Aurora Spine Corporation (ASG) Earnings Call Transcript & Summary

Good day, and welcome to the Aurora Spine Second Quarter Financial Year 2025 Results Conference Call. [Operator Instructions] Please note this event is being recorded. I would now like to turn the conference over to Mr. Adam Lowensteiner, Vice President of Lytham Partners. Please go ahead, sir.

Thank you, Chuck. Welcome, everyone, and thank you for joining us today to conduct an update with investors and review the financial results for Aurora Spine for the second quarter fiscal year 2025 that ended June 30, 2025. With us on the call representing the company today are Trent Northcutt, President and CEO; Chad Clouse, Chief Financial Officer; and Matt Goldstone, Chief Commercial Officer. Before we begin, I would like to remind everyone that statements made during the course of this call may be considered forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 as amended and Section 21E of the Securities Act of 1934. These statements reflect current expectations concerning future events and results. Words such as expect, intend, believe, may, will, should, could, anticipate and similar expressions are words that are used to identify forward-looking statements, but their absence does not mean a statement is not forward-looking. These statements are not guarantees of future performance and are subject to risks and uncertainties and other important factors that could cause actual performance or achievements to be materially different from those projected. For a full discussion of these risks, uncertainties and factors, you are encouraged to read Aurora Spine's documents on file with SEDAR, including those set forth in periodic reports filed under the Forward-Looking Statements and Risk Factors section. Aurora Spine does not intend to update or revise any forward-looking statements whether as a result of new information, future events or otherwise. On this call, management may refer to EBITDAC, adjusted EBITDAC, adjusted net income or adjusted EPS, which are not measures of financial performance under generally-accepted accounting principles, or GAAP. Management believes that these non-GAAP figures, in addition to other GAAP measures, provide meaningful supplemental information regarding the company's operational performance. Investors should recognize that these non-GAAP figures might not be comparable to similarly titled measures of other companies. These measures should be considered in addition to, not as a substitute for, or superior to any measure of performance prepared in accordance with GAAP. A reconciliation of non-GAAP measures to the most directly comparable GAAP measures in accordance with the SEC Regulation G can be found in the company's earnings release. With that, I'd like to now turn the call over to Mr. Trent Northcutt, President and Chief Executive Officer of Aurora Spine. Trent, please proceed.

Thank you, Adam. I'd like to welcome everyone to this call to update everyone about Aurora Spine. To lay out the agenda for today's call, I plan on updating everyone on the company's operation and then hand the call over to Chad to review the financials. Afterwards, I will make some brief conclusion remarks, and then open the call to answer any questions you may have. I am pleased with the financial results reported for the second quarter of 2025, which showed an increase in revenues from last year by 10.2% and improved EBITDAC levels from last year's second quarter and first quarter of 2025. The improvements are from the efforts we have been building through our internal sales efforts. While we have more work to do, we are excited about our future and have the right products available to deliver for the best outcomes for patients. We are very busy during the second quarter and we are focused on selling -- to outreach of our existing proprietary products like the ZIP and the SiLO TFX, which continue to make up the majority of the company's revenues. During the quarter, we surpassed some key product milestones with more than 2,500 SiLO SI Joint Fusion products implanted -- being implanted -- sorry, Fusion System products being implanted, over 1,500 surgeries we've done with using the DEXA-C. We also, through -- though made some important strides with our DEXA series, primarily the DEXA-C product, which I'll get into -- which is the DEXA-L product, excuse me, which I'll get into in a few moments. Also keeping us busy in this newly FDA-cleared product is the FACET Joint, which was rebranded the Hydra A.E.R.O., formerly known as just A.E.R.O. The rebranded name will help us with the marketing of the product and create a new family name for other products which we have under the Hydra brand. During the second quarter, we worked very diligently to produce the product for initial surgeries, which commenced shortly after the quarter's close. I'm pleased to share that initial surgeries are continuing and that the product is performing well, and we have taken initial feedback to make any minor adjustments and modifications ahead in the next order of our inventory. We do believe that this product series is revolutionary and has a strong future ahead. We anticipate several doctors to start implanting the product throughout the remainder of the year. We are also eager to share the results of the REFINE study we conducted for our ZIP device, which is used for patients suffering from back pain due to symptomatic degenerative disc disease. The positive results were presented at the ASPN Annual Conference in mid-July by Dr. Steven Falowski in a peer-reviewed discussion titled Functional Outcomes in Low Back Pain Subjects with a Novel Interspinous Fusion Devices. REFINE study 12-month result, the study included results gathering from 11 doctors who -- and who has conducted on behalf of Aurora's to determine the utility of this interspinous fusion device as a standalone therapy for treatment of lumbar spinal stenosis. The treatment of lumbar spinal stenosis is a large unmet treatment need that bridges the gap between conservative measures and minimally invasive surgical procedures. This REFINE study is an exciting validation of Aurora Spine's ZIP device, which has shown to be proven safe and effective outcomes. We are encouraged with the 12-month data collection points that was delivered at ASPN, as well as having data covering a 24-month period, which also showed positive outcomes with patients having no adverse effects. Moving on to another revenue contributor for Aurora is the SiLO platform, which has a series of proprietary products, including the SiLO TFX system, where revenues were $2.64 million in the second quarter, an increase of 32.8% from the second quarter last year. The SiLO TFX series is just 1 of 5 proprietary product platforms that was developed in the past few years and has gained significant attraction in a short amount of time. We believe that we are still in early innings of the SI joint market opportunity and expect TFX to continue to expand market share. We are also pleased to see the new publication on the TFX in the last few months, including one of the evaluated as biomechanics performance compared to traditional posterior transosseous techniques. This demonstrates the TFX's superior performance and leading to a positive patient outcomes. Just a brief update on DEXA. As I mentioned in the last conference call, we have a few newer salespeople that are dedicated to the spine orthopedic market and have been working diligently to open up more hospitals to use DEXA. As a result of these renewed efforts on the surgical spine market, sales in our cervical products, including mostly DEXA-C, showed an increase of 70% during the first half of 2025 over the prior year and nearly $800,000 in revenue. This is definitely refreshing news to share as we demonstrate that we are able to penetrate doctors and have them utilize the DEXA-C. But we're even more excited about the momentum that we are commencing for the DEXA-L, for the lumbar procedure, in the coming weeks. We have high hopes for DEXA-L as subsidence issues occur more frequently in the lumbar section of the spine due to heavier loads that we put on the portion of the spine. We are gearing up and excited about this launch and will update investors as things progress. That concludes my formal comments. I will now turn the conversation over to Chad Clouse, Aurora's CFO, for some commentary on our financials. Chad, please proceed.

Thank you, Trent. The company's financial performance in the second quarter continued to show progress. I'll discuss some highlights. Total revenues for the second quarter of 2025 were approximately $4.5 million, an increase of 10.2% when compared to $4 million in the same period a year ago. Improvements in revenue in 2025 were due to more procedures conducted in the ambulatory surgical and pain centers that incorporated Aurora's products like the ZIP and SiLO TFX. The company targeted pain market with increased marketing, training, new product releases and an increase in sales staff. Moving on to gross margins, which on total revenues were 62.2% in the second quarter, an improvement from 58% for the quarter of 2024 and in line with -- comparable to 62.4% in Q2 of 2025 (sic) [ Q2 of 2024 ]. Gross margin was at a strong level in the quarter, and we believe that level is sustainable, and we will sell more proprietary products. Moving on to operating expenses. Total operating expenses were approximately $3 million for the second quarter of 2025, compared to $2.7 million in the second quarter of 2024. Operating expenses in Q2 2025 included $0.3 million of noncash expenses, compared to $0.2 million noncash expenses in the year during the second quarter. Operating expenses were slightly higher during the current quarter, primarily due to an increase in sales commissions, marketing and insurance, offset by a decrease in G&A expenses and consulting fees. EBITDAC, a non-GAAP, non-IFRS measure, defined as earnings before interest, tax, depreciation and amortization and stock-based compensation, was approximately $142,000 for the second quarter, compared to $106,000 in the second quarter of 2024. EBITDAC was higher than the year-ago results due to increase in revenue levels and strong gross margins from selling more proprietary products. Net loss was $199,000 for the second quarter of 2025, compared to the second quarter of 2024, which was a net loss of $154,000. Basic and diluted net loss/income per share was $0.00 per share in the second quarter of 2025 and $0.00 per share in the second quarter of 2024. Moving to the balance sheet. At the end of the quarter, we ended the quarter with nearly $600,000 in cash. Account receivables were basically flat when compared to first quarter of 2025. Cash collections continue to be a major focus for us as we've been successful on improving collections, especially in older receivables. We have been very diligent in making sure we collect our receivables in a timely fashion. As I mentioned in the past, we've added personnel to assist in improving our collection process. And the majority of the receivables on the balance sheet reflect those of 30 days or less. We believe the capital structure is sufficient to meet our budget needs for the remainder of the year and should continue to improve as we continue to make progress on our collection efforts and experience growth in the business. That concludes my comments. I'll now turn the conversation back to Trent.

Thanks, Chad. To summarize, I'm very proud of our team's efforts and performance in staying focused on building this company. We are positioned to take advantage of the minimally invasive procedures in spine health with many of our new proprietary products. We remain focused on penetrating these markets further in this year through continued training sessions, industry conferences and sharing the updates on the clinical data of our products that we are currently in treating patients. While we are pleased with the quarter's results, we are working diligently to enhance the company's revenue growth. We are very excited about the company's future opportunities and product lines we have brought to market. As we move to focusing on our commercialization efforts, we continue to build the sales team efforts, educate the marketplace of our products and the value they bring to patients. While we are experiencing a time to longer sales cycle to onboard new doctors, we remain committed to our sales efforts and believe that our efforts through continued education and training. We are very excited about the addition of the Hydra A.E.R.O. and the DEXA-L in the back half of the 2025 year, and believe that they both should act as some growth catalysts for the remainder of the year. With that said, operator, we are ready to take any questions.

[Operator Instructions] And the first question will come from Tom Fedichin with Microcap Connection.

Congratulations on a good quarter. Really excited about where the company is moving forward, especially with these new implants coming with the DEXA-L and, of course, the new Facet. Curious if you could talk about how many Facet surgeries you plan on doing in Q3? And maybe give investors an idea as to what the rollout would look like. Will it be similar to what we saw when the SiLO TFX first came out where it was a gradual rollout and the beta phase, make sure, of course, nothing goes wrong? But will we see any sales of significance in Q3? Or will that kind of start to show in Q4 or 2026?

Tom, thanks for joining our call today. Yes, it's very similar to what we did with TFX where we had a minimal amount of sets. In this case, we have 10 surgical kits that we made for the Hydra A.E.R.O. set just to make sure that the tooling was right. And as far as the numbers go, we're more projecting revenues of the product. I know that I said on some recent calls that we were shooting in the first part of the quarter, beginning of Q3, to be able to do $20,000 worth of implants in July, and then $40,000 then $50,000 , another $50,000 then $80,000. That was our conservative approach to these numbers just because we wanted to roll the product in, in just case there was any type of hiccups with some of the instrumentation. There was some mild changes to one of the instruments that you use for prepping the disc base. I've also included on this call, Matt Goldstone. He's on the call with us to be able to answer also additional sales questions. And I'll let Matt comment about A.E.R.O. from his perspective.

Yes, this will be a very similar strategy to the rollout of TFX in which we start off with our alpha phase physicians to make sure to transpoint, everything moves exactly smoothly through every case, and we have the correct outcomes for patients. With that, we are already moving into kind of the limited launch phase with a larger subset of physicians. We have been able to meet our initial targets of what we wanted to do for sales, and we continue to hope to see sales grow throughout the back half of 2025.

Perfect. Will there need to be any additional sales staff to handle the rollout of this? Or will this be something that can easily be trained to the existing regional sales director network that you guys have built?

So we have fortunately a phenomenal sales team that has access to quite a few physicians through previous customer relationships. So we will be rolling it out to the customers that we currently have as well as new customers in their markets. We are also always trying to hire the correct people for a given market. So there'll be a little bit of a few additional head count we look to hope to hire if we find the right people, mixed in with training the team to roll it out to the accounts we currently have. It is a new indication unrelated to the other products we've had in our bag before.

Okay. And from Q3 into Q4, looking forward, do you expect to see -- you're starting off with these 10 kits to start off in Q3. Q4, will that gradually increase as you leave -- enter -- or exit 2025, entering into 2026? What sort of growth will we see in the kit size as we move from quarter-to-quarter?

So with the initial feedback from the sets that we've had, it's all been very positive. And I think we are close to locking the design of the tooling at the moment. And so we will be looking to manufacture more sets and hopefully have those towards the beginning of next year.

And we'll put the forecast to CapEx on that in the -- going into the fourth quarter. The time to delivery of these sets is not lengthy, so we feel confident in getting more instrument sets out as needed.

Wonderful. Moving on to the DEXA-C. Sales have increased. It's great to see. Can you elaborate on what has led to sales growth? I know you've said you put more sales efforts into pushing the DEXA-C product into the market? And you brought on, I believe, Ron Eckstein, I think might be his name. Can you elaborate on what has led to the increased sales? And will this continue to improve?

Absolutely, yes. Ron Eckels has done a great job of coming on and reengaging a lot of new neurosurgeon and orthosurgeon customers in the market. So we've seen an increase in the number of customers substantially. We've also worked diligently to pair DEXA-C with a quality plate. So that way we can establish the whole procedural share for that customer. And with that, we've seen a great response from the physicians that have used the product thus far.

I will add to Matt's comment on that, just to give a note to questions that we are having a retooling of our cervical plate, which is the Apollo Cervical Plate, that we've had to readjust the locking mechanism in the manufacturing process. That slowed down some of our sales with the cervical plate, the Apollo plate. And that is something that the company is now working to get out and solve that issue that we had with it as fast as possible. And the internal engineering team and manufacturing team are working on that diligently. But I wanted to bring that up as a note.

Okay. You have the Hydra pedicle screws that came on out, I believe, maybe was it Q1 they first entered the market? Somewhere in that time frame. Can you speak about the success of that? Have you gained some traction from the Hydra screws? And are you seeing the growth that you expected from that? I know it wasn't mentioned in the press release.

No, we're not seeing it yet because where we are with the Hydra and the Hydra Osteo Onyx lumbar screw, essentially we're replacing the third-party product that we had as a screw. So we're trying to integrate that system into those locations for that evaluation period. Would I like to see it increase more? Yes, I would. It's not currently hitting the clip that we would like to see it at. It is performing very well. So with that, I'm encouraged. But as far as like the current tracking of those revenues, it's not hitting the mark that I wanted to hit just yet. And we're putting all our efforts into the Hydra screw system and the Osteo Onyx screw system with a renewed focus here going into the fourth quarter.

Okay. And speaking of the TFX, have you seen sales start to increase? I know you had mentioned that, on previous calls, that there was a little bit of a lull in the sales. They're still good, but there was a little bit of a lull. Have you started to see an uptick? We know last year, Q3 was the strongest quarter of the year. Are we seeing kind of a carry-on on a comparative basis to last year in Q3 so far this quarter that you've just entered?

Yes. Q3 has started to look very good for SI Fusion. As you look at kind of the numbers through last year into this year, we always see the Q1, Q2 kind of build up, and then Q3, Q4 be stronger just due to the nature of -- the cyclical nature of the business. But in Q2 of this year, we did $2.1 million in SI Fusion portfolio, between SiLO and SiLO TFX, which would be ahead of last year at $1.7 million.

Good. Fantastic. Congratulations on that. That's good to hear. Can you speak to any surprises that you see as -- that's popped up, whether positive or negative, with the company? Obviously, there's many things going on in the business from VA to -- Veterans Affairs, which isn't a big portion of your business, and overall, that is. But there's many different facets where business is coming from, whether it be a regional area that's giving you more sales in another area, or certain regional sales directors that's giving you more sales, what sort of surprises have you seen?

I think overall we've just been very encouraged by the movement in the interventional spine market, watching all the other companies invest and move strategically focused on that market. There's been a lot of new companies wanting to take their position in that market, which gives us indication that, that place will continually grow.

Okay. And last question is more on the rollout of your regional sales directors. You've been adding new regional sales directors, subtracting some where they haven't performed. How many of those do you have today? And what are your plans going forward for adding throughout the balance of 2025 into 2026?

So to your point, we've had to replace a couple of directors. We're currently sitting about 11 field staff between directors and managers, and then another 50 distributors that we are keenly working with. As we move forward, we'd like to fill in at least another 3 to 4 directors in the next 6 months, but we have to find the right people to fill those roles.

I just want to add to that. We're focusing on the right candidates for markets that are either in the interventional side, or, if by chance that the people who are interviewing for this position have a strong spine background, obviously, that would be a win for us as well. So the 2 different sales focus groups is where we're sorting through to find the right person that regional position. Because we still have a lot of open spaces across the country.

Okay. And actually, there was one more question, sorry. And that is more related to the accounts receivables you guys are keeping on top. Cash isn't a concern?

Chad, do you want to answer that one?

Yes. We're staying on top of the receivables. You can see they didn't grow between Q1 and Q2, so -- and end of the year. So we -- cash could be better, but I think as we continue along and sales increase towards the end of the year like we've commented earlier, that our cash position should be fine for the rest of the year.

Perfect. Well, ongratulations on a good quarter. Really looking forward to Q3 and the balance of the year. So again, congratulations.

Thanks, Tom.

[Operator Instructions] Our next question will come from Lindsay Leeds with Microcap Opportunities.

Congratulations on a strong quarter. I wanted to ask about A.E.R.O. and the cross-selling possibilities. Are you seeing doctors that have never bought an Aurora Spine product before looking at A.E.R.O.? Can you talk about that please?

Absolutely. Thank you, Lindsay, for the question. And this product class is very, very exciting for us. So not only do we see customers that are current Aurora users very interested in this product, but we also do see many customers that might have chosen another brand in a particular product class coming forward to want to work with Aurora due to this product. It is a unique market and there are quite a few less competitors in it than per se like an SI fusion where there's 50 to 100 other competitors in that space.

Okay. When we're looking at what I would call a full launch of A.E.R.O. where you're just pedal to the metal, what quarter might that be? Is that Q1 or Q2 of next year?

So as we are ramping up [ trays ] and getting everyone kind of moving, I would love to say that it would be Q1, but as time always takes its toll, I think Q2 would be more realistic.

This concludes our question-and-answer session. I'd like to turn the conference back over to management for any closing remarks. Please go ahead.

Thank you for joining us. We appreciate your time and interest in Aurora Spine. We are very excited about what's ahead. We appreciate your interest and support in Aurora Spine and are looking forward to updating everyone in the upcoming months on our progress. We will be participating at the Lytham Partners Fall 2025 Investors Conference later this month, on September 30. And if you'd like to participate and meet with us, please reach out to Adam Lowensteiner from Lytham Partners and we'd be happy to schedule a meeting. Thanks again, everyone, and have a great rest of your day.

The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.