Momentum seen coming out of our second quarter continued and accelerated as we progressed through 2025, resulting in a record Q4 performance. Our team delivered, showing great poise and determination during a period of growth and change. Focusing first on our top-level financial performance for the full year 2025, Globus delivered $2.939 billion of revenue and $3.98 of fully diluted non-GAAP earnings per share, growing 16.7% and 30.8% as reported, respectively. Full year 2025 base business revenue, excluding the contributions from Nevro, grew 5% as reported, with Nevro adding $293.6 million in revenue for the full year.

Shifting into Q4, revenue totaled $826.4 million, growing 25.7% versus the prior year quarter, while non-GAAP EPS finished at $1.28, growing 52.1% versus Q4 2024. Digging into this further, our base business revenue of $726.7 million grew 10.6% versus the prior year quarter and included double-digit U.S. spine growth, as well as record Enabling Technologies revenue for the quarter. Looking at the second half of 2025 versus the second half of 2024, our consolidated base business grew organically at 8.8%.

Our Q4 and full year 2025 results demonstrates our performance against those objectives. spine business grew 10% in Q4 as compared to the prior year quarter, coming off a third quarter where U.S. We've seen this trend continue and now sit at 48 weeks of consecutive growth, with this momentum continuing thus far into our first quarter of 2026. Operationally, we've leaned into inventory and set production to feed this growth, instilling confidence in the sales force while ensuring we can meet the needs of our customers and the patients they serve.

What went well
  • Q4 revenue totaled $826.4 million, growing 25.7% versus the prior year quarter, with non-GAAP EPS of $1.28 growing 52.1% over Q4 2024, capping a record quarter.
  • Full year 2025 revenue was $2.939 billion (up 16.7%) and full year non-GAAP EPS was $3.98 (up 30.8%), with Nevro adding $293.6 million in revenue for the year.
  • U.S. spine grew 10% in Q4 (third consecutive quarter of about 10% growth), and the company now sits at 48 weeks of consecutive growth carrying into Q1 2026.
  • Enabling Technologies posted record Q4 revenue of $55.6 million, growing 18.5%, with record sales in both dollars and units as elongated pipeline deals finally closed.
  • The Nevro business was confirmed EPS accretive within the first nine months post-acquisition, beating initial guidance by 15 months, and Nevro standalone adjusted EBITDA margin expanded to 21.2% from 16.2% in Q3.
  • Adjusted gross profit margin reached 69.2%, up from 67.1% a year earlier, marking the sixth consecutive quarter of adjusted gross margin expansion, and base business adjusted EBITDA returned to mid-30s at 35.7% in Q4.
What went wrong
  • Enabling Technologies was a lumpy business through 2025, with a disappointing Q1 and Q3 before the Q4 bounce back, reflecting elongation of pipeline deals taking longer to close.
  • International spine was impacted by supply chain shortages early in 2025, as the U.S. was prioritized for supply, though it improved sequentially and ended with a record Q4.

Guidance Changes

MetricPeriodCurrent guidance
Adjusted gross profit marginFY202669%-70% (at least 100 bps improvement) (improving)
R&D expenseFY2026ramp toward 5%-6% range (increasing)
CapExFY20265%-6% of sales (unchanged)
Base business sales growthFY2026mid to high single digit (reiterated)

Performance Breakdown

MetricYoYNote
Total Q4 revenue +25.7% as reported (+24.7% constant currency) Domestic spine, record Enabling Technologies, and Nevro contribution
Base business Q4 revenue +10.6% as reported Double-digit U.S. spine growth and record Enabling Technologies
U.S. spine +9.7% as reported Competitive rep recruiting, new products, and leaning into inventory and sets
Enabling Technologies +18.5% as reported Increased ExcelsiusGPS sales as elongated pipeline deals closed, primarily cash deals
Trauma +26.8% as reported Continued momentum after resolving Precice manufacturing constraints
Q4 international revenue +19% as reported (+14.2% constant currency) Led by Enabling Technologies and international spine across UK, Australia, Germany, Brazil, Mexico, Poland
Adjusted gross profit margin 69.2% vs 67.1% Favorable sales mix, sales leverage, and synergy execution

Earnings Call Themes & Trends

TopicPrevious mentionCurrent periodTrend
Enabling Technologies deal structurePrimarily outright cash salesGreater flexibility with operating leases and placements; higher lease mix expected in 2026Shifting
U.S. spine durabilityRe-achieved 10% growth in Q310% growth in Q4, 48 weeks consecutive growth, viewed as durableSustained
Nevro turnaroundTargeted accretion within two yearsEPS accretive within nine months, but lumpiness expected to continue into 2026Improving but lumpy
Gross margin path to mid-70sSequential improvement, in-sourcing manufacturingSixth consecutive quarter of expansion, targeting low 70s in 2H 2026 and mid-70s (72%+) beyondImproving

Q&A Summary

Can you bridge from second-half 2025 growth to the mid to high single-digit 2026 guide, and how should we think about margins over time?
Keith Pfeil described 2025 as a tale of two halves with a slow start and U.S. spine reaccelerating, helped by product launches and inventory investment. Kyle Kline said they expect at least 100 bps of gross margin improvement to 69%-70% in 2026 versus 68.1% in 2025, following the typical seasonal cadence.
What drove the Enabling Technologies bounce back in Q4 and what is contemplated in 2026 guidance for leases?
Keith Pfeil said it was a lumpy year and the elongated pipeline deals finally closed in Q4, without losing deals to competition. He said operating leases are an option they will push more aggressively to drive implant pull-through, and Kyle Kline confirmed guidance assumes a mix of sales and fair-market-value leases with a higher lease mix in 2026.
How sustainable is the U.S. spine growth, and how do you view a competitor's new robot navigation system?
Keith Pfeil said the growth is durable, supported by product launches, sales force growth, and competitive rep conversions. He said recent competitive offerings reinforce what ExcelsiusGPS introduced in 2017 and that Globus is well positioned to weather competitive threats.
How much more synergy is left at Nevro and could synergies exceed expectations like NuVasive?
Kyle Kline said most G&A synergy actions are done over the nine-month period; the focus now pivots to maintaining the sales force and growing volume. He sees some COGS improvement opportunity (gross profit running 68%-69%) but no large remaining synergies.
Why guide legacy musculoskeletal to mid-single-digit growth if Q1 momentum is strong?
Keith Pfeil said Nevro will remain choppy and not grow linearly, and the Enabling Technologies shift toward operating leases may not produce the same upfront revenue recognition. He remains optimistic on core spine, international improving through the year, and trauma, and believes the guidance is achievable with Globus conservatism.
Can adjusted EBITDA margins go higher given the need to invest more in R&D?
Kyle Kline said R&D was down to about 5% of sales for the year and they want to ramp toward the 5%-6% range, investing across spine, trauma, and capital, while continuing to work back to the mid-30s EBITDA Globus has been known for.

More on Globus Medical Inc

Reported 2026-02-24 · figures from the Globus Medical Inc Q4 2025 earnings call.

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