Carlsmed generated $50.5 million in revenue in its first full year as a public company, marking an 86% increase over the prior year. In the fourth quarter, sales exceeded $15 million at a 76.5% gross margin, and guidance for 2025 targets $70 million to $75.5 million in revenue, implying 44% growth at the midpoint. IPO proceeds have provided sufficient cash runway toward cash-flow breakeven.

The company expanded its trained surgeon user base by nearly 70% to 253 users last year through a hybrid commercial model combining operating-room presence, sales agents, distributors, and a direct sales team focused on preoperative planning, training, and support. Operational improvements include reducing order-to-delivery times from approximately eight weeks to six days and maintaining a zero-inventory model for hospital customers.

Two-year data showed a 74% reduction in revision rates for patients treated with the aprevo personalized spine platform versus traditional stock devices, supporting FDA Breakthrough Device designations. Carlsmed secured an NTAP that provides hospitals with over $21,000 in incremental reimbursement for cervical procedures and permanent DRG payments for lumbar fusion, creating strong incentives for adoption.

The aprevo Technology Platform delivers patient-specific 3D surgical planning, on-demand 3D-printed implants, and sterile single-use instruments across the preoperative, intraoperative, and postoperative workflow. Having launched its cervical platform, the company now addresses a combined U.S. spine procedure market of over 800,000 cases annually (445,000 lumbar and 373,000 cervical).