aprevo technology platform Provides patient-specific 3D surgical plans, on-demand 3D-printed implants and sterile single-use devices throughout the pre/intra/postop workflow; The company has expanded into cervical cases and reduced delivery times from eight weeks to six days.
Financial perspective: Carlsbad generated $50.5M in revenue in its first public year (Q4 “north of $15M” and a 76.5% gross margin) and guided $70M–$75.5M For 2025 (≈44% growth at the midpoint) with IPO gains paving the way toward a cash flow breakout.
Clinical and reimbursement benefits: Two-year data published in the Global Spine Journal showed a 74% reduction in revision rates compared to conventional stock devices, and the company has FDA breakthrough device designs and NTAP and permanent DRG payments that provide significantly increased hospital payments (including NTAP for cervical procedures reported as $200).
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Carlsmid (NASDAQ: CARL) used its presentation at Canaccord Genet’s Musculoskeletal Conference to highlight its mission to improve outcomes and lower the cost of spine surgery by reducing reoperation rates in spinal fusion procedures through a personalized, data-driven technology platform. The company, which was founded in 2018 and is newly public, has developed a pre-operative, intraoperative and post-operative workflow that combines patient-specific digital surgical planning with on-demand implants and post-operative data collection, said CEO Mike Cordonier.
Cardoneer highlighted Carlsbad’s latest results and guidance, emphasizing rapid revenue growth and high gross margins. He said the company delivered “north of $15 million” in fourth-quarter revenue and reported a gross margin of 76.5%. He also pointed to a 61% year-over-year growth in Q4 compared to the previous quarter.
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For the full year, Cardonier said Carlsbad generated $50.5 million in revenue in its first year as a public company, representing 86% year-over-year growth. He added that the IPO proceeds left the company with a strong cash balance and “a path to cash flow breakeven.”
Looking ahead, Cardonier said the company’s most recent guidance calls for revenue of $70 million to $75.5 million this year, which he describes as growth of 44% in the middle.
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Cardonere said initial customer flow has been strong, noting that Carlsmid expanded its user base by nearly 70% last year and ended the year with 253 trained surgeon users. He described the company’s business approach as a hybrid model: the presence of a traditional operating room supported by sales agents and distributors, combined with a direct team focused on customer acquisition, training, and account support – especially in the pre-planning phase.
Carlsbad is focusing on the US spine market and now serves both lumbar and cervical segments after launching its latest Cervical Platform. Cardoneer estimates the annual US addressable procedure volume to be about 445,000 lumbar spine fusion procedures and about 373,000 cervical procedures, for a total of more than 800,000 procedures.
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He attributed Carlsmid’s distinction to its Aperio technology platform, which he said enables the company to:
Use standard imaging (X-ray and CT) to reconstruct the patient’s anatomy in 3D.
Create a patient-specific surgical plan and personalized implants designed to achieve targeted correction.
Submit the plan to surgeons through the Myaprevo platform for review and approval.
Create sterile packaged, single-use devices and 3D printed implants on demand.
Collect post-operational data on the Aprio Intelligence platform to compare planned and achieved corrections and how results hold up over time.
This closed-loop dataset is continuously used to train and refine the platform, including personalization for patient populations and individual surgeons, Cardonere said.
Cardoneer cited clinical validation as central to the company’s value proposition. He said that two years of data were published in it International Journal of Spine Compared to traditional fusion procedures using stock devices, Aprevo showed a 74% reduction in revision rates over two years for patients treated with the personalized approach.
Regarding reimbursement, he said that Carlsmid received an FDA breakthrough device designation for its solar offering, which helped the company receive a New Technology Add-on Payment (NTAP) during initial commercialization. He added that after continuing to gather clinical data, Carlsbad received a permanent DRG payment, effective in late 2024, providing incremental reimbursement for lumbar fusion using Oprio technology over traditional stock devices. Cardonere said this payment profile is encouraging hospitals to adopt the technology.
Carlsmid recently expanded to cervical spine procedures, targeting ACDF (anterior cervical discectomy and fusion) cases, particularly in patients with osteopenia or osteoporosis where weakness can result in a high risk of revision and revision, Cardoneer said. Carlsmid has created patient-specific cervical implants designed to match anatomy, he said, with a wide footprint extending into the non-breasted joint to promote surface area contact — an approach he contrasts with conventional nose-shaped cervical implants that may require endplate drilling.
He said initial cervical clinical evaluation data presented at the CSRS meeting in December, coinciding with the product launch, demonstrates the company’s ability to deliver unique intervertebral alignment.
For compassionate payment, Cardoneer said Carlsbad also received a breakthrough device design and an active NTAP that provides hospitals with an incremental payment “north of $21,000” on top of current DRG payments, with a focus on inpatients, particularly elderly patients.
Operationally, Cordoner discussed the developments of the lead times. He said that at the company’s inception, the delivery time for delivery was about eight weeks, but the company has now reduced it to six days – a development he said was important to target the wider mass market.
He also highlighted new product and procedure milestones, including the completion of the first poster minimally invasive bilateral approach using the Aprevo platform, and the announcement of the CORRA Personalized Cervical Plating Platform, designed to offer personalized planning and customization with external plating options. Cardoneer emphasized the company’s “zero inventory” model for hospitals, with sterile, on-demand delivery aimed at avoiding centralized processing and reducing tray logistics.
During the Q&A, Cardonier said that Carlsbad is not directly integrating wearable technology for skin monitoring, although it is aware of clinical studies using wearables to track recovery. Asked about competition from expandable cages in the lumbar spine, he said the company’s surgeons value a pre-planned, anatomically fitting approach and describe the implants as “self-aligning.” He also confirmed that the company’s devices are boneless, 3D-printed titanium alloys designed for osseointegration. Regarding expansion beyond spine, he said the company is focusing on the US spine and hopes to add more brands within spine before considering other markets.
We are a commercial-stage medical technology company offering AI-enabled personalized spine surgery solutions with a mission to improve outcomes and reduce healthcare costs in spine surgery and beyond. We are focused on becoming the standard of care for spinal fusion surgery. The Aprio Technology Platform consists of artificial intelligence (“AI”)-enabled software solutions and interbody implants that we custom design for each patient’s unique pathology and vertebral bone topography, and single-use surgical instruments (the “Apprio Technology Platform”).
The article “Carlsmid Unveils Personal Spine Platform, Targets $70M-$75.5M 2025 Revenue at Conference” was originally published by MarketBeat.
