ATEC to Report Second Quarter 2026 Financial Results on August 4, 2026

CARLSBAD, Calif.,February 27,2024–AlphatecHoldings, Inc. (Nasdaq: ATEC), a provider of innovative solutions dedicated to revolutionizing the approach to spine surgery,today announced financial results for the quarterand full yearendedDecember 31,2023, andbusinesshighlights.

FourthQuarterand Full Year2023FinancialResults

| Quarter EndedDecember 31,2023 | Year EndedDecember 31,2023

Total revenue | $138 million | $482 million

GAAP gross margin | 69.0% | 64.3%

Non-GAAPgross margin(prior definition)* | 72.9% | 72.6%

Non-GAAPgross margin(updated definition)* | 69.7% | 69.8%

Operating expenses | $140million | $484million

Non-GAAP operating expenses | $106million | $387 million

GAAP operating loss | ($49) million | ($187) million

Non-GAAP adjusted EBITDA(prior definition)* | $6 million | $4 million

Non-GAAP adjusted EBITDA(updated definition)* | $2 million | ($9) million

Endingcashbalance | $221 million

Quarter Ended

December 31,2023

Year Ended

December 31,2023

Total revenue

$138 million

$482 million

GAAP gross margin

69.0%

64.3%

Non-GAAPgross margin(prior definition)*

72.9%

72.6%

Non-GAAPgross margin(updated definition)*

69.7%

69.8%

Operating expenses

$140million

$484million

Non-GAAP operating expenses

$106million

$387 million

GAAP operating loss

($49) million

($187) million

Non-GAAP adjusted EBITDA(prior definition)*

$6 million

$4 million

Non-GAAP adjusted EBITDA(updated definition)*

$2 million

($9) million

Endingcashbalance

$221 million

*Refer to discussion ofupdated non-GAAP financialdefinition.Numbers and percentages may not foot due to rounding.

PatMiles, Chairman and Chief Executive Officer, said,"The success we’ve achieved to dateistestament: ATEC lateral sophistication, alone, is capable of building a good, profitablecompany.But we aspire for much more.We are building a spine monster,and the informatics andproceduralinnovation thatour 100% spine-focusedknowhow willunleashin the years aheadwill further ourmissiontotrulyrevolutionize spine care.We are all systems go in the pursuit of ATEC’s best, whichis yet to come."

The Company is updating its non-GAAP financial measuresto include thenon-cashimpact ofthe provisionfor excess and obsolete inventory(“E&O”)in thecalculation of Cost of Goods Sold. With the majority ofATEC’sstrategic portfolio transformation complete, the Company has determined thatE&O chargesarea normal and recurring aspect of operating the business andshould be included in the assessment of operating performance.  For detail on the impact of this reporting change on previously reported periodsand 2024 guidance, areconciliation of non-GAAP financial measures under both the updated and prior definitions has been included in this release and ontheInvestor Relations Sectionof ATEC’s Corporate Website.

The Companycontinues toexpect total revenue for the fiscal year ended December 31, 2024, to approximate $595million, reflecting growth of approximately23% compared to2023.This includessurgicalrevenue of$530millionand approximately $65million ofEOSrevenue.The Company expectsfull year 2024non-GAAP adjusted EBITDAto approximate $22million, which implies560basis points ofimprovement in adjusted EBITDA margin compared to full year 2023. Under the prior non-GAAP financial definition, adjusted EBITDA guidance would have approximated $40 million.

The Company will host a live webcasttodayat 1:30 p.m. PT / 4:30 p.m. ET.To access the live webcast, please visit theInvestor Relations Sectionof ATEC’s Corporate Website.To dial intothelive webcast, please registeratthis link.  Access details will be shared via email.A replay of the webcast will be available beginningapproximatelytwo hours after the webcast’s completionthroughMarch5, 2024.Access thereplaybydialing(800)770-2030 and referencingconference ID number97241.

To supplement the Company’s financial statements presented in accordance with generally accepted accounting principlesin the United States of America(“GAAP”), the Company reports certain non-GAAP financial measures, including non-GAAP gross margin, non-GAAP operating expenses, non-GAAP operating loss, and non-GAAPadjustedEBITDA. The Company believes that these non-GAAP financial measures provide investors with an additional tool for evaluating the Company's core performance, which management uses in its own evaluation of continuing operating performance, and a baseline for assessing the future earnings potential of the Company. The Company’s non-GAAP financial measures may not provide information that is directly comparable to that provided by other companies in the Company’s industry, as other companies in the industry may calculate non-GAAP financial results differently, particularly related to non-recurring, unusual items. Non-GAAP financial results should be considered in addition to, and not as a substitute for, or superior to, financial measures calculated in accordance with GAAP. Included below are reconciliations of the non-GAAP financial measures to the comparable GAAP financial measuresand a discussion of the Company’s non-GAAP definitions.We have not reconciled our adjusted operating expenses and adjusted EBITDA estimates for full year 2024 because certain items that impact these figures are uncertain or out of our control and cannot be reasonably predicted. Accordingly, a reconciliation of 2024 adjusted operating expenses and adjusted EBITDA estimates is not available without unreasonable effort.

As an inducement material to accepting employment with the Company, and in accordance with Nasdaq Listing Rule 5635(c)(4), ATEC today announced that the independent Compensation Committee of the Board of Directors has approved aggregate grants to 22 new employees (who are not executive officers) of, collectively, 31,780 restricted stock units (“RSUs”) under the Company’s 2016 Employment Inducement Award Plan. The RSUs will vest in equal annual installments on each of the first four anniversaries of the grant date, provided that the recipient remains continuously employed by ATEC as of such vesting date. In addition, the RSUs will vest fully upon a change of control of ATEC.

ATEC, through its wholly owned subsidiaries, Alphatec Spine, Inc., EOS imaging S.A.S.and SafeOpSurgical, Inc., is a medical device company dedicated to revolutionizing the approach to spine surgery through clinical distinction. ATEC’s Organic InnovationMachineTMis focused on developing new approaches that integrate seamlessly with the Company’s expandingAlphaInformatiXPlatform to better inform surgery and more safely and reproducibly achieve the goals of spine surgery. ATEC’s vision is to become the Standard Bearer in Spine. For more information, visit us atwww.atecspine.com.

This press release contains "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995 that involve risks and uncertainty. Such statements are based on management's current expectations and are subject to a number of risks and uncertainties that could cause actual results to differ materially from those described in the forward-looking statements. The Company cautions investors that there can be no assurance that actual results will not differ materially from those projected or suggested in such forward-looking statements as a result of various factors. Forward-looking statements include, but are not limited to: references to the Company’s revenue, balance sheet, growth and financial outlook; planned product launches, introductions, regulatory submissions or clearances; efforts to transform sales and distribution channels; the Company’s ability to compel surgeon adoption; and the Company’s future ability to finance its operations and sufficiency of its cash runway. Important factors that could cause actual operating results to differ significantly from those expressed or implied by such forward-looking statements include, but are not limited to: the uncertainty of success in developing new products or products currently in the pipeline; the uncertainties in the Company’s ability to execute upon its strategic operating plan; the uncertainties regarding the ability to successfully license or acquire new products, and the commercial success of such products; failure to achieve acceptance of the Company’s products by the surgeon community; failure to obtain FDA or other regulatory clearance or approval or unexpected or prolonged delays in the process; continuation of favorable third-party reimbursement; unanticipated expenses or liabilities or other adverse events affecting cash flow or the Company’s ability to achieve profitability; uncertainty of additional funding; the Company’s ability to compete with other products or with emerging technologies; product liability exposure; an unsuccessful outcome in any litigation; patent infringement claims; claims related to the Company’s intellectual property; and the Company’s ability to meet its financial obligations. A further list and description of these and other factors, risks and uncertainties can be found in the Company's most recent annual report, and any subsequent quarterly and current reports, filed with the Securities and Exchange Commission. ATEC disclaims any intention or obligation to update or revise any forward-looking statements, whether as a result of new information, future events, or otherwise, unless required by law.

| Three Months Ended | Year Ended

| December 31, | December 31,

| 2023 | 2022 | 2023 | 2022

| (unaudited) |

Revenue: | | | |

Revenue from products and services | $137,970 | $105,944 | $482,262 | $350,852

Revenue from international supply agreement | — | — | — | 15

Total revenue | 137,970 | 105,944 | 482,262 | 350,867

Cost of sales | 42,780 | 37,093 | 72,059 | 117,808

Gross profit | 95,190 | 68,851 | 310,203 | 233,059

Operating expenses: | | | |

Research and development | 22,284 | 11,604 | 70,115 | 44,033

Sales, general and administrative | 104,120 | 81,920 | 374,080 | 300,013

Litigation-related expenses | 9,472 | 7,314 | 22,287 | 23,943

Amortization of acquired intangible assets | 3,823 | 2,934 | 14,284 | 10,115

Transaction-related expenses | (65) | — | 113 | 120

Restructuring expenses | 386 | 106 | 719 | 1,810

Total operating expenses | 140,020 | 103,878 | 483,598 | 380,034

Operating loss | (44,830) | (35,027) | (173,395) | (146,975)

Interest expense and other expense, net: | | | |

Interest expense, net | (4,416) | (1,329) | (16,641) | (5,505)

Other income (expense), net | 44 | 1,049 | 3,121 | 471

Total interest expense and other expense, net | (4,372) | (280) | (13,520) | (5,034)

Net loss before taxes | (49,202) | (35,307) | (186,915) | (152,009)

Income tax benefit | (124) | (524) | (277) | (716)

Net loss | $(49,078) | $(34,783) | $(186,638) | $(151,293)

Net loss per share, basic and diluted | $(0.37) | $(0.33) | $(1.54) | $(1.46)

Weighted average shares outstanding, basic and diluted | 133,750 | 105,858 | 121,242 | 103,373

Stock-based compensation included in: | | | |

Cost of sales | $481 | $1,157 | $25,082 | $2,597

Research and development | 9,154 | 1,029 | 18,741 | 5,016

Sales, general and administrative | 10,880 | 906 | 37,421 | 32,943

| $20,515 | $10,092 | $81,244 | $40,556

| December 31,2023 | December 31,2022

ASSETS

Current assets: | |

Cash and cash equivalents | $220,970 | $84,696

Accounts receivable, net | 72,613 | 60,060

Inventories | 136,842 | 101,521

Prepaid expenses and other current assets | 20,666 | 9,357

Total current assets | 451,091 | 255,634

Property and equipment, net | 149,835 | 101,952

Right-of-use assets | 26,410 | 28,360

Goodwill | 73,003 | 47,367

Intangible assets, net | 102,451 | 82,781

Other assets | 2,418 | 4,874

Total assets | $805,208 | $520,968

LIABILITIES AND STOCKHOLDERS' DEFICIT

Current liabilities: | |

Accounts payable | $48,985 | $34,742

Accrued expenses and other current liabilities | 87,712 | 72,382

Contract liabilities | 13,910 | 11,956

Short-term debt | 1,808 | 14,948

Current portion of operating lease liabilities | 5,159 | 4,842

Total current liabilities | 157,574 | 138,870

Total long-term liabilities | 545,915 | 393,162

Redeemable preferred stock | 23,603 | 23,603

Stockholders' deficit | 78,116 | (34,667)

Total liabilities and stockholders' deficit | $805,208 | $520,968

| Three Months Ended | Year Ended

| December 31, | December 31,

| 2023 | 2022 | 2023 | 2022

(unaudited) | |

Gross profit, GAAP | $95,190 | $68,851 | $310,203 | $233,059

Add: amortization of intangible assets | 278 | 27 | 939 | 64

Add: stock-based compensation | 481 | 1,157 | 25,082 | 2,597

Add: purchase accounting adjustments on acquisitions | 198 | 565 | 393 | 1,349

Non-GAAP gross profit | $96,147 | $70,600 | $336,617 | $237,069

Add: excess and obsolete write-down | 4,420 | 2,769 | 13,608 | 9,792

Non-GAAP gross profit adjusted for excess and obsolete write-down | $100,567 | $73,369 | $350,225 | $246,861

Gross margin, GAAP | 69.0% | 65.0% | 64.3% | 66.4%

Add: amortization of intangible assets | 0.2% | 0.0% | 0.2% | 0.0%

Add: stock-based compensation | 0.3% | 1.1% | 5.2% | 0.7%

Add: purchase accounting adjustments on acquisitions | 0.1% | 0.5% | 0.1% | 0.4%

Non-GAAP gross margin | 69.7% | 66.6% | 69.8% | 67.6%

Add: excess and obsolete write-down | 3.2% | 2.6% | 2.8% | 2.8%

Non-GAAP gross margin adjusted for excess and obsolete write-down | 72.9% | 69.3% | 72.6% | 70.4%

| Three Months Ended | Year Ended

| December 31, | December 31,

| 2023 | 2022 | 2023 | 2022

(unaudited) | |

Operating expenses, GAAP | $140,020 | $103,878 | $483,598 | $380,034

Adjustments: | | | |

Stock-based compensation | (20,034) | (8,935) | (56,162) | (37,959)

Litigation-related expenses | (9,472) | (7,314) | (22,287) | (23,943)

Amortization of intangible assets | (3,823) | (2,934) | (14,284) | (10,115)

Transaction-related expenses | 65 | — | (2,113) | (120)

Restructuring expenses | (386) | (106) | (719) | (1,810)

Other non-recurring expenses1 | — | — | (1,349) | —

Non-GAAP operating expenses | $106,370 | $84,589 | $386,684 | $306,087

| Three Months Ended | Year Ended

| December 31, | December 31,

| 2023 | 2022 | 2023 | 2022

(unaudited) | |

Operating loss, GAAP | $(44,830) | $(35,027) | $(173,395) | $(146,975)

Depreciation | 11,918 | 8,388 | 40,916 | 30,989

Amortization of intangible assets | 4,101 | 2,961 | 15,223 | 10,179

EBITDA | (28,811) | (23,678) | (117,256) | (105,807)

Add back significant items: | | | |

Stock-based compensation | 20,515 | 10,092 | 81,244 | 40,556

Purchase accounting adjustments on acquisitions | 198 | 565 | 393 | 1,349

Litigation-related expenses | 9,472 | 7,314 | 22,287 | 23,943

Transaction-related expenses | (65) | — | 2,113 | 120

Restructuring expenses | 386 | 106 | 719 | 1,810

Other non-recurring expenses1 | — | — | 1,349 | —

Adjusted EBITDA | $1,695 | $(5,601) | $(9,151) | $(38,029)

Excess & obsolete write-down | 4,420 | 2,769 | 13,608 | 9,792

Adjusted EBITDA adjusted for excess & obsolete write-down | $6,115 | $(2,832) | $4,457 | $(28,237)

1Non-recurring consulting fees associated with the implementation of our state tax-planning strategy

Represents amortization expense in connection with business combinations or asset acquisitions associated with acquired intangible assets including, but not limited to customer relationships, intellectual property and trade names.

We are involved in various litigation matters that from time-to-time result in settlements. Litigation matters can vary in their characteristics, frequency and significance to our operating results and core business operations. We review litigation matters from both a qualitative and quantitative perspective to determine whether such matters are a normal and recurring part of our business. We include in our GAAP financial statements litigation fees and settlement expenses that we determine to be normal, recurring and routine to our business. When we determine that certain litigation matters are not normal and recurring to our core business operations, we believe excluding these expenses will provide our management and investors with useful incremental information. Litigation fees and settlement expenses excluded from our non-GAAP financial measures in the periods presented relate primarily to patent litigation and other litigation matters that relate directly to the business transformation that we started in 2018 and are discussed more fully in our periodic reports filed with the Securities Exchange Commission.

These expenses represent non-recurring expenses that we consider to be one-time in nature.

Includes non-cash expenses incurred as a result of fair value asset step-ups associated with tangible assets acquired from business combinations or asset acquisitions.

From time-to-time, in order to realign the Company’s operations or to achieve synergies associated with an acquisition, the Company may eliminate roles or restructure its operations and footprint. In such cases the Company may incur one-time severance and personnel costs associated with workforce reductions, or costs associated with exiting and/or relocating facilities. We exclude these costs as we do not consider such amounts to be part of the ongoing operations.

Stock-based compensation is charged to cost of revenue and operating expenses. We exclude stock-based compensation from certain of our non-GAAP financial measures because we believe that excluding these non-cash expenses provides meaningful supplemental information regarding operational performance. Because of the variety of equity awards used by companies, the varying methodologies for determining stock-based compensation expense, the subjective assumptions involved in those determinations, and the volatility in valuations that can be driven by market conditions outside the Company’s control, the Company believes excluding stock-based compensation expense enhances the ability of management and investors to understand and assess the underlying performance of its business over time.

These expenses represent one-time costs associated with business combinations and asset acquisitions. These items may include but are not limited to consulting and legal fees, contract termination costs and other related deal costs.

Represents earnings before non-operating income/expense, taxes, depreciation and amortization, as adjusted for the applicable non-GAAP adjustments previously described.