Hello everyone, and thank you all for joining us during the Lytham Partners Fall 2025 Investor Conference. My name is Adam Lowensteiner, Vice President of Lytham Partners, and today I'll be moderating a Q&A discussion with Trent Northcutt, President and CEO at Aurora Spine, along with Matt Goldstone, Chief Commercial Officer, and Chad Clouse, Chief Financial Officer of Aurora . Aurora Spine trades under the ticker symbol ASAPF on the OTCQX and ASG on the Toronto Venture Exchange. Let's get started. Welcome, Trent, Matt, and Chad.
Thank you, Adam. Thanks for having us.
First off, thank you so much for taking the time and participating in this conversation. Let's expand on a few topics. To start the conversation, can you please tell us, Trent, a little bit about Aurora Spine and briefly discuss the proprietary product platforms the company has been developing in recent years?
Yes, and thanks again for having us, Adam. We appreciate you having us on the show here. Aurora started out as a minimally invasive company with a series of inventions that were basically designed for the most minimal approaches to lumbar, cervical, and even SI joint fusion. We started with our first device, which was the zip device, which was the first screwless procedure of its kind where a patient could have a lumbar fusion without any screws being put into their body. This was a very small incision, outpatient procedure that really is what got the company started. Since we got this company started, we started working towards multicenter study data and also a capturing of business with the ortho, neuro, and pain market. I'll let Matt talk more about the zip and where we're going with the studies.
Thank you, Trent, and thank you, Adam. With all new products, you absolutely want to have clinical evidence. Clinical evidence is going to have physicians interested in the product. It's also going to show that it works for long term, and it's really going to help with payer policy. Payer policy is the crux of being able to maintain these therapies over long periods of time. What we were able to do this year is complete the zip study, which was neurosurgeon, orthopedic surgeon, and pain surgeons all working together with different sites to analyze the success of zip. We have collected all that data, and we'll be going to publication later this year. It's been a fantastic opportunity to put out evidence in the space to protect the product and to provide access to more patients.
Tell me, Matt, more about the commercialization phases of that. Tell me what's on the sales cycle. What does it look like for a patient to, or a doctor, to use our product with their patients?
Absolutely. When you're looking at patients, it really comes down to patient selection, right? Who out there has stenosis, neurogenic claudication, and the symptoms that would benefit from a zip device? When you're looking at those patients, they're in multiple different specialties, but a lot of them start out in that PCP bucket and end up in a pain medicine office. Those patients are getting epidurals, they're getting PT, and before you want to jump into a major, major surgery, you're looking at what options do these patients have? If you are in a clinic which offers a zip, it could be something that they potentially could get.
The opportunity cost or the degenerative spine market is massive, and there's so many patients out there in need, but it's about providing access to the care that is what takes the training and everything else we have to do in order to get patients out there access to care.
Set it back to you, Adam. That's the first phase of Aurora Spine. You'd like to learn more about our company products?
Yes, along the lines of proprietary product platforms, one of them is also the SiLO, which includes an allograft version and a metal transfixing device. They both have shown significant growth since the FDA clearance and also a rapid increase in record revenue levels in the recently reported second quarter results. Can you maybe discuss a bit about the opportunity? Why has the product grown so fast, and can it keep growing?
Absolutely. What we did following the zip study and the zip data that we were driving, along with the involvement of the ortho, the neuro, and the pain doctors, we ran a series of training and educational symposiums where we were bringing people in to learn more about the product and how the product worked. With the big, significant attendance records that we were setting in these labs, we were able to get more hands-on training, more hands-on ideas, and get that collection of ideas from a big collection of ortho, neuro, and pain doctors across the country. We had some of the top leading doctors involved in the discussions and the training. In this, it came up with the zip protocols, came out the new SiLO allograft about the size of a penny implant, and of course the new SiLO-TFX.
This helped us stage these revenue numbers that were able to bring us together not only from a clinical standpoint, but also from a business standpoint and how the business was coming together where we could actually make a product, get the product reviewed and investigated, and then actually turn into revenues for the company. I believe Chad's got some slides behind him that'll show some of those revenue differences.
I do. You can see that we launched this product in Q1 of 2023 with $600,000 in sales, and we just closed Q2 of 2025 with $2.6 million. The increase from Q1 to Q2 is about 40%, and Q2 to Q2 is about 53%. Strong growth.
Thank you, Chad.
We got together with these devices and started pulling the data together, then getting more collaborative work with the doctors that we could say, how does this look in your practice? How is this going to support your business? They said that they have a very large, robust amount of patients that are looking for that outpatient option for them. They wanted to get away from what we call the end result of a big lumbar surgery or a big SI joint surgery. What Aurora Spine was focused on was a two-part series for this where we are in the front half of the business before we get to the back half. What does that mean? We call it the continuum of care.
In this particular slide, it shows that you have all the patients that are on this side, excuse me, that are getting the treatment for an injection, a modulator, or maybe even type of an ablation. This is all very minimally invasive approaches where the end result is big surgery. What happens over here is that you're going to have big pedicle screws. You're going to have big devices put into your spine for this lumbar surgery. Things that look a lot like this, where we can only do so much with this following revision surgery. Once all this is in, chances of this coming out is very, very low. The chances of adjacent segment disease is also a problem. This is why we focus on the most minimally invasive approaches to implants.
The company recently launched two new proprietary product platforms, the HYDRA A.E.R.O., a Facet joint product, and DEXA-L, a new standalone lumbar cage. Can you discuss these products, their importance, and the differentiation, and what kind of growth driver they each can be to Aurora Spine?
Yes. The first product that we just recently commercialized is the DEXA-L, which is part of a series of multicenter studies that we're doing for the cervical neck and now just starting in the lumbar. This is bigger surgery. This surgery is meant to match the patient's bone density, which is one of a kind. No one else has a product quite like this. The doctor, for the first time intraoperatively, can actually use what they call the DEXA scoring system or a bone density scoring system to actually pick the right density for the implant to fit that patient's bone density. What is true with you may not be true with one of your loved ones or one of the people you care about. That's really the key for Aurora . Aurora focuses on patient care that's more unique to that individual patient.
That way, the patient can have an implant that's going to fit their anatomy or fit their bone density. The second implant was the AERO device, which is a very small, minimally invasive implant that fits into the facets. What happens is that your facets begin to deteriorate, and you're now going to have facet pain or joint pain. You might even have irritation within the nerve endings. What Aurora is trying to accomplish and has accomplished is we're able to make implants with the most smallest approach. Here's a quick image of that. This is what the new HYDRA A.E.R.O looks like. What's really exciting about this product is that we're now in the beginning stages of a commercialization phase of both our DEXA-L and our HYDRA A.E.R.O.
I'll let Matt talk about the rollout of how he's getting distribution, direct sales, and getting more customers to not just use it once, but add it to their continuum of care.
Thank you, Trent.
Yes, the opportunity to have a facet fusion product as a minimally invasive option for these patients is enormous. The number one indication or procedure that a pain physician offers is usually an MVP, which is a medial branch block. That in and of itself is a diagnostic and sometimes therapeutic injection that identifies that the Facet is mediating their pain. With that, this device would then address those opportunities. It is a huge opportunity that we're being very thoughtful about rolling out carefully. We partnered with both neuro, ortho, IR, and spine physicians in order to do alpha sites to have the top 20, 30 physicians in the country get access to start offering this therapy, making sure that everything goes very smoothly and all the outcomes are fantastic. We will be rolling into a multicenter study for this as well, going into next year.
This is an opportunity to continue to bring options forward for patients, as well as push data forward in order to keep coverage for policy and insurance.
I know it's still in early stages of the launches, but how's the launch of each of these products going?
Fantastic. The team has done a phenomenal job of identifying key sites to start these therapies. Those key sites are thought-leading physicians that have piloted and pioneered new technologies before, and they're helping us to make sure that the cases go perfectly. All the tooling adjustments we want to make, extra laser markings, all the things to make the product very user-friendly, we've been able to do that now. We're moving out of kind of our alpha phase and starting into a limited launch phase now, as we've had such success in the first so many cases.
The company embarked nearly a year and a half ago and built out an internal sales team. What's the sales team at Aurora comprised of, and currently how many territories do you currently cover? Are there many more out there?
Absolutely. There's a very blue ocean still. Right now, we have a sales team of Regional Directors that both have direct business in some markets and distributors in other markets. That has to do with the limiting factor of just their time. Really, that's, I think, what is the bottleneck of any one of our team members is just how far can you get with efficiencies in your own daily activities? There is such a large amount of dirt still out there that we haven't covered yet. We are still growing as quickly as we can, but we want to do it thoughtfully. We've seen other companies kind of go with that shotgun approach of hiring 50 people and then just letting the cream rise. What we want to do is pick wisely and really partner with reputable sales individuals that have experience in their markets.
They know the products, they understand the treatment algorithm, and they understand how to engage physicians to help their practices launch these types of therapies. It's been a great opportunity to continually grow that team. We recently hired two more people on the East Coast, and we're hoping to add people in the Midwest and the Northeast or Northwest later this year.
Can you take some time to discuss who's your target market? Is it ortho, neurosurgeons, or interventionalists, or both?
It's absolutely both. I mean, I think that goes back to the patients and where the patients are. Sometimes if you're more severe on what Trent was showing as kind of that continuum of care and you need to go to someone that can address you with pedicle screws and inner body, then that's absolutely where you need, right? If you're earlier in the degenerative cascade of spine care and you're like, you know, I have symptoms, I have pain, I'm uncomfortable, I might not be able to walk or stand super long, but I'm still not all the way where I have severe instability or any weakness at that point. Those are two different places in the care continuum, which could be addressed with two different types of physicians potentially, depending on where those patients are in their referral networks.
We absolutely are partnering with the neuro and ortho physicians as well as the interventional physicians in order to address patients in the market.
Can you discuss how your products get into the hands of the doctors and then into patients? How quickly does a doctor adopt using your products? What needs to happen for that to occur? Maybe explain the training process and them getting comfortable with your products, but also discuss the multiplier effect that can happen as you offer more products to your customers and as you build that relationship.
That's a great question. Just to the first part of what's the sales cycle like? I always kind of give it a rule of thumb of 90 days, right? By the time you meet a physician, you schedule a meeting for a lunch, you have conversations, you show them the products, you get them interested in it, then you go through the contracting process of getting their facilities set up and organized. Then they get trained, and then they have to go through just kind of working up their patients at that point to select the correct ones for a given therapy. Typically, it could go quicker, it could go longer, but normally it's about a 90-day process.
With that, when you add another product into their treatment bag, it can be much quicker because you are already in that office, you might already have relationships, they're already working an algorithm of patient selection, you already might have contracts to their facilities. What has been a great opportunity is adding in HYDRA A.E.R.O into what they already are offering if they're offering zip or they're offering TFX. It has been an opportunity to continually expand our care options for an individual physician while not burdening the rep with having to go into another place and call in a brand new physician. It is an economy of scale, and it does help with the efficiencies of how much impact our team can have.
The future looks really exciting for Aurora Spine. How's the company's financials look? Are you profitable? How's the capital structure look? Is there any need for additional capital?
At this time, we don't feel like we're at that stage. We are trying to use the resources that we have and, of course, continue to collect deeper in our AR. I'll let Chad dive into more of those numbers on our income statement.
Sure. You can see the last six years of income statement highlights here. Our revenue has grown from a low of $8.6 million in COVID-riddled 2020 up to $17.6 million in 2024. We're currently in 2025, we're about $800,000 higher in the first half than in 2024. Gross profit margin in that timeframe has gone from 32% all the way up to 60%. This is from us launching our new products, which have a lower COGS. All that has translated into positive EBITDA in 2024. Some other good things happening is our cash flow from operations has been positive over the last two quarters. Our receivables are down from Q1 to Q2, meaning we're collecting properly. Our total liabilities are down as we pay down our lease liabilities and our payables are flat.
Thank you, Chad. Gentlemen, in your opinion, what are some key catalysts that investors should be focused on in the future here?
Since we started out as a small company that had the first screwless procedure, as you can see, we've evolved and we've matured as a company, giving really a big bang we think for the investor. You know, why would you want to invest in Aurora ? Why would you want to buy Aurora shares? We're making a difference out there. We're not only getting patients back up on their feet, we're doing it the most minimally invasive way possible. The one thing we know for sure is that small companies like Aurora are the innovation factor.
We are the ones that are actually working on the updated data, the ones that are working on the results of implants that are the most minimal of their kind, such as the AERO implant device, the zip , the SiLO, and the SiLO-TFX, that we believe that if you're trying to treat your loved ones, you're trying to treat the ones that are closest to you, Aurora is that company that's going to make a big impact. Big companies acquire and little companies innovate, and Aurora is one of the biggest little companies I know that's making a big difference out in the market.
Anything else you want to add before we conclude the discussion?
I think to just echo what Trent was saying about the opportunity in the market. As we look at the multi-billion dollar spine market and where most patients currently choose their treatment options, as we get more physicians trained and more access to the market, those patients, if it was your mother and you're like, what would be the least invasive option for this patient to have the best result? That is really what we want to be offering to all these potential patients out there. Having that, it is what we feel is the best choice for these patients. If they, as we get further out there, the opportunity is very large. We see that as our responsibility to really commercialize these products so patients do get access to the care.
Also, I'll add to that is that we were in a very heavy R&D phase for a number of years, the last five years. Where we are right now is in the sales execution phase of the company. The products have been manufactured, the products have been tested, we continue to study them and continue to work towards making any improvements with them. Right now, it's truly on a sales focus. Matt touched on it earlier. We're only in a few selected locations around the U.S. We're expanding that, we're growing and getting the word out in Aurora and new exciting locations while we continue to mature and grow the areas that we're in. This is really the key part for the people involved with Aurora from the beginning to where we are today.
This is what you've invested in and this is where we're going to continue to go and grow. I look forward to meeting more of the investors and people who are really trying to get this word out on the street on Aurora. Aurora is here to stay and Aurora is making changes and Aurora is here for the long term.
Great. Thank you, Trent, Chad, and Matt for taking the time to do this interview. Thank you for everyone for watching. If you have any questions, would like to schedule a meeting with Aurora Spine, please send me an email at lowensteiner@lythampartners.com. If you'd like to learn more about Lytham Partners, you can visit our website at lythampartners.com or follow us on LinkedIn to stay connected about future events. We hope you'll enjoy the rest of the conference and have a great day.