Globus Medical (NYSE:GMED) reported what executives described as a “record Q4 performance” to close fiscal 2025, with management highlighting accelerating momentum in the company’s base spine franchise, a rebound in enabling technologies, and progress integrating recent acquisitions.
Fourth-quarter and full-year results
For the full year 2025, Globus delivered revenue of $2.939 billion and $3.98 in fully diluted non-GAAP earnings per share, representing growth of 16.7% and 30.8%, respectively, as reported. CFO Kyle Kline said GAAP net income for the year was $537.9 million (or $3.92 in fully diluted EPS), while non-GAAP net income was $545.6 million. Full-year adjusted EBITDA margin was 31.3%.
Management emphasized the performance of the “base business” (excluding Nevro). CEO Keith Pfeil said full-year 2025 base business revenue grew 5% as reported, while Nevro added $293.6 million of revenue during the year. In Q4, base business revenue was $726.7 million, up 10.6%, which included double-digit U.S. spine growth and record enabling technologies revenue.
Spine momentum and product focus
Pfeil said the U.S. spine business grew roughly 10% in Q4 and cited 48 consecutive weeks of growth, noting momentum had continued “thus far into” the first quarter of 2026. He attributed the trend to recruiting, new product launches, and operational steps to support growth, including leaning into inventory and set production.
Management called out broad-based U.S. spine growth across product categories, while highlighting strength in expandable TLIF systems, MIS pedicle screw lines, and power tools including DuraPro. Pfeil said surgeons have provided positive feedback on DuraPro, including its ability to cut and remove bone around neural elements and facilitate disc removal “in a safer, more controlled fashion” versus traditional approaches.
On recent launches, Pfeil said the company launched a total of six spine products in 2025, with four of those in Q4:
- CREO Traction (reduction instrument system used with CREO screws for deformity correction)
- Reline 3D Towers (for deformity and MIS fixation cases enabling MIS rod placement)
- AMS FreeHand instruments (software and instrumentation supporting AMS spacer portfolio with EGPS and EHub)
- HEDRON C-MIS (3D-printed cervical fusion spacer with biomimetic lattice)
Pfeil said spine product development would remain a focal point, with increased investment planned to support innovation.
Enabling technologies rebound and deal structure changes
Enabling technologies revenue in Q4 was $55.6 million, up 18.5% year over year. Both Pfeil and Kline characterized enabling technology performance as “lumpy” during the year, with Q4 benefiting from pipeline deals closing after earlier “elongation” in decision timelines. Kline added the quarter represented record sales in both dollars and units across the capital portfolio and the ExcelsiusGPS robotic system.
Pfeil said Q4 capital sales were “primarily cash deals with immediate revenue recognition,” but the company is increasingly quoting deals with greater flexibility. During Q&A, management discussed using operating leases and other structures more aggressively in 2026 to drive placements and implant pull-through, while acknowledging that leasing can change revenue recognition dynamics versus upfront sales.
Pfeil also addressed competitive developments in imaging/navigation/robotics, arguing that Globus continues to “stand alone” in pairing imaging, navigation, and robotics and that new competitive clearances “only serve to reinforce” the workflow of ExcelsiusGPS, which was introduced in 2017.
Trauma growth and Nevro integration progress
Pfeil said the trauma business grew approximately 27% in Q4, driven by uptake in the legacy trauma line and precise limb lengthening products. He highlighted the ANTHEM elbow plating system, launched in Q3 2025, saying it has exceeded expectations in both revenue and demand.
Nevro contributed $99.7 million of Q4 revenue and delivered a 21.2% adjusted EBITDA margin, up from 16.2% in Q3, according to Kline. Management said the integration remains in progress and the path may not be linear in the short term, but expectations are high longer term.
Kline also said Nevro became EPS accretive within the first nine months post-acquisition—earlier than Globus’ prior guidance—calling it “a phenomenal achievement.” In Q&A, management said synergy actions to date have focused primarily on G&A, while future profitability improvements are expected to come from sales growth and, longer term, manufacturing and procurement efficiencies rather than large new synergy programs.
Margins, cash deployment, and 2026 guidance
Gross margin improvement was a key theme. Q4 GAAP gross margin was 65.7% versus 57.2% a year ago, which Kline said was driven primarily by lower inventory step-up amortization. Adjusted gross margin was 69.2%, up from 67.1%, due to sales mix, sales leverage, and synergy execution. For the full year, GAAP gross margin was 64.3% and adjusted gross margin was 68.1%. Kline said the company has delivered six consecutive quarters of adjusted gross margin expansion and continues to target a long-term mid-70s adjusted gross margin profile.
On operating expenses, Q4 SG&A was $318.5 million (38.5% of sales) and included one-time net charges for estimated litigation of $13.4 million. Excluding those charges, consolidated SG&A was 36.9% of sales. The company expects 2026 SG&A to be 38%–39% of net sales, and R&D to be 5%–6% as it increases investment across spine, orthopedics, robotics, and musculoskeletal markets.
Globus ended 2025 with $629.1 million in cash, cash equivalents, and marketable securities, down from $956.2 million at the end of 2024. Kline attributed the decline to repayment of $450 million in convertible debt in Q1 2025, the $252.5 million Nevro acquisition, and $300.5 million of share repurchases (about 4.3 million shares). The company had $390 million remaining under its $500 million authorization as of December 31, 2025, and expects 2026 capex of 5%–6% of net sales.
For 2026, Globus reaffirmed revenue guidance of $3.18 billion to $3.22 billion and raised its non-GAAP diluted EPS outlook to $4.40 to $4.50 from a prior range of $4.30 to $4.40, citing confidence in sustained margin expansion.
About Globus Medical (NYSE:GMED)
Globus Medical, Inc (NYSE:GMED) is a leading medical device company specializing in musculoskeletal solutions for spine and orthopaedic applications. Founded in 2003 by David C. Paul and headquartered in Audubon, Pennsylvania, the company develops, manufactures and markets implantable devices and surgical instruments designed to treat spinal disorders and promote bone healing. Its product portfolio encompasses solutions for minimally invasive and open surgical procedures, including interbody fusion devices, pedicle screw systems, and biologics used to enhance fusion outcomes.
In addition to its core spine business, Globus Medical has expanded into robotics and navigation systems to support precision and efficiency in the operating room.
