Thank you, everyone. So glad you guys are here today. We are thrilled to be here as part of the Planet MicroCap Conference. My name is Trent Northcutt. I'm the CEO of Aurora Spine. Aurora was founded at the end of 2023. We got started, by the way, in 2012, and then started in 2014. Aurora is a pure spine implant company. I felt it was on your cervical all the way down to your low back and out to your [facet] and that side joint. The theories of the implants here, like I said, we are located in a town called Carlsbad, California, just 35 mi north of San Diego. Spine Market, our legacy business that we started and really focused on with spine and ortho spine and neuro spine surgery.
We began to expand and start to move our technology into an additional segment of the market, which was through the interventional market. You might take that to open heart surgeries performed by open heart vascular surgeons. Then we started to extend from shunts to the small and more minimally invasive approach. Aurora started to speak to these minimally invasive approaches to doctors about taking a closer look at Aurora's technology. It's done quite well. The pain market, we have something that's really started to expand for Aurora in and outnumber to the [ortho neuro] community [6] to 1. The goal is to keep the collaboration between the ortho and neuro community all the way. Our philosophy is to really work towards an implant that's going to better fit the implant to the patient's anatomy versus the patient's anatomy trying to fit the implant.
Everything we make is to focus on how that implant's going to fit and interact with that patient's bone structure. It's always a little bit different. Different types, different sizes, different weight of patients, different names of women. We have to be able to make sure the implant truly fits and works, fits in that person's anatomy. We were able to record additional growth revenues, $4.8 million during Q3 2024, an increase of 21% over Q3 2023 due to strong sales of the ZIP and the SiLO, which is based upon our SI and our lumbar fusion devices. We had a positive net income in Q3 of 2024, which was the first positive net income of the company. That's a rarity in our space. A lot of med tech companies, especially in the med tech spine, often burn through a lot of cash.
Now, we were always kind of right on that edge. That is our goal in 2024, to be able to report EBITDA positive for the company. That has been our goal going forward into 2025, to have a breakout year and be able to really focus on true cash positive. Five consecutive quarters of positive EBITDA. The SiLO franchise is really starting to continue to gain and grow in adoption. The SiLO market is the SI market. You've probably heard of some competitive companies out there such as SI-BONE. We are an approach to minimally invasive on the SI fusion market. We've got two SI joints to the left and the right side. This implant really helped us stand up into the marketplace.
It gave us an adoption with the ortho, the neuro, and the pain doctors, which is now roughly over 40% of our monthly revenues with that product. That's been a nice turnaround for our company. Along with the ZIP device too, now you've got these two products in the bag that allows our company to have a door-opening opportunity with those doctors. We ramped up our internal team. We now have over 14 direct sales reps in the field. With over 14 direct sales reps in the field, we have over 40 independent distributors in the field. This is about 110 feet-120 feet on the street across the country. There's plenty of pockets out there that we need to expand into, like the Great Northwest, some of the Atlantic areas, and other areas where we are adding people in those locations. We're going to add a new hire.
We had an announcement on it last week in sales. We're going to add two more additional salespeople here in the first half of the year, one to two more in the second half of the year, and that'll be just much bigger for us. The sales and the training are simultaneous. Every single training we have in the ortho, neuro, and pain market allows us to be in there and get their hands on it and see how it is different from what [audio distortion] versus what we're currently using in the company. The pain market is, again, something you've heard me touch on a few times now. It's got a very large growth area.
What happens is if a patient comes into the pain care where it starts with a patient's kind of pain, a back problem, and then they step right into that first doctor's appointment. That's where you might get your first physical therapy session. You might get your first SI joint injection. You might get your first facet injection. You're going to get.
Thank you. Is that better? Sorry about that. This allows you to get into, you're in the continuum of care. Now you're able to have that doctor treat that segment. What happens from there is that you're going to go from the injection or the ablation start of the pain location into a much larger fusion. That is where Aurora steps into the picture. We focus on the idea of the facet fusion, the lumbar fusion, and the SI joint infusion. That is that treatment as it intensifies when the patient first walks in the door. The number one reason why a patient misses—sorry, number one reason why somebody loses time at work is the common cold or flu. The second reason why they miss time at work is back pain. That is the second reason. It is that large.
The global pain market is something that's much larger in scale than you can even imagine, right? There's just such a big global market because everyone's trying to treat how the symptoms of pain are, where the pain triggers are. How do you treat it? Is it just physical therapy? Is it just an injection? Is it just a metal implant? It's to be studied and continue to grow on. For us, we entered into that market in 2020 and started showing them mechanical fixations, small incisions about this big. How do we take an incision size this big and treat that patient and allow that patient to walk into a surgery center and walk out the same day pain-free?
These pain physicians have now started reducing their opioids, started doing less of the old style of pain management treatment to where now they've added mechanical fixation and management treatment to that patient. Again, all of our procedures, you can walk in, get an incision size about this big. Less than one hour later, you're in recovery. Just about an hour after that, you're actually getting into your car and you're going home. This is some of my team members that are part of our crew. I'm the CEO and founder, as I mentioned. This group is out there actively, constantly just charging hard in the market. We also are an ISO 13485 company. It allows us to do business in a lot of locations, but currently we are focused on North America. We have approval in Mexico, Central America, and South America.
Most of our sales are in the U.S., but we have a couple new announcements coming up for Canada, and we do surgeries in Canada currently. We also have in-house manufacturing. The majority of our products are actually manufactured in-house. A few of them are manufactured outsourced, manufacturing around the U.S. market. We have one OUS manufacturing site for an implant, and we have one OUS manufacturer that helps us with one of our devices out of Switzerland for one of our tools, but not the implant. In 2014, we had our first patented product, which was the ZIP device. The ZIP device right here was how we entered into the market. This was a screwless procedure, allowing the patient to actually not have big lumbar surgery performed on them. This is an incision size, again, this big for that patient.
It allows them to address that segment on a screwless location, and the patient can actually have that device put in their body in less than one hour. The next steps was we started to explore how do we expand from the low back over to the SI joint. That is when the SiLO TFX and the DEXA, the Hydra, and the AERO, which I will talk about separately, how we worked on a plan where we could say we went from one device and then how do we add an additional four more key growth factor products coming out of COVID, right? It was quite the challenge, as you can imagine. How do we address that and be able to stay focused on those products and those projects with the headwinds of COVID? We did it with the SiLO and the SiLO TFX.
The SiLO and the SiLO TFX went from zero, no revenue in the company, brand new napkin drawing idea from a napkin drawing to a product that now represents a little over 40% of our monthly sales. We expect that each one of these technologies you see up here are going to be continued growth factors of the company as we release them into the marketplace as we have all the way through now 2025. The ZIP has started, as I mentioned. We have over 10,000 procedures performed year to date. It reduces the operating room by 36%. Essentially, you just walk into the surgery center and you walk out the same day, as I mentioned. It's no days in the hospital. You don't need to stay in the hospital.
is 69% less blood loss, which really reduces the morbidity, the risk of infection, a smaller incision size. This is what true minimally invasive surgery is. The SiLO and the SiLO allograft system, this addresses this major market. One of the things that we focused on here when we started to look at this market was there's a good company out there that said that there was a very large amount of SI fusion availability for patients to be fused in the SI joint. We saw that they had over 289,000 procedures estimated from this very large SI company, competitor of ours. In that same chart, it mentions 1.2 million injections. Okay, I like 300,000 procedures, but I love 1.2 million injections. That means the person or the people that are doing those 1.1 million injections are the experts in this market.
That's where Aurora focused it on, and that's where the interventional space came in. If there's 1.2 million injections performed annually, and we're just talking about North America, we should get into that marketplace. That's what we did with our interventional space. That's how the SiLO system was born, that crossover product that allowed us to be able to get into that space very fluently. We have a lot of work to do still, but here's some estimates on the SiLO TFX, the MIS system where it allows it to grow, and this is how we've been able to get it stepped into the marketplace. This started out with the first five instrument sets. Instrument sets are reusable instruments that you use in surgery.
The implant is then implanted, and the instrument sets are sent back to the office and shipped off to the next location. We have gone from five instrument sets to 20 instrument sets. We went from 20 instrument sets to 30 instrument sets. Now we have over 56 instrument sets in the field just recently. We are going to continue to expand on those kits because, again, they are reusable. They have a low cost of manufacture and a high yield. The COG on these implants are about $138 per unit, an average selling price of over $7,500 per case. The proprietary part of our company is that we have got some major implant products that are doing great revenues, great growth, and really put us in a position for success. We also have some futures.
What we call futures inside of our company is something that's even bigger than what the market shows is that bone density and bone quality and bone health is such a major issue in the marketplace, global marketplace. We were really proud that just a little over a year and a half ago, we got a big major patent approved for the DEXA Technology. Who's ever heard of a DEXA scan or a DEXA bone score, right? Almost everyone, right? The idea of a DEXA scan is that you get your bone scanned, and it tells you what the health quality of your bone is. Now, DEXA was an acronym that was actually owned by a company called GE. Some of you might have heard of them. They abandoned the trademark. The trademark was abandoned, and we acquired the trademark for $360.
I thought it was a great trademark for us to pick up, and it gave us the great platform for us to run off of. Because if bone density wasn't an issue and bone quality wasn't an issue, then why is there a scan? Why is there a scoring system? Why is there a color-coding system? We acquired that and made all this apply to our first entry into the cervical fusion market, where you could actually send the patient down for a regular old scan, and the doctor could put in the right implant based upon that patient's T-score, or even more important for Aurora, where we become unique to that surgeon in that operating room. The doctor can be in surgery interoperatively and look up at you and say, "The patient's got terrible bone.
What do you got? And they can make a decision on the fly and actually put in an implant that matches that patient's bone density. Medtronic doesn't have that. Johnson & Johnson doesn't have that. The biggest spine companies in the world do not have this technology. We do. It's new. It's just out. We're in a multicenter study. The multicenter study is going fantastic. We're starting with cervical. We just put out an announcement. We got our lumbar approval. We'll start doing lumbar studies on this. This is going to be one of those slow growth products, but the product is going to be impactful. It's going to show major impact. This is what really draws in the orthopedic surgeon back to Aurora.
If they didn't like the idea that we were working with interventional, they're going to love the idea of this because they deal with bone issues every single day. In this scoring system right here, right there at that 2.5 right here, every orthopedic, every neurospine surgeon makes a decision. If that's the score of that patient, do I do a surgery on that patient or not? Now, we have many loved ones and many patients that we know. They can't make the decision to do surgery on that. That patient just has to live with that pain. It's an opioid issue. It's a constant treatment issue. It's not a healing issue. It's just a treatment issue. This now turns into, how can I fix that patient's bone? And that's what we're proving right now.
We're putting these implants that are color-coded, match within the scoring system of a global scoring system. The doctor can pick the color if they don't want to have to worry what the number is, and on the fly, put an implant in there that treats that patient. It is very, very impactful. If you guys follow Aurora at all, get on LinkedIn. You'll see some of my posts, some of the company's posts. We post DEXA almost every week. We show posts on Instagram, TikTok, because these are a younger generation of doctors coming up, right? They like to show their X-rays. They like to show their studies. They like to show their results. This product is the plate that covers up over the DEXA. This is a great X-ray right here. Here is a patient that actually you show right here. This is DHD.
That means DEXA high density. As you can see, this implant is right in there mimicking that patient's bone. This patient's going to get better outcomes, in our opinion. The patient's going to get better results, in our opinion. It's going to reduce their pain score. This, again, gives that doctor that interoperative decision. That doctor could have been in this surgery, and if this wasn't good bone quality where they could use a green cage, in this case, the doctor could have pivoted on the fly and said, "Patient's got osteopenia or some type of osteoporosis issue. Give me your lower density implant." This is part of our big surgery project. You're going to hear more about this as we talk about it throughout 2025, 2026. We are starting to do scoliosis and deformity work. We've been performing a number of surgeries now, doing corrective surgeries.
This is big, hard, complicated procedures, but we wanted to be in this arena as well because we're very serious about treating patients and trying to help them. You will see some posts out there how we've been doing some very large corrective work in scoli and deformity. This is a growth factor for us too because the idea of it having been our own product. When I first started talking to many of the shareholders that I know, some of them here in this room, the big comment was, "How are you going to get away from some of the third-party products that Aurora is representing as we were distributing products to making your own products?" Now, five years later, we don't sell anyone else's product. They're all our own products.
That was part of that investment ride that I'm asking for all of you to join on as we continue to grow our company. This is going to be something you're going to hear a whole lot about from me over the next number of years, but this can be one of probably one of the most exciting products I have ever been part of and created. This is a product that's approved from C2 to S1. This gives us more shots on goal than any other product we've ever created. You've only got two SI joints.
Not every patient needs to have multi-level fusions, but if we can get in and treat patients on an incision size about the size of a ballpoint pen and put an implant in their metallic fixation in the implant into their facet and do this all within less than an hour, we've got a win on our hands. We think this product is going to be one of the fastest growing, if not the fastest growing product in the bag. This is going to be about $132 COG on this device, average selling price about $9,000-$10,000 per case. All the professional fees are baked in, so all the doctors are going to make their return on their surgery. This is all covered by every single insurance carrier around the country. This is a product that is approved with the DOD contract.
All of our products are approved on the DOD contract. This is going to be one of the fastest growing segment products in the second half of this year, and it'll really expand in 2026. Here is our current income statements and highlights. Maybe some of you would say some lowlights, and I would too. The idea of it is that we're growing as a company. We do what we say we're going to do. If we say we're going to get away from third-party manufacturing or third-party distribution and create our own products, we did that. If we're going to fight through and work with a continuum and consortium of pain doctors and ortho and neuro, then we're going to do that. We're going to say we're going to do it.
If we're going to do the studies, improve and validate the studies, we're going to do that. We do that indeed. Here are the revenue numbers on here. When we have the question-and-answer period, you guys can answer some of our questions. We were EBITDA positive, as I mentioned, in 2024, and we're going to continue that trend through 2025. Income statement on the quarterlies and the revenues. One of the factors that here is really important for everyone to recognize, of course, is the gross margins, right? We really wanted to increase on the gross margins and constantly be pushing a reason where we could get to a faster return on our dollars and make a faster dollar on our own dollars. This is where we were as of 9/30/2024, closed out.
We have not announced the total end of the year yet, but we are publicly traded on the [Toronto Stock Exchange], as you guys know. We went public day one, and we quarterly audited, yearly audited. It's helped us be on national contracts as being a publicly traded company on the [Toronto Stock Exchange], even though we're based out of Carlsbad. We're not looking for any dollars. What we are looking for is people who want to invest in our company, meaning like be a shareholder, be a believer, be an evangelist, get out there and spread the word. We think we're the best-kept secret in spine. I don't want it to be a secret anymore. I want everyone to be talking about this. We have the best products in the market. We've got a growing sales force. We've got an emerging story.
We've got an EBITDA positive company that's going to break into big cash position, I believe, in 2025. It'll put us in a nice position for 2026 to move ourselves over to the NASDAQ. That would be the great play for Aurora Spine, and that's where we're moving towards. Continuing to focus on the proprietary platform and drive revenues with growth and profitability is ZIP, SiLO TFX, the DEXA, the AERO. We're going to expand into our internal sales team, expand more focus on where we can hit quick wins and get those quick shots on goal, right? That's where we know we can get more shots on goal and get quick shots on goal. Continue the multicenter studies. We got multicenter studies in the cervical, as I mentioned. We got a multicenter study in the ZIP device, which is the first product we released.
We're going to enter into we just finished our safety study with the SiLO and the TFX. That's a very impressive study. You guys will be really impressed by that. We're going to go into the AERO study, which is going to show that that's also safety and efficacy. Of course, the multicenter on the facet system. Having something approved from C2 to S1, put that down in your notes. It's going to be big. Improve capital structure in investor communications. Obviously, we want more believers, like I said, more evangelists, more people who really can get behind the story. There's a good story here. Do your homework, of course, but everyone here has a couch in their house.
I think you guys could knock off a few cushions and find some change to knock out of that couch and buy a couple of shares of Aurora at CAD 0.22 or CAD 0.30 a share, whatever Canadian exchange or U.S. exchange you want to buy it on. It's a great investment. Same members. CFO has been with the same guy, but he's been with us for a number of years now. Laszlo is my Chief Technology Officer. Dave Myers is our in-house counsel, manages all the shares, makes sure we have all our contracts in place. The board's exactly the same. We just had one who wanted to retire, and he's actually doing some work with us inside the building. Same board members since day one. Three Canadians and now two U.S. Like I said, one board member is U.S. No changes, no issues, no headaches, no hiccups.
Really straightforward organization. A lot of patents, a lot of IP. We have four big pending, over 10 patents issued. Not everything's defendable, but a lot of things that we have are defendable. We focus on the ones that are defendable, right? We don't want to—we're not a litigious group. We want to defend what we know we can defend, and we want to fight where we know we should fight. We stand on our principles of our products. Everything we do, if it is patentable, we patent it. We don't just try to knock something me too off. We want to make sure it actually has some merits. For those who don't know a lot about spine, this is what I was talking about today. It's a big arena. It's a lot of segments in the market. This is who we are.
I'll open it up from here if anyone's got any questions.
The doctors themselves want to reduce the opioids because they get scored by the state. Each state has a different scoring system of how many opioids they've written prescriptions for. They need to be very careful about how many prescriptions they write for opioids. That's more of a medical office issue. If they can sit there and talk to a patient and say, "Hey, look, I can keep prescribing you pills, or I can make an incision this big on you, and you could walk out of the surgery center in less than an hour." That's pretty revealing, right? Because popping pills is not something that anyone, long term, I think, really want to do. Certainly, there's people who are addicted to it and constantly continue it.
I think that's how the conversation goes with the doctor.
Yeah, that's a good question. PEEK is a great product. The reason why a lot of people went to PEEK Polymers was because it had the best modulus of elasticity, right? It was different than the old hard titanium cages or old stainless steel type cages. That was one of the important things about DEXA that we actually tuned the additive manufacturing. The patent for the additive manufacturing is not just for 3D printed titanium, but it's additive manufacturing for all things additive for the next 18 years for us, okay? We actually were able, even in the green cage I showed up on the screen here, it's actually lower as a better modulus than PEEK. We actually were able to dial it down and actually have a better modulus.
Our red cage is much softer. I highly recommend stop by the booth over there. I'll put one of the cages in your hand. You'll be able to actually close your eyes and feel the weight difference on a little implant this big. It's really bizarre how it's there. It's not mental. The patients who have osteoporosis, their bone is that frail. They don't need a big hard cage. PEEK is very dense. Metal is super dense and super rigid. In fact, all 3D printed implants that are out there that are not Aurora are 1.1 newton strength or higher. No bone is that strong. Our lowest implant cage is below the PEEK value. We're able to match the patient's bone density with DEXA. It holds the graft perfectly because it integrates faster. Yes, we add BMP. We add DBM.
We have different types of microfibers and bone fibers that we put in. We've used every single allograft and third-party allograft system in our cage so far. Everyone's using, including. So in the Infuse product from Medtronic, where they can still use that product, they've used it on our devices. Yeah. You're welcome. I think I'm being kicked out, but I really appreciate your time. Again, my name is Trent Northcutt. Come by the booth. I'm happy to show these products more. Thank you.
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