounts like HSS and Duke that were previously inaccessible.

Management emphasized that EOS Insight accounts see a 30% revenue lift per surgeon post-adoption, reinforcing the platform's role as a volume multiplier.

Strategic focus remains on 'clinical distinction' in lateral procedures, where the company sees its highest competitive advantage and reproducible success.

The business model is shifting toward a structured data advantage, using EOS imaging to create predictive, quantitative intelligence for surgical planning.

Full-year 2026 revenue guidance was revised to $882 million to reflect realistic near-term EOS performance while maintaining the $805 million surgical revenue target.

The company expects a reacceleration in the second half of 2026, with EOS contributing more meaningfully as sales and marketing reinforcements ramp up.

Guidance for the remainder of the year assumes high-teens surgical volume growth and flattish revenue per procedure as biologics attachment improves.

Management reaffirmed the 2027 long-range plan revenue target of $1 billion, viewing current EOS issues as execution-related 'lumpiness' rather than a thesis failure.

Free cash flow is projected to be at least $20 million for the full year, with Q2 expected to be approximately break-even.

A new $350 million credit facility led by JPMorgan simplifies the capital structure and is expected to reduce interest expense by over $6 million annually.

The company invested $33 million in inventory and instruments during Q1 to support the 20% plus growth in surgeon adoption and sales team expansion.

EOS Edge installed base grew 39% year-over-year, which management views as a critical prerequisite for future EOS Insight software adoption.

Weather-related logistics disruptions in January, specifically affecting FedEx and the Northeast, contributed to the sequential surgical revenue decline.

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Management remains confident in the $1 billion revenue target for 2027 despite the Q1 shortfall.

The EOS issues are viewed as near-term execution gaps in sales and marketing that have already been addressed with new talent.

The 3% decline was driven by mix (cervical and international) and low biologics attachment at 38%.

Management expects biologics attachment to rise in Q2 and Q3 due to 'deformity season,' which involves longer, more complex surgical constructs.

Management clarified that EOS weakness is due to internal execution and site construction timelines, not a broader decline in hospital capital appetite.

The complexity of structural build-outs for EOS units makes revenue recognition timing 'choppy' and less predictable.

The Valence system is trending above internal targets and is being utilized primarily in PTP (Prone TransPsoas) procedures.

Management noted the system's small footprint and seamless workflow integration are driving positive surgeon feedback without disrupting OR efficiency.

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