Carlsmed reported fourth-quarter revenue of $15.2 million, a 61.2% increase from $9.4 million a year earlier, and full-year 2025 revenue of $50.5 million, up 86% from $27.2 million. Gross margins improved to 76.5% in Q4 (versus 74.7% in Q4 2024) and to 75.3% for the full year (versus 73.8%), while net losses widened to $8.6 million in Q4 and $29.6 million for the year.

The company published two-year aprevo lumbar data showing a 74% reduction in revision rates versus non-aprevo patients, launched the aprevo cervical system and myaprevo ecosystem, and completed first-in-human procedures for aprevo bi-lateral posterior fusion at the University of Colorado and personalized corra cervical plating at UC San Francisco in February 2026.

Operating expenses rose to $20.9 million in Q4 (versus $11.7 million) and $68.6 million for the full year (versus $44.2 million), driven by increased R&D, sales and marketing, and G&A spend. Adjusted EBITDA losses expanded to $8.4 million in Q4 and $28.4 million for 2025, reflecting continued investment in scaling and innovation.

Carlsmed expects 2026 revenue between $70 million and $75 million, implying 44% growth at the midpoint. The guidance assumes continued market adoption of AI-enabled personalized spine solutions and further gross margin expansion as production scale increases.