0001493152-25-021512 | 10-Q | XBRL Viewer | Xtant Medical Holdings INC

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Schedule of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2025	Dec. 31, 2024
Property, Plant and Equipment [Line Items]
Total cost	$ 31,869	$ 29,968
Less: accumulated depreciation	(21,860)	(19,837)
Property and equipment, net	10,009	10,131
Equipment [Member]
Property, Plant and Equipment [Line Items]
Total cost	7,353	7,239
Computer Equipment [Member]
Property, Plant and Equipment [Line Items]
Total cost	1,321	1,254
Computer Software [Member]
Property, Plant and Equipment [Line Items]
Total cost	361	361
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Total cost	4,454	4,356
Surgical Instruments [Member]
Property, Plant and Equipment [Line Items]
Total cost	17,660	15,798
Assets not yet in Service [Member]
Property, Plant and Equipment [Line Items]
Total cost	$ 720	$ 960

Property and Equipment, Net

9 Months Ended

Sep. 30, 2025

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

(6) Property and Equipment, Net

Property and equipment, net are as follows (in thousands):

Schedule of Property and Equipment, Net

	September 30, 2025			December 31, 2024
Equipment	$	7,353		$	7,239
Computer equipment		1,321			1,254
Computer software		361			361
Leasehold improvements		4,454			4,356
Surgical instruments		17,660			15,798
Assets not yet in service		720			960
Total cost		31,869			29,968
Less: accumulated depreciation		(21,860	)		(19,837	)
Property and equipment, net	$	10,009		$	10,131

Depreciation expense related to property and equipment, including property under finance leases, was $0.7 million for both the three months ended September 30, 2025 and 2024, and $2.1 million and $1.8 million for the nine months ended September 30, 2025 and 2024, respectively.

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2025	Dec. 31, 2024
Current Assets:
Cash and cash equivalents	$ 10,400	$ 6,199
Restricted cash	241	22
Trade accounts receivable, net of allowance for credit losses and doubtful accounts of $2,025 and $1,437, respectively	25,517	20,660
Inventories	40,714	38,634
Prepaid and other current assets	1,458	1,601
Total current assets	78,330	67,116
Property and equipment, net	10,009	10,131
Right-of-use asset, net	3,619	829
Goodwill	7,302	7,302
Intangible assets, net	7,060	8,356
Other assets	1	103
Total Assets	106,321	93,837
Current Liabilities:
Accounts payable	6,856	7,918
Accrued liabilities	11,535	7,771
Advances from pending sale of Coflex/CoFix assets and international hardware business	5,000
Current portion of lease liability	760	703
Current portion of finance lease obligations	44	69
Line of credit	11,308	12,120
Total current liabilities	35,503	28,581
Long-term Liabilities:
Lease liability, less current portion	2,949	166
Finance lease obligation, less current portion	22	47
Long-term debt, plus premium and less issuance costs	17,404	22,038
Other liabilities	60	42
Total Liabilities	55,938	50,874
Commitments and Contingencies (note 13)
Stockholders’ Equity:
Preferred stock, $0.000001 par value; 10,000,000 shares authorized; no shares issued and outstanding
Common stock, $0.000001 par value; 300,000,000 shares authorized; 140,004,240 shares issued and outstanding as of September 30, 2025 and 139,045,664 shares issued and outstanding as of December 31, 2024
Additional paid-in capital	304,787	302,738
Accumulated other comprehensive income (loss)	139	(316)
Accumulated deficit	(254,543)	(259,459)
Total Stockholders’ Equity	50,383	42,963
Total Liabilities & Stockholders’ Equity	$ 106,321	$ 93,837

Schedule of Long-term Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2025	Dec. 31, 2024
Debt Disclosure [Abstract]
Amounts due under the term loan	$ 17,000	$ 22,000
Accrued end-of-term payments	734	465
Less: unamortized debt issuance costs	(330)	(427)
Long-term debt, less issuance costs	$ 17,404	$ 22,038

- Definition

Amount, after deduction of unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

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The carrying value as of the balance sheet date of the noncurrent portion of long-term obligations drawn from a line of credit, which is a bank's commitment to make loans up to a specific amount. Examples of items that might be included in the application of this element may consist of letters of credit, standby letters of credit, and revolving credit arrangements, under which borrowings can be made up to a maximum amount as of any point in time conditional on satisfaction of specified terms before, as of and after the date of drawdowns on the line. Includes short-term obligations that would normally be classified as current liabilities but for which (a) postbalance sheet date issuance of a long term obligation to refinance the short term obligation on a long term basis, or (b) the enterprise has entered into a financing agreement that clearly permits the enterprise to refinance the short-term obligation on a long term basis and the following conditions are met (1) the agreement does not expire within 1 year and is not cancelable by the lender except for violation of an objectively determinable provision, (2) no violation exists at the BS date, and (3) the lender has entered into the financing agreement is expected to be financially capable of honoring the agreement.

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Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2025	Dec. 31, 2024
Statement of Financial Position [Abstract]
Allowance for credit losses, net	$ 2,025	$ 1,437
Preferred stock, par value	$ 0.000001	$ 0.000001
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.000001	$ 0.000001
Common stock, shares authorized	300,000,000	300,000,000
Common stock, shares issued	140,004,240	139,045,664
Common stock, shares outstanding	140,004,240	139,045,664

Schedule of Income Taxes (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
Schedule of Income Taxes (Details) - USD ($) $ in Thousands	Sep. 30, 2025	Sep. 30, 2024	Sep. 30, 2025	Sep. 30, 2024
Income Tax Disclosure [Abstract]
Income tax expense from continuing operations	$ 257	$ 62	$ 487	$ 166
Income (loss) from continuing operations before income taxes	$ 1,565	$ (4,962)	$ 5,403	$ (13,118)
Effective income tax rate	16.40%	(1.20%)	9.00%	(1.30%)

- Definition

Amount of income (loss) from continuing operations, including income (loss) from equity method investments, before deduction of income tax expense (benefit), and income (loss) attributable to noncontrolling interest.

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Business Description, Basis of Presentation and Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2025
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Use of Estimates	Use of Estimates The preparation of the condensed consolidated financial statements requires management of the Company to make a number of estimates and assumptions relating to the reported amount of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenue and expenses during the period. Significant estimates include the carrying amount of property and equipment; goodwill, intangible assets and liabilities; valuation allowances for trade receivables, inventory, deferred income tax assets and liabilities; current and long-term lease obligations and corresponding right-of-use asset; and estimates for the fair value of long-term debt, stock options and other equity awards upon which the Company determines stock-based compensation expense. Actual results could differ from those estimates.
Cash, Cash Equivalents, and Restricted Cash	Cash, Cash Equivalents, and Restricted Cash The Company considers all highly liquid investments purchased with an original maturity date of three months or less to be cash equivalents. Cash equivalents are recorded at cost, which approximates market value. The Company maintains its cash balances primarily with two financial institutions. These balances generally exceed federally insured limits. The Company has not experienced any losses in such accounts and believes it is not exposed to any significant credit risk in cash and cash equivalents. Cash and cash equivalents classified as restricted cash on the Company’s condensed consolidated balance sheets are restricted as to withdrawal or use under the terms of certain contractual agreements. The September 30, 2025 and December 31, 2024 balances included lockbox deposits that are temporarily restricted due to timing at the period end. The lockbox deposits are applied against the Company’s line of credit the next business day.
Long-Lived Assets	Long-Lived Assets The Company reviews its long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of the asset may not be recovered. No impairments of long-lived assets were recorded for the three and nine months ended September 30, 2025 and 2024.
Goodwill	Goodwill Goodwill represents the excess of costs over fair value of assets of businesses acquired. Goodwill and intangible assets acquired in a purchase business combination and determined to have indefinite useful lives are not amortized. Instead, they are tested for impairment at least annually, and whenever events or circumstances indicate, the carrying amount of the asset may not be recoverable. No impairments of goodwill were recorded for the three and nine months ended September 30, 2025 and 2024.
Stock-Based Compensation	Stock-Based Compensation The Company accounts for stock-based compensation in accordance with Financial Accounting Standards Board, or FASB, Accounting Standards Codification (“ASC”) 718, Compensation-Stock Compensation. ASC 718 requires the recognition of compensation expense, using a fair-value based method, for costs related to all stock-based payments including stock options, restricted stock units, performance stock units, and shares issued under its employee stock purchase plan. ASC 718 requires companies to estimate the fair value of all share-based payment option awards on the date of grant using an option pricing model. The fair value of stock options is recognized over the period during which an optionee is required to provide services in exchange for the option award, known as the requisite service period (usually the vesting period), on a straight-line basis. The Company accounts for option forfeitures as they occur. The Company accounts for stock-based compensation for restricted stock units and deferred stock units at their fair value, based on the closing market price of the Company’s common stock on the date of grant. These costs are recognized on a straight-line basis over the requisite service period, which is usually the vesting period. The Company accounts for stock-based compensation for performance stock units with market-based conditions at their fair value on the date of the award using the Monte Carlo simulation model. These costs are recognized over the requisite service period, which is usually the vesting period, regardless of the likelihood of achievement of the market-based performance criteria.
Recently Issued Accounting Pronouncements	Recently Issued Accounting Pronouncements In December 2023, the Financial Accounting Standards Board issued Accounting Standards Update (“ASU”) No. 2023-09, Income Taxes (Topic 740): Improvement to Income Tax Disclosures to enhance the transparency of income tax disclosures. The guidance in ASU No. 2023-09 allows for a prospective method of transition, with the option to apply the standard retrospectively. The standard is effective for fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the effect of this new guidance on its consolidated financial statements. In November 2024, the Financial Accounting Standards Board issued ASU 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40). This ASU requires that public business entities disclose additional information about specific expense categories in the notes to financial statements at interim and annual reporting periods. The prescribed categories include purchases of inventory, employee compensation, depreciation, intangible asset amortization, and depletion. This authoritative guidance is effective for annual periods beginning after December 15, 2026 and interim periods beginning after December 15, 2027, with early adoption permitted. The Company is currently evaluating the effect of this new guidance on its consolidated financial statements.
Foreign Currency	Foreign Currency The Company generates revenues outside the United States in multiple foreign currencies including euros, Swiss francs, British pounds and in U.S. dollar-denominated transactions conducted with customers who generate revenue in currencies other than the U.S. dollar. The Company also incurs operating expenses in euros, Swiss francs and British pounds. All assets and liabilities of foreign subsidiaries which have a functional currency other than the U.S. dollar are translated at the rate of exchange at period-end, while elements of the income statement are translated at the average exchange rates in effect during the period. The net effect of these translation adjustments is shown as a component of accumulated other comprehensive income. Foreign currency transaction gains and losses are reported in other income, net.
Fair Value of Financial Instruments	Fair Value of Financial Instruments The carrying values of financial instruments, including trade accounts receivable, accounts payable, accrued liabilities, and long-term debt, approximate their fair values based on terms and related interest rates as of September 30, 2025 and December 31, 2024.

- Definition

Disclosure of accounting policy for award under share-based payment arrangement. Includes, but is not limited to, methodology and assumption used in measuring cost.

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Schedule of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2025	Jun. 30, 2025	Mar. 31, 2025	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2025	Sep. 30, 2024
Net Income (Loss) Per Share:
Net income (loss)	$ 1,308	$ 3,550	$ 58	$ (5,024)	$ (3,861)	$ (4,400)	$ 4,916	$ (13,284)
Basic – weighted average shares outstanding	139,712,969			135,100,233			139,366,489	131,881,302
Employee restricted stock units and deferred stock units	5,412,153						5,293,691
Warrants	5,252,112						5,252,112
Diluted – weighted average shares outstanding	150,377,234			135,100,233			149,912,292	131,881,302
Basic earnings (loss) per share	$ 0.01			$ (0.04)			$ 0.04	$ (0.10)
Diluted earnings (loss) per share	$ 0.01			$ (0.04)			$ 0.03	$ (0.10)

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+ Details

Schedule of Revenues by Geographic Region (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2025	Sep. 30, 2024	Sep. 30, 2025	Sep. 30, 2024
Revenues from External Customers and Long-Lived Assets [Line Items]
Total revenue	$ 33,255	$ 27,937	$ 101,570	$ 85,754
UNITED STATES
Revenues from External Customers and Long-Lived Assets [Line Items]
Total revenue	30,312	25,342	92,561	76,752
Non-US [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total revenue	$ 2,943	$ 2,595	$ 9,009	$ 9,002

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

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+ Details

Commitments and Contingencies (Tables)

9 Months Ended

Sep. 30, 2025

Commitments and Contingencies Disclosure [Abstract]

Schedule of Future Minimum Payments for Operating Leases

Future minimum payments as of September 30, 2025 under these long-term operating leases are as follows (in thousands):


Remainder of 2025	$	305
2026		1,035
2027		925
2028		893
2029		874
Thereafter		689
Total future minimum lease payments		4,721
Less: amount representing interest		(1,012	)
Present value of obligations under operating leases		3,709
Less: current portion		(760	)
Long-term operating lease obligations	$	2,949

Warrants (Details Narrative) - Warrant [Member] - $ / shares	Sep. 30, 2025	Dec. 31, 2024
Class of Warrant or Right [Line Items]
Exercisable warrants	12,237,470	12,237,470
Weighted average exercise price	$ 1.53	$ 1.53
Weighted average remaining contractual term	1 year	1 year 9 months 18 days

Schedule of Revenues from Product Lines (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2025	Sep. 30, 2024	Sep. 30, 2025	Sep. 30, 2024
Disaggregation of Revenue [Line Items]
Revenue	$ 33,255	$ 27,937	$ 101,570	$ 85,754
Percentage of total revenue	100.00%	100.00%	100.00%	100.00%
Orthobiologics [Member]
Disaggregation of Revenue [Line Items]
Revenue	$ 17,149	$ 16,579	$ 54,593	$ 48,123
Percentage of total revenue	52.00%	59.00%	54.00%	56.00%
Spinal Implant [Member]
Disaggregation of Revenue [Line Items]
Revenue	$ 10,623	$ 11,358	$ 32,899	$ 37,631
Percentage of total revenue	32.00%	41.00%	32.00%	44.00%
License Revenue [Member]
Disaggregation of Revenue [Line Items]
Revenue	$ 5,483		$ 14,078
Percentage of total revenue	16.00%		14.00%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Sep. 30, 2025
Insider Trading Arrangements [Line Items]
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Accrued Liabilities (Tables)

9 Months Ended

Sep. 30, 2025

Payables and Accruals [Abstract]

Schedule of Accrued Liabilities

Accrued liabilities consist of the following (in thousands):

Schedule of Accrued Liabilities

	September 30, 2025		December 31, 2024
Cash compensation/commissions payable	$	7,537	$	5,565
Other accrued liabilities		3,998		2,206
Accrued liabilities	$	11,535	$	7,771

Debt

9 Months Ended

Sep. 30, 2025

Debt Disclosure [Abstract]

Debt

(9) Debt

Long-term debt consists of the following (in thousands):

Schedule of Long-term Debt

	September 30, 2025			December 31, 2024
Amounts due under the term loan	$	17,000		$	22,000
Accrued end-of-term payments		734			465
Less: unamortized debt issuance costs		(330	)		(427	)
Long-term debt, less issuance costs	$	17,404		$	22,038

The effective rate of the term loan, inclusive of amortization of debt issuance costs and accretion of the final payment, was 13.18% as of September 30, 2025. The effective rate of the revolving line of credit was 8.89% as of September 30, 2025. As of September 30, 2025, the Company had $5.7 million available under its revolving line of credit.

The credit agreements contain affirmative and negative covenants customarily applicable to senior secured credit facilities, including covenants that, among other things, limit or restrict the ability of certain subsidiaries of the Company, as borrowers (the “Borrowers”), subject to negotiated exceptions, to incur additional indebtedness and additional liens on their assets, engage in mergers or acquisitions or dispose of assets, pay dividends or make other distributions, voluntarily prepay other indebtedness, enter into transactions with affiliated persons, make investments, undergo a change in control, and change the nature of their businesses. On April 9, 2025, the credit agreements were amended to increase the common stock ownership threshold that triggers a change in control from 40% to 49.9% to accommodate the sale of common stock from funds affiliated with OrbiMed Advisors LLC to Nantahala Capital Management, LLC. In addition, on July 7, 2025, the Company and certain of its subsidiaries entered into the Term Loan Limited Consent and Revolving Loan Limited Consent with MidCap under which MidCap agreed, subject to the terms and conditions set forth therein, to, among other things, consent to the Company entering into the Coflex/CoFix Agreement and Paradigm Agreement and the consummation of the Transactions in accordance with the terms and subject to the conditions set forth therein, including the prepayment in accordance with the Term Loan Credit Agreement of $9.6 million to MidCap from the proceeds of the transactions contemplated by the Coflex/CoFix Agreement and Paradigm Agreement, $7.5 million of which has been already prepaid from the $7.5 million in non-refundable deposits previously paid to the Company, $5.0 million of which was repaid as of September 30, 2025. See Note 2, “Pending Sale of Coflex/CoFix Assets and International Hardware Business.” In addition, the credit agreements require the Borrowers and the Company to maintain net product revenue at or above minimum levels and to maintain a certain minimum liquidity level, in each case as specified in the credit agreements. As of September 30, 2025, the Company was in compliance with all covenants under the credit agreements.

Each of the Borrowers, and the Company, as guarantor, are jointly and severally liable for all of the obligations under the term loan and revolving line of credit agreements. The Borrowers’ obligations, and the Company’s obligations as a guarantor, under the credit agreements are secured by first-priority liens on substantially all of their assets, including, without limitation, all inventory, equipment, accounts, intellectual property and other assets of the Company and the Borrowers.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

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+ Details

Intangible Assets

9 Months Ended

Sep. 30, 2025

Goodwill and Intangible Assets Disclosure [Abstract]

Intangible Assets

(7) Intangible Assets

The following table sets forth information regarding intangible assets (in thousands):

Schedule of Intangible of Assets

September 30, 2025:	Weighted Average Life	Cost		Accumulated Amortization			Net
Patents	11 years	$	2,777	$	(1,155	)	$	1,622
Customer List	6 years		8,000		(3,445	)		4,555
Tradenames	10 years		1,190		(307	)		883
		$	11,967	$	(4,907	)	$	7,060

December 31, 2024:	Weighted Average Life	Cost		Accumulated Amortization			Net
Patents	11 years	$	2,777	$	(948	)	$	1,829
Customer List	6 years		8,000		(2,445	)		5,555
Tradenames	10 years		1,190		(218	)		972
		$	11,967	$	(3,611	)	$	8,356

Amortization expense was $0.4 million for both the three months ended September 30, 2025 and 2024, and $1.3 million for both the nine months ended September 30, 2025 and 2024.

Schedule of Deferred Stock Units and Restricted Stock Activity (Details) - Deferred Stock Units and Restricted Stock Units [Member] - 2023 and 2018 Equity Incentive Plan [Member] - $ / shares	9 Months Ended
	Sep. 30, 2025	Sep. 30, 2024
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Shares Outstanding, Beginning balance	5,455,472	3,524,675
Weighted Average Fair Value at Grant Date, Outstanding Beginning Balance	$ 0.90	$ 1.07
Shares, Granted	100,000	4,195,363
Weighted Average Fair Value at Grant Date Per Share, Granted	$ 0.62	$ 0.84
Shares, Vested	(1,154,820)	(1,482,056)
Weighted Average Fair Value at Grant Date, Vested	$ 0.67	$ 1.08
Shares, Cancelled	(80,116)	(675,820)
Weighted Average Fair Value at Grant Date, Cancelled	$ 0.98	$ 0.90
Shares Outstanding, Ending Balance	4,320,536	5,562,162
Weighted Average Fair Value at Grant Date, Outstanding Ending Balance	$ 0.96	$ 0.91

Schedule of Accrued Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2025	Dec. 31, 2024
Payables and Accruals [Abstract]
Cash compensation/commissions payable	$ 7,537	$ 5,565
Other accrued liabilities	3,998	2,206
Accrued liabilities	$ 11,535	$ 7,771

Net Income (Loss) Per Share (Tables)

9 Months Ended

Sep. 30, 2025

Net Income (Loss) Per Share:

Schedule of Basic and Diluted Earnings Per Share

The table below sets forth the computation of basic and diluted earnings (loss) per share (in thousands, except per share data):

	2025		2024			2025		2024
	Three Months Ended September 30,					Nine Months Ended September 30,
	2025		2024			2025		2024
Numerator:
Net income (loss)	$	1,308	$	(5,024	)	$	4,916	$	(13,284	)
Denominator:
Basic – weighted average shares outstanding		139,712,969		135,100,233			139,366,489		131,881,302
Effect of dilutive securities:
Employee restricted stock units and deferred stock units		5,412,153		—			5,293,691		—
Warrants		5,252,112		—			5,252,112		—
Diluted – weighted average shares outstanding		150,377,234		135,100,233			149,912,292		131,881,302
Basic earnings (loss) per share		0.01		(0.04	)		0.04		(0.10	)
Diluted earnings (loss) per share		0.01		(0.04	)		0.03		(0.10	)

Revenue (Details Narrative) - USD ($) $ in Thousands	3 Months Ended			9 Months Ended		12 Months Ended
Revenue (Details Narrative) - USD ($) $ in Thousands	Sep. 30, 2025	Dec. 31, 2024	Sep. 30, 2024	Sep. 30, 2025	Sep. 30, 2024	Dec. 31, 2025
Disaggregation of Revenue [Line Items]
Revenue	$ 33,255		$ 27,937	$ 101,570	$ 85,754
Licensing Agreement [Member]
Disaggregation of Revenue [Line Items]
Cash payment received		$ 1,500
Licensing Agreement [Member] \| Forecast [Member]
Disaggregation of Revenue [Line Items]
Guaranteed quarterly royalty minimums to be received						$ 3,750
Bill and Hold Transactions [Member]
Disaggregation of Revenue [Line Items]
Revenue				$ 600

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Income Taxes (Tables)

9 Months Ended

Sep. 30, 2025

Income Tax Disclosure [Abstract]

Schedule of Income Taxes

Information on the Company’s income taxes for the periods reported is as follows:

Schedule of Income Taxes

	2025			2024			2025			2024
	Three Months Ended September 30,						Nine Months Ended September 30,
	2025			2024			2025			2024
Income tax expense from continuing operations	$	257		$	62		$	487		$	166
Income (loss) from continuing operations before income taxes	$	1,565		$	(4,962	)	$	5,403		$	(13,118	)
Effective income tax rate		16.4	%		-1.2	%		9.0	%		-1.3	%

Property and Equipment, Net (Tables)

9 Months Ended

Sep. 30, 2025

Property, Plant and Equipment [Abstract]

Schedule of Property and Equipment, Net

Property and equipment, net are as follows (in thousands):

Schedule of Property and Equipment, Net

	September 30, 2025			December 31, 2024
Equipment	$	7,353		$	7,239
Computer equipment		1,321			1,254
Computer software		361			361
Leasehold improvements		4,454			4,356
Surgical instruments		17,660			15,798
Assets not yet in service		720			960
Total cost		31,869			29,968
Less: accumulated depreciation		(21,860	)		(19,837	)
Property and equipment, net	$	10,009		$	10,131

Debt (Details Narrative) - USD ($) $ in Millions	Sep. 30, 2025	Jul. 07, 2025	Apr. 09, 2025	Apr. 08, 2025	Nov. 11, 2025
Line of Credit Facility [Line Items]
Line of credit facility remaining borrowing	$ 5.7
Debt instrument, convertible, threshold percentage of stock price trigger			49.90%	40.00%
Limited Consent Agreements [Member] \| MidCap Funding IV Trust [Member]
Line of Credit Facility [Line Items]
Repayments of debt	$ 5.0	$ 9.6
Prepaid funds					$ 7.5
Non-refundable deposits					$ 7.5
Term Loan [Member]
Line of Credit Facility [Line Items]
Line of credit issuance costs	13.18%
Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Line of credit issuance costs	8.89%

Condensed Consolidated Statements of Equity (Unaudited) - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	AOCI Attributable to Parent [Member]	Retained Earnings [Member]
Balance at Dec. 31, 2023	$ 51,349		$ 294,330	$ 29	$ (243,010)
Balance, shares at Dec. 31, 2023		130,180,031
Common stock issued upon settlement of restricted stock units
Common stock issued upon vesting and settlement of restricted stock units, shares		44,496
Withholding of common stock upon settlement of restricted stock units	(17)		(17)
Withholding on common stock upon vesting and settlement of restricted stock units, shares		(7,986)
Stock-based compensation	910		910
Foreign currency translation adjustment	(162)			(162)
Net income (loss)	(4,400)				(4,400)
Balance at Mar. 31, 2024	47,680		295,223	(133)	(247,410)
Balance, shares at Mar. 31, 2024		130,216,541
Balance at Dec. 31, 2023	51,349		294,330	29	(243,010)
Balance, shares at Dec. 31, 2023		130,180,031
Foreign currency translation adjustment	25
Net income (loss)	(13,284)
Balance at Sep. 30, 2024	45,725		301,966	54	(256,295)
Balance, shares at Sep. 30, 2024		138,680,874
Balance at Mar. 31, 2024	47,680		295,223	(133)	(247,410)
Balance, shares at Mar. 31, 2024		130,216,541
Common stock issued upon settlement of restricted stock units
Common stock issued upon vesting and settlement of restricted stock units, shares		97,831
Stock-based compensation	1,228		1,228
Foreign currency translation adjustment	(42)			(42)
Net income (loss)	(3,861)				(3,861)
Balance at Jun. 30, 2024	45,005		296,451	(175)	(251,271)
Balance, shares at Jun. 30, 2024		130,314,372
Common stock issued upon settlement of restricted stock units
Common stock issued upon vesting and settlement of restricted stock units, shares		689,977
Withholding of common stock upon settlement of restricted stock units	(93)		(93)
Withholding on common stock upon vesting and settlement of restricted stock units, shares		(155,833)
Stock-based compensation	1,139		1,139
Foreign currency translation adjustment	229			229
Net income (loss)	(5,024)				(5,024)
Private placement of common stock, net of issuance costs of $191	4,456		4,456
Private placement of common stock, net of issuance costs, shares		7,812,500
Exercise of stock options	13		13
Exercise of stock options, shares		19,858
Balance at Sep. 30, 2024	45,725		301,966	54	(256,295)
Balance, shares at Sep. 30, 2024		138,680,874
Balance at Dec. 31, 2024	42,963		302,738	(316)	(259,459)
Balance, shares at Dec. 31, 2024		139,045,664
Common stock issued upon settlement of restricted stock units
Common stock issued upon vesting and settlement of restricted stock units, shares		44,496
Withholding of common stock upon settlement of restricted stock units	(9)		(9)
Withholding on common stock upon vesting and settlement of restricted stock units, shares		(7,986)
Stock-based compensation	758		758
Foreign currency translation adjustment	107			107
Net income (loss)	58				58
Balance at Mar. 31, 2025	43,877		303,487	(209)	(259,401)
Balance, shares at Mar. 31, 2025		139,082,174
Balance at Dec. 31, 2024	42,963		302,738	(316)	(259,459)
Balance, shares at Dec. 31, 2024		139,045,664
Foreign currency translation adjustment	455
Net income (loss)	4,916
Balance at Sep. 30, 2025	50,383		304,787	139	(254,543)
Balance, shares at Sep. 30, 2025		140,004,240
Balance at Mar. 31, 2025	43,877		303,487	(209)	(259,401)
Balance, shares at Mar. 31, 2025		139,082,174
Common stock issued upon settlement of restricted stock units
Common stock issued upon vesting and settlement of restricted stock units, shares		342,128
Withholding of common stock upon settlement of restricted stock units	(52)		(52)
Withholding on common stock upon vesting and settlement of restricted stock units, shares		(108,580)
Stock-based compensation	766		766
Foreign currency translation adjustment	361			361
Net income (loss)	3,550				3,550
Balance at Jun. 30, 2025	48,502		304,201	152	(255,851)
Balance, shares at Jun. 30, 2025		139,315,722
Common stock issued upon settlement of restricted stock units
Common stock issued upon vesting and settlement of restricted stock units, shares		768,196
Withholding of common stock upon settlement of restricted stock units	(55)		(55)
Withholding on common stock upon vesting and settlement of restricted stock units, shares		(79,678)
Stock-based compensation	641		641
Foreign currency translation adjustment	(13)			(13)
Net income (loss)	1,308				1,308
Balance at Sep. 30, 2025	$ 50,383		$ 304,787	$ 139	$ (254,543)
Balance, shares at Sep. 30, 2025		140,004,240

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2025	Sep. 30, 2024
Operating activities:
Net income (loss)	$ 4,916	$ (13,284)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and amortization	3,404	3,076
Gain on disposal of fixed assets	(16)	(182)
Non-cash interest	415	369
Stock-based compensation	2,165	3,277
Provision for expected credit losses	568	330
Provision for excess and obsolete inventory	1,318	695
Other	68	(1)
Changes in operating assets and liabilities:
Accounts receivable	(5,639)	(128)
Inventories	(2,789)	(5,657)
Prepaid and other assets	314	(503)
Accounts payable	(1,279)	1,290
Accrued liabilities	3,721	(1,843)
Net cash provided by (used in) operating activities	7,166	(12,561)
Investing activities:
Purchases of property and equipment	(1,987)	(3,441)
Proceeds from sale of fixed assets	206	278
Advances from pending sale of Coflex/CoFix assets and international hardware business	5,000
Net cash provided by (used in) investing activities	3,219	(3,163)
Financing activities:
Payments on financing leases	(51)	(49)
Borrowings on line of credit	77,573	86,315
Repayments on line of credit	(78,385)	(78,050)
Payments on long-term debt	(5,000)
Proceeds from private placement, net of cash issuance costs		4,456
Proceeds from issuance of long-term debt		5,000
Debt issuance costs	(49)	(648)
Proceeds from the exercise of stock-based compensation		13
Payments of taxes from withholding of common stock on settlement of restricted stock units	(116)	(110)
Net cash (used in) provided by financing activities	(6,028)	16,927
Effect of exchange rate changes on cash and cash equivalents and restricted cash	63	(40)
Net change in cash and cash equivalents and restricted cash	4,420	1,163
Cash and cash equivalents and restricted cash at beginning of period	6,221	5,923
Cash and cash equivalents and restricted cash at end of period	10,641	7,086
Reconciliation of cash and cash equivalents and restricted cash reported in the condensed consolidated balance sheets
Cash and cash equivalents	10,400	6,596
Restricted cash	241	490
Total cash and restricted cash reported in condensed consolidated balance sheets	$ 10,641	$ 7,086

Revenue (Tables)

9 Months Ended

Sep. 30, 2025

Revenue from Contract with Customer [Abstract]

Schedule of Revenues from Product Lines

	Three Months Ended		Percentage of			Three Months Ended		Percentage of
	September 30, 2025		Total Revenue			September 30, 2024		Total Revenue
Orthobiologics	$	17,149		52	%	$	16,579		59	%
Spinal implant		10,623		32	%		11,358		41	%
License revenue		5,483		16	%		—		—	%
Total revenue	$	33,255		100	%	$	27,937		100	%

	Nine Months Ended		Percentage of			Nine Months Ended		Percentage of
	September 30, 2025		Total Revenue			September 30, 2024		Total Revenue
Orthobiologics	$	54,593		54	%	$	48,123		56	%
Spinal implant		32,899		32	%		37,631		44	%
License revenue		14,078		14	%		—		—	%
Total revenue	$	101,570		100	%	$	85,754		100	%

Debt (Tables)

9 Months Ended

Sep. 30, 2025

Debt Disclosure [Abstract]

Schedule of Long-term Debt

Long-term debt consists of the following (in thousands):

Schedule of Long-term Debt

	September 30, 2025			December 31, 2024
Amounts due under the term loan	$	17,000		$	22,000
Accrued end-of-term payments		734			465
Less: unamortized debt issuance costs		(330	)		(427	)
Long-term debt, less issuance costs	$	17,404		$	22,038

Warrants

9 Months Ended

Sep. 30, 2025

Warrants

Warrants

(11) Warrants

As of September 30, 2025 and December 31, 2024, there were outstanding and exercisable warrants to purchase an aggregate of 12,237,470 shares of our common stock at a weighted average exercise price of $1.53 per share, with a weighted average remaining contractual term of 1.0 years and 1.8 years, respectively.

Schedule of Future Minimum Payments for Operating Leases (Details) - USD ($) $ in Thousands	Sep. 30, 2025	Dec. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Remainder of 2025	$ 305
2026	1,035
2027	925
2028	893
2029	874
Thereafter	689
Total future minimum lease payments	4,721
Less: amount representing interest	(1,012)
Present value of obligations under operating leases	3,709
Less: current portion	(760)	$ (703)
Long-term operating lease obligations	$ 2,949	$ 166

Schedule of Calculation of Consolidated Net (Loss) Income (Details) - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2025	Jun. 30, 2025	Mar. 31, 2025	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2025	Sep. 30, 2024
Segment Reporting [Abstract]
Revenue	$ 33,255			$ 27,937			$ 101,570	$ 85,754
Less cost of sales	11,263			11,630			35,051	33,562
Gross Profit	$ 21,992			$ 16,307			$ 66,519	$ 52,192
Gross Margin	66.10%			58.40%			65.50%	60.90%
General and administrative	$ 7,071			$ 7,493			$ 22,082	$ 22,991
Sales and marketing	11,746			11,890			34,566	37,530
Research and development	634			701			1,643	1,863
Interest expense	904			1,199			2,953	3,026
Unrealized foreign currency translation loss (gain)	56			(27)			(146)	(106)
Other expense	16			13			18	6
Provision for income taxes	257			62			487	166
Net Income (Loss)	$ 1,308	$ 3,550	$ 58	$ (5,024)	$ (3,861)	$ (4,400)	$ 4,916	$ (13,284)

Inventories

9 Months Ended

Sep. 30, 2025

Inventory Disclosure [Abstract]

Inventories

(5) Inventories

Inventories consist of the following (in thousands):

Schedule of Inventories

	September 30, 2025		December 31, 2024
Raw materials	$	5,601	$	6,622
Work in process		4,535		2,812
Finished goods		30,578		29,200
Total	$	40,714	$	38,634

Net Income (Loss) Per Share

9 Months Ended

Sep. 30, 2025

Net Income (Loss) Per Share:

Net Income (Loss) Per Share

(15) Net Income (Loss) Per Share

Basic net income (loss) per share is computed by dividing net income (loss) by the weighted average number of shares of common stock outstanding. Shares issued during the period and shares reacquired during the period are weighted for the portion of the period that they were outstanding. Diluted net income (loss) per share is computed in a manner consistent with that of basic earnings per share while giving effect to all potentially dilutive shares of common stock outstanding during the period, which include the assumed exercise of stock options and warrants using the treasury stock method. Diluted net income (loss) per share was the same as basic net income (loss) per share for the three and nine months ended September 30, 2024, as shares issuable upon the exercise of stock options and warrants were anti-dilutive as a result of the net loss incurred for those periods.

The table below sets forth the computation of basic and diluted earnings (loss) per share (in thousands, except per share data):

	2025		2024			2025		2024
	Three Months Ended September 30,					Nine Months Ended September 30,
	2025		2024			2025		2024
Numerator:
Net income (loss)	$	1,308	$	(5,024	)	$	4,916	$	(13,284	)
Denominator:
Basic – weighted average shares outstanding		139,712,969		135,100,233			139,366,489		131,881,302
Effect of dilutive securities:
Employee restricted stock units and deferred stock units		5,412,153		—			5,293,691		—
Warrants		5,252,112		—			5,252,112		—
Diluted – weighted average shares outstanding		150,377,234		135,100,233			149,912,292		131,881,302
Basic earnings (loss) per share		0.01		(0.04	)		0.04		(0.10	)
Diluted earnings (loss) per share		0.01		(0.04	)		0.03		(0.10	)

For the three months ended September 30, 2025 and 2024, an aggregate of 11,294,922 and 23,969,346 stock options, restricted stock units, deferred stock units and warrants were excluded for the diluted earnings (loss) per share calculation as they were anti-dilutive. For the nine months ended September 30, 2025 and 2024, an aggregate of 11,413,384 and 23,969,346 stock options, restricted stock units, deferred stock units and warrants were excluded for the diluted earnings (loss) per share calculation as they were anti-dilutive.

Pending Sale of Coflex/CoFix Assets and International Hardware Business (Details Narrative) - USD ($)	Sep. 30, 2025	Jul. 07, 2025	Nov. 11, 2025	Nov. 03, 2025	Sep. 04, 2025
Coflex/CoFix Agreement [Member] \| Surgalign SPV, Inc. [Member]
Business Combination [Line Items]
Future proceeds to be received		$ 17,500,000
Non-refundable deposits		2,500,000
Additional cash deposit		2,500,000			$ 2,500,000
Cash payments		1,800,000
Unsecured promissory note		8,200,000
Coflex/CoFix Agreement [Member] \| Surgalign SPV, Inc. [Member] \| Subsequent Event [Member]
Business Combination [Line Items]
Additional cash deposit				$ 2,500,000
Paradigm Agreement and Coflex/CoFix Agreement [Member]
Business Combination [Line Items]
Deductible amount		250,000
Maximum amount, awarded		2,000,000.0
Paradigm Agreement and Coflex/CoFix Agreement [Member] \| Paradigm Spine GmbH [Member]
Business Combination [Line Items]
Purchase price		1,700,000
Limited Consent Agreements [Member] \| MidCap Funding IV Trust [Member]
Business Combination [Line Items]
Non-refundable deposits			$ 7,500,000
Repayments of term loan	$ 5,000,000.0	$ 9,600,000
Prepaid funds			$ 7,500,000

Supplemental Disclosure of Cash Flow Information

9 Months Ended

Sep. 30, 2025

Supplemental Cash Flow Elements [Abstract]

Supplemental Disclosure of Cash Flow Information

(16) Supplemental Disclosure of Cash Flow Information

Supplemental cash flow information is as follows (in thousands):

	2025		2024
	Nine Months Ended
	September 30,
	2025		2024
Cash paid during the period for:
Interest	$	2,538	$	2,657
Non-cash activities:
Increase in right of use assets and lease liability	$	3,219	$	—

Segment and Geographic Information (Details Narrative) - Segment	3 Months Ended		9 Months Ended
	Sep. 30, 2025	Sep. 30, 2024	Sep. 30, 2025	Sep. 30, 2024
Revenue, Major Customer [Line Items]
Number of reportable segment			1
Number of operating segment			1
Customer Concentration Risk [Member] \| Revenue from Contract with Customer Benchmark [Member] \| UNITED STATES
Revenue, Major Customer [Line Items]
Concentration risk, percentage	91.00%	91.00%	91.00%	91.00%

- Definition

For an entity that discloses a concentration risk in relation to quantitative amount, which serves as the "benchmark" (or denominator) in the equation, this concept represents the concentration percentage derived from the division.

+ References + Details

Property and Equipment, Net (Details Narrative) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2025	Sep. 30, 2024	Sep. 30, 2025	Sep. 30, 2024
Property, Plant and Equipment [Abstract]
Depreciation expenses	$ 0.7	$ 0.7	$ 2.1	$ 1.8

Inventories (Tables)

9 Months Ended

Sep. 30, 2025

Inventory Disclosure [Abstract]

Schedule of Inventories

Inventories consist of the following (in thousands):

Schedule of Inventories

	September 30, 2025		December 31, 2024
Raw materials	$	5,601	$	6,622
Work in process		4,535		2,812
Finished goods		30,578		29,200
Total	$	40,714	$	38,634

Related Party Transactions

9 Months Ended

Sep. 30, 2025

Related Party Transactions

(12) Related Party Transactions

As described in more detail under Note 1, “Business Description and Summary of Significant Accounting Policies,” and Note 19, “Related Party Transactions,” in the Company’s Annual Report on Form 10-K for the year ended December 31, 2024, the Company was party to an Investor Rights Agreement, as amended, several Registration Rights Agreements and certain other agreements with OrbiMed Royalty Opportunities II, LP and ROS Acquisition Offshore LP, which are funds affiliated with OrbiMed Advisors LLC (collectively, “OrbiMed”). OrbiMed beneficially owned 52.6% of the Company’s common stock as of March 31, 2025, but in April 2025 sold all of its shares of the Company’s common stock to several investors in a private secondary resale transaction. As the lead purchaser in such transaction, funds affiliated with Nantahala Capital Management, LLC (“Nantahala”), an existing stockholder of the Company, purchased 57.0 million shares of the Company’s common stock, which together with shares of common stock previously held by Nantahala, resulted in Nantahala holding shares of common stock representing 49.1% of the issued and outstanding shares of the Company’s common stock. A family member of Stavros Vizirgianakis, a Board member, also participated in the transaction and purchased shares from OrbiMed. The Company was not party to the stock purchase agreement, which was privately negotiated amongst OrbiMed and the purchasers; however, to facilitate the transaction, the Company entered into a registration rights agreement with the purchasers pursuant to which the Company agreed to prepare and file a shelf resale registration statement with the SEC for purposes of registering the resale of the shares and to use commercially reasonable efforts to cause the registration statement to be declared effective by the SEC. The Company also agreed, among other things, to indemnify the selling stockholders from certain liabilities and to pay all fees and expenses incident to its performance of or compliance with the registration rights agreement. The Company filed this registration statement on May 12, 2025 and it became effective on May 19, 2025. The sale of OrbiMed’s shares resulted in the termination of the Investor Rights Agreement.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-2

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-5

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-6

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(g)(3))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(c))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(e))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org/850/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-6

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

+ Details

Schedule of Stock Options Activity (Details) - 2023 and 2018 Equity Incentive Plan [Member] - $ / shares	9 Months Ended
	Sep. 30, 2025	Sep. 30, 2024
Share-Based Payment Arrangement, Option [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Shares, Granted
Weighted Average Exercise Price, Granted
Weighted Average Exercise Price, Exercised
Equity Option [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Shares, Outstanding, Beginning balance	3,925,403	4,875,828
Weighted Average Exercise Price, Outstanding, Beginning balance	$ 1.29	$ 1.31
Shares, Exercised		(19,858)
Weighted Average Exercise Price, Exercised		$ 0.64
Shares, Cancelled or expired	(164,931)	(397,032)
Weighted Average Exercise Price, Cancelled or expired	$ 1.19	$ 1.16
Shares, Outstanding, Ending balance	3,760,472	4,458,938
Weighted Average Exercise Price, Outstanding, Ending balance	$ 1.30	$ 1.32
Weighted Average Remaining Contract Term (Years) Outstanding	6 years 1 month 9 days	6 years 7 months 6 days
Shares, Exercisable, Ending balance	3,006,140	2,279,049
Weighted Average Exercise Price, Exercisable, Ending balance	$ 1.34	$ 1.41
Weighted Average Remaining Contract Term (years), Exercisable	5 years 9 months 7 days	5 years 10 months 24 days

Business Description, Basis of Presentation and Summary of Significant Accounting Policies

9 Months Ended

Sep. 30, 2025

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Business Description, Basis of Presentation and Summary of Significant Accounting Policies

(1) Business Description, Basis of Presentation and Summary of Significant Accounting Policies

Business Description and Basis of Presentation

The accompanying condensed consolidated financial statements include the accounts of Xtant Medical Holdings, Inc. (“Xtant”), a Delaware corporation, and its wholly owned subsidiaries, which are jointly referred to herein as “Xtant” or the “Company”. The terms “we,” “us” and “our” also refer to Xtant. All intercompany balances and transactions have been eliminated in consolidation.

Xtant is a global medical technology company focused on the design, development, and commercialization of a comprehensive portfolio of orthobiologics and spinal implant fixation systems to facilitate spinal fusion in complex spine, deformity, and degenerative procedures.

The accompanying condensed consolidated balance sheet as of December 31, 2024, which has been derived from audited financial statements, and the unaudited interim condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”). They do not include all disclosures required by generally accepted accounting principles for annual consolidated financial statements, but in the opinion of management include all adjustments, consisting only of normal recurring items, necessary for a fair presentation.

Interim results are not necessarily indicative of results that may be achieved in the future for the full year ending December 31, 2025.

These condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto, which are included in Xtant’s Annual Report on Form 10-K for the year ended December 31, 2024. The accounting policies set forth in those annual consolidated financial statements are the same as the accounting policies utilized in the preparation of these condensed consolidated financial statements, except as modified for appropriate interim consolidated financial statement presentation.

Use of Estimates

The preparation of the condensed consolidated financial statements requires management of the Company to make a number of estimates and assumptions relating to the reported amount of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported amounts of revenue and expenses during the period. Significant estimates include the carrying amount of property and equipment; goodwill, intangible assets and liabilities; valuation allowances for trade receivables, inventory, deferred income tax assets and liabilities; current and long-term lease obligations and corresponding right-of-use asset; and estimates for the fair value of long-term debt, stock options and other equity awards upon which the Company determines stock-based compensation expense. Actual results could differ from those estimates.

Cash, Cash Equivalents, and Restricted Cash

The Company considers all highly liquid investments purchased with an original maturity date of three months or less to be cash equivalents. Cash equivalents are recorded at cost, which approximates market value. The Company maintains its cash balances primarily with two financial institutions. These balances generally exceed federally insured limits. The Company has not experienced any losses in such accounts and believes it is not exposed to any significant credit risk in cash and cash equivalents.

Cash and cash equivalents classified as restricted cash on the Company’s condensed consolidated balance sheets are restricted as to withdrawal or use under the terms of certain contractual agreements. The September 30, 2025 and December 31, 2024 balances included lockbox deposits that are temporarily restricted due to timing at the period end. The lockbox deposits are applied against the Company’s line of credit the next business day.

Long-Lived Assets

The Company reviews its long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of the asset may not be recovered. No impairments of long-lived assets were recorded for the three and nine months ended September 30, 2025 and 2024.

Goodwill

Goodwill represents the excess of costs over fair value of assets of businesses acquired. Goodwill and intangible assets acquired in a purchase business combination and determined to have indefinite useful lives are not amortized. Instead, they are tested for impairment at least annually, and whenever events or circumstances indicate, the carrying amount of the asset may not be recoverable. No impairments of goodwill were recorded for the three and nine months ended September 30, 2025 and 2024.

Stock-Based Compensation

The Company accounts for stock-based compensation in accordance with Financial Accounting Standards Board, or FASB, Accounting Standards Codification (“ASC”) 718, Compensation-Stock Compensation. ASC 718 requires the recognition of compensation expense, using a fair-value based method, for costs related to all stock-based payments including stock options, restricted stock units, performance stock units, and shares issued under its employee stock purchase plan. ASC 718 requires companies to estimate the fair value of all share-based payment option awards on the date of grant using an option pricing model. The fair value of stock options is recognized over the period during which an optionee is required to provide services in exchange for the option award, known as the requisite service period (usually the vesting period), on a straight-line basis. The Company accounts for option forfeitures as they occur.

The Company accounts for stock-based compensation for restricted stock units and deferred stock units at their fair value, based on the closing market price of the Company’s common stock on the date of grant. These costs are recognized on a straight-line basis over the requisite service period, which is usually the vesting period.

The Company accounts for stock-based compensation for performance stock units with market-based conditions at their fair value on the date of the award using the Monte Carlo simulation model. These costs are recognized over the requisite service period, which is usually the vesting period, regardless of the likelihood of achievement of the market-based performance criteria.

Recently Issued Accounting Pronouncements

In December 2023, the Financial Accounting Standards Board issued Accounting Standards Update (“ASU”) No. 2023-09, Income Taxes (Topic 740): Improvement to Income Tax Disclosures to enhance the transparency of income tax disclosures. The guidance in ASU No. 2023-09 allows for a prospective method of transition, with the option to apply the standard retrospectively. The standard is effective for fiscal years beginning after December 15, 2024, with early adoption permitted. The Company is currently evaluating the effect of this new guidance on its consolidated financial statements.

In November 2024, the Financial Accounting Standards Board issued ASU 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40). This ASU requires that public business entities disclose additional information about specific expense categories in the notes to financial statements at interim and annual reporting periods. The prescribed categories include purchases of inventory, employee compensation, depreciation, intangible asset amortization, and depletion. This authoritative guidance is effective for annual periods beginning after December 15, 2026 and interim periods beginning after December 15, 2027, with early adoption permitted. The Company is currently evaluating the effect of this new guidance on its consolidated financial statements.

Foreign Currency

The Company generates revenues outside the United States in multiple foreign currencies including euros, Swiss francs, British pounds and in U.S. dollar-denominated transactions conducted with customers who generate revenue in currencies other than the U.S. dollar. The Company also incurs operating expenses in euros, Swiss francs and British pounds. All assets and liabilities of foreign subsidiaries which have a functional currency other than the U.S. dollar are translated at the rate of exchange at period-end, while elements of the income statement are translated at the average exchange rates in effect during the period. The net effect of these translation adjustments is shown as a component of accumulated other comprehensive income. Foreign currency transaction gains and losses are reported in other income, net.

Fair Value of Financial Instruments

The carrying values of financial instruments, including trade accounts receivable, accounts payable, accrued liabilities, and long-term debt, approximate their fair values based on terms and related interest rates as of September 30, 2025 and December 31, 2024.

Related Party Transactions (Details Narrative) - shares shares in Millions	Apr. 15, 2025	Mar. 31, 2025
Nantahala Capital Management, LLC [Member]
Related Party Transaction [Line Items]
Number of shares purchased	57.0
Percentage of shares issued and outstanding	49.10%
OrbiMed Advisors LLC [Member]
Related Party Transaction [Line Items]
Ownership percentage		52.60%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/1943274/2147480738/235-10-S50-1

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (SX 210.4-08(k)(2))
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Subparagraph (SX 210.6-07(2)(g)(3))
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+ Details

Net Income (Loss) Per Share (Details Narrative) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2025	Sep. 30, 2024	Sep. 30, 2025	Sep. 30, 2024
Net Income (Loss) Per Share:
Antidilutive securities	11,294,922	23,969,346	11,413,384	23,969,346

Income Taxes

9 Months Ended

Sep. 30, 2025

Income Tax Disclosure [Abstract]

Income Taxes

(14) Income Taxes

Information on the Company’s income taxes for the periods reported is as follows:

Schedule of Income Taxes

	2025			2024			2025			2024
	Three Months Ended September 30,						Nine Months Ended September 30,
	2025			2024			2025			2024
Income tax expense from continuing operations	$	257		$	62		$	487		$	166
Income (loss) from continuing operations before income taxes	$	1,565		$	(4,962	)	$	5,403		$	(13,118	)
Effective income tax rate		16.4	%		-1.2	%		9.0	%		-1.3	%

Our effective tax rate for the three and nine months ended September 30, 2025 differs from the statutory rate due to a valuation allowance against deferred tax assets, offset by the impact of cash state and foreign taxes.

Our effective tax rate for the three and nine months ended September 30, 2024 differs from the statutory rate due to a valuation allowance against deferred tax assets, offset by the impact of cash state and foreign taxes.

As of September 30, 2025, the Company is not currently under examination by tax authorities.

On July 4, 2025, the One Big Beautiful Bill Act (“OBBBA”) was signed into law, which enacts significant changes to U.S. tax and related laws. Some of the provisions of the new tax law affecting corporations include but are not limited to expensing of domestic research expenses, increasing the limit of the deduction of interest expense, and one hundred percent bonus depreciation on eligible property acquired after January 19, 2025. The impact of the tax law changes from the OBBBA did not have a material impact on the tax rate and has been included in the Company’s condensed consolidated financial statements beginning with the three months ended September 30, 2025.

- Definition

The entire disclosure for income tax.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 942
-SubTopic 740
-Name Accounting Standards Codification
-Section 50
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Business Description, Basis of Presentation and Summary of Significant Accounting Policies (Details Narrative) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2025	Sep. 30, 2024	Sep. 30, 2025	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Impairments of long-lived assets	$ 0	$ 0	$ 0	$ 0
Impairments of goodwill	$ 0	$ 0	$ 0	$ 0

- Definition

Amount of impairment loss from asset representing future economic benefit arising from other asset acquired in business combination or from joint venture formation or both, that is not individually identified and separately recognized.

+ References + Details

Revenue

9 Months Ended

Sep. 30, 2025

Revenue from Contract with Customer [Abstract]

Revenue

(3) Revenue

In the United States, the Company generates a substantial portion of its revenue from independent commissioned sales agents. The Company consigns its orthobiologics products to hospitals and consigns or loans its spinal implant sets to independent sales agents. The spinal implant sets typically contain the instruments, disposables, and spinal implants required to complete a surgery. Consigned sets are managed by the sales agent to service hospitals that are high volume users for multiple procedures.

The Company ships replacement inventory to independent sales agents to replace the consigned inventory used in surgeries. Loaned sets are returned to the Company’s distribution center, replenished, and made available to sales agents for the next surgical procedure.

For each surgical procedure, the sales agent reports use of the product by the hospital and, as soon as practicable thereafter, ensures that the hospital provides a purchase order to the Company. Revenue is recognized upon utilization of product.

Additionally, the Company sells product directly to domestic and international stocking resellers, original equipment manufacturer resellers and private label resellers. Upon receipt and acceptance of a purchase order from a stocking reseller, the Company ships product and invoices the reseller. The Company recognizes revenue when the control is transferred upon shipment or upon delivery, based on the contract terms and legal requirements, and the transfer of title and risk of loss occurs. There is generally no customer acceptance or other condition that prevents the Company from recognizing revenue in accordance with the delivery terms for these sales transactions. In the normal course of business, the Company accepts returns of product that have not been implanted. Product returns are not material to the Company’s consolidated statements of operations. The Company accounts for shipping and handling activities as a fulfillment cost rather than a separate performance obligation. The Company’s policy is to record revenue net of any applicable sales, use, or excise taxes. Payment terms are generally net 30 days from invoice date and some customers are offered discounts for early payment. The consideration for goods or services reflects any fixed amount stated per the contract and estimates for any variable consideration, such as returns, discounts or rebates, to the extent that it is probable that a significant reversal of cumulative revenue recognized will not occur when the uncertainty associated with the variable consideration is resolved. For certain sales transactions, we incur group purchasing organization fees that are based on a contractual percentage of applicable sales and are treated as consideration payable to a customer and recorded as a reduction of revenue.

The Company recognizes revenue in certain circumstances before product delivery occurs (commonly referred to as bill-and-hold transactions). When the Company enters into bill-and-hold arrangements, the Company determines if the customer obtains control of the product by determining (a) the reason for the bill-and-hold arrangement; (b) whether the product was identified separately as belonging to the customer; (c) whether the product was ready for physical transfer to the customer; and (d) whether the Company was unable to utilize the product or direct it to another customer. For bill-and-hold arrangements, the associated product inventory is identified separately by the Company as belonging to the customer and is ready for physical transfer. At September 30, 2025, $0.6 million was included in revenue for products that had not shipped. Occasionally the Company will receive consideration in advance of transferring products to its customers and records a contract liability. Contract liabilities are recognized as revenue in proportion to when control of the goods is transferred to the customer.

Licensing revenue

Licensing revenue is recognized when control of the intellectual property (“IP”) rights is transferred to a customer in an amount that reflects the consideration the Company expects to be entitled to in exchange for the licensing of the Company’s IP. Revenue for IP rights is accounted for based on the nature of the promise to grant the license. In determining whether the Company’s promise is to provide a right to access its IP or a right to use its IP, the Company considers the nature of its IP to which the customer will have rights. IP is either functional IP which has significant standalone functionality or symbolic IP which does not have significant standalone functionality. Revenue from functional IP is recognized at the point in time when control of the distinct license is transferred to the customer. Revenue from symbolic IP is recognized over the access period to the Company’s IP.

Revenues from sales-based royalties promised in exchange for a license of IP are recognized at the later of when the underlying sale occurs or the performance obligation to which some or all of the sales-based royalty has been allocated is satisfied.

The Company has a license agreement which grants an exclusive, nontransferable, non-sublicensable, royalty-bearing right to manufacture and commercialize one of our products in the United States. The Company concluded this represented one performance obligation of transferring the IP rights to manufacture and commercialize the product. This was determined to be functional IP. The transaction price includes an upfront non-refundable fee of $1.5 million, as well as quarterly royalty payments based on the volume of product sold, subject to guaranteed quarterly minimums, which aggregate to $3.75 million during 2025. Variable consideration is included in the transaction price only to the extent significant reversal of cumulative revenue recognized is not probable of occurring when the uncertainty associated with the variable consideration is subsequently resolved. Significant judgment is required in estimating variable consideration for the performance obligation identified in the contract. This judgment involves assessing factors outside of our influence, including the accessibility of the licensed products to certain reimbursement codes determined by regulatory authorities. Accordingly, the guaranteed quarterly minimums past the third quarter of 2025 were considered constrained and, therefore, not recognized when the performance obligation was satisfied as it was not probable as of September 30, 2025 that there would not be a significant reversal of cumulative revenue due to uncertainty with a Centers for Medicare & Medicaid Services (“CMS”) policy change and language in the license agreement. On April 12, 2025, CMS announced that the effective date of the local coverage determination, which determines the eligibility of the reimbursement code contained in the license agreement, had been deferred until January 2026. However, additional policy changes by CMS, or other government organizations, may further restrict reimbursement such that all quarterly minimums will not be recognized prior to commencement of the local coverage determination.

Disaggregation of revenue

The Company operates in one reportable segment with its net revenue derived primarily from the sale of orthobiologics and spinal implant products across North America, Europe, Asia Pacific, and Latin America. Sales are reported net of returns, discounts and rebates. The following table presents revenues from these product lines for the three and nine months ended September 30, 2025 and 2024 (in thousands):

	Three Months Ended		Percentage of			Three Months Ended		Percentage of
	September 30, 2025		Total Revenue			September 30, 2024		Total Revenue
Orthobiologics	$	17,149		52	%	$	16,579		59	%
Spinal implant		10,623		32	%		11,358		41	%
License revenue		5,483		16	%		—		—	%
Total revenue	$	33,255		100	%	$	27,937		100	%

	Nine Months Ended		Percentage of			Nine Months Ended		Percentage of
	September 30, 2025		Total Revenue			September 30, 2024		Total Revenue
Orthobiologics	$	54,593		54	%	$	48,123		56	%
Spinal implant		32,899		32	%		37,631		44	%
License revenue		14,078		14	%		—		—	%
Total revenue	$	101,570		100	%	$	85,754		100	%

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 7
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-7

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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
-URI https://asc.fasb.org/606/tableOfContent

+ Details

Segment and Geographic Information (Tables)

9 Months Ended

Sep. 30, 2025

Segment Reporting [Abstract]

Schedule of Calculation of Consolidated Net (Loss) Income

The table below provides the calculation of consolidated net income (loss), which is the performance measure that is most consistent with GAAP, and the significant operating expenses included in this performance measure (in thousands):

	2025			2024			2025			2024
	Three Months Ended September 30,						Nine Months Ended September 30,
	2025			2024			2025			2024
Revenue	$	33,255		$	27,937		$	101,570		$	85,754
Less cost of sales		11,263			11,630			35,051			33,562
Gross Profit		21,992			16,307			66,519			52,192
Gross Margin		66.1	%		58.4	%		65.5	%		60.9	%
Less:
General and administrative		7,071			7,493			22,082			22,991
Sales and marketing		11,746			11,890			34,566			37,530
Research and development		634			701			1,643			1,863
Interest expense		904			1,199			2,953			3,026
Unrealized foreign currency translation loss (gain)		56			(27	)		(146	)		(106	)
Other expense		16			13			18			6
Provision for income taxes		257			62			487			166
Net Income (Loss)	$	1,308		$	(5,024	)	$	4,916		$	(13,284	)

Schedule of Revenues by Geographic Region

	2025		2024
	Three Months Ended September 30,
	2025		2024
United States	$	30,312	$	25,342
Rest of world		2,943		2,595
Total revenue	$	33,255	$	27,937

	2025		2024
	Nine Months Ended September 30,
	2025		2024
United States	$	92,561	$	76,752
Rest of world		9,009		9,002
Total revenue	$	101,570	$	85,754

Intangible Assets (Details Narrative) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2025	Sep. 30, 2024	Sep. 30, 2025	Sep. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense	$ 0.4	$ 0.4	$ 1.3	$ 1.3

- Definition

The aggregate expense charged against earnings to allocate the cost of intangible assets (nonphysical assets not used in production) in a systematic and rational manner to the periods expected to benefit from such assets.

+ References

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-Name Accounting Standards Codification
-Section 45
-Paragraph 28
-Subparagraph (b)
-SubTopic 10
-Topic 230
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-Subparagraph (d)
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+ Details

Supplemental Disclosure of Cash Flow Information (Tables)

9 Months Ended

Sep. 30, 2025

Supplemental Cash Flow Elements [Abstract]

Schedule of Supplemental Cash Flow Information

Supplemental cash flow information is as follows (in thousands):

	2025		2024
	Nine Months Ended
	September 30,
	2025		2024
Cash paid during the period for:
Interest	$	2,538	$	2,657
Non-cash activities:
Increase in right of use assets and lease liability	$	3,219	$	—

Schedule of Inventories (Details) - USD ($) $ in Thousands	Sep. 30, 2025	Dec. 31, 2024
Inventory Disclosure [Abstract]
Raw materials	$ 5,601	$ 6,622
Work in process	4,535	2,812
Finished goods	30,578	29,200
Total	$ 40,714	$ 38,634

Stock-Based Compensation (Details Narrative) - USD ($) $ / shares in Units, $ in Thousands		1 Months Ended	3 Months Ended		9 Months Ended
	Jul. 26, 2023	Apr. 30, 2024	Sep. 30, 2025	Sep. 30, 2024	Sep. 30, 2025	Sep. 30, 2024
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Stock-based compensation expense			$ 600	$ 1,100	$ 2,165	$ 3,277
Deferred Stock Units and Restricted Stock Units [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Weighted-average period					2 years 4 months 24 days
Compensation cost related to unvested stock units			2,000		$ 2,000
Performance Shares [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Weighted-average period					1 year 4 months 24 days
Compensation cost related to unvested stock units			1,200		$ 1,200
Equity Option [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Unrecognized compensation expense			$ 600		$ 600
Weighted-average period					1 year 9 months 18 days
2023 Equity Incentive Plan [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Share based compensation, description	The maximum number of shares of our common stock available for issuance under the 2023 Plan, subject to adjustment pursuant to the terms of the 2023 Plan, is (i) 5,500,000 shares of common stock; (ii) 7,695,812 shares of common stock remaining available for issuance under the 2018 Plan but not subject to outstanding awards under the 2018 Plan as of July 26, 2023; and (iii) up to 6,686,090 shares of common stock subject to awards outstanding under the 2018 Plan as of July 26, 2023 but only to the extent such awards are subsequently forfeited, cancelled, expire, or otherwise terminate without the issuance of such shares of common stock after such date.
Number of shares available for grant	5,500,000
2023 Equity Incentive Plan [Member] \| Performance Shares [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Number of shares awarded		1,772,217
Volatility		93.34%
Risk-free interest rate		4.53%
Correlation with index		$ 0.06
Dividend yield		0.00%
2023 Equity Incentive Plan [Member] \| Performance Shares [Member] \| Minimum [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Vesting rights, percentage		0.00%
2023 Equity Incentive Plan [Member] \| Performance Shares [Member] \| Maximum [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Vesting rights, percentage		200.00%
2018 Equity Incentive Plan [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Number of shares available for grant	7,695,812
Share based compensation, award outstanding	6,686,090

Schedule of Supplemental Cash Flow Information (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2025	Sep. 30, 2024
Supplemental Cash Flow Elements [Abstract]
Interest	$ 2,538	$ 2,657
Increase in right of use assets and lease liability	$ 3,219

Schedule of Intangible of Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2025	Dec. 31, 2024
Finite-Lived Intangible Assets [Line Items]
Intangible assets, gross	$ 11,967	$ 11,967
Accumulated amortization	(4,907)	(3,611)
Intangible assets, net	$ 7,060	$ 8,356
Patents [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted avereage life	11 years	11 years
Intangible assets, gross	$ 2,777	$ 2,777
Accumulated amortization	(1,155)	(948)
Intangible assets, net	$ 1,622	$ 1,829
Customer Relationships [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted avereage life	6 years	6 years
Intangible assets, gross	$ 8,000	$ 8,000
Accumulated amortization	(3,445)	(2,445)
Intangible assets, net	$ 4,555	$ 5,555
Trade Names [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted avereage life	10 years	10 years
Intangible assets, gross	$ 1,190	$ 1,190
Accumulated amortization	(307)	(218)
Intangible assets, net	$ 883	$ 972

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

Stock-Based Compensation

9 Months Ended

Sep. 30, 2025

Share-Based Payment Arrangement [Abstract]

Stock-Based Compensation

(10) Stock-Based Compensation

On July 26, 2023, our stockholders approved and adopted the Xtant Medical Holdings, Inc. 2023 Equity Incentive Plan (the “2023 Plan”), which replaced the Xtant Medical Holdings, Inc. 2018 Equity Incentive Plan (the “2018 Plan”) with respect to future grants of equity awards, although the 2018 Plan continues to govern equity awards granted under the 2018 Plan. The 2023 Plan permits the Board of Directors, or a committee thereof, to grant to eligible employees, non-employee directors, and consultants of the Company non-statutory and incentive stock options, stock appreciation rights, restricted stock awards, restricted stock units, deferred stock units, performance awards, non-employee director awards, and other stock-based awards. The Board of Directors may select 2023 Plan participants and determine the nature and amount of awards to be granted. The maximum number of shares of our common stock available for issuance under the 2023 Plan, subject to adjustment pursuant to the terms of the 2023 Plan, is (i) 5,500,000 shares of common stock; (ii) 7,695,812 shares of common stock remaining available for issuance under the 2018 Plan but not subject to outstanding awards under the 2018 Plan as of July 26, 2023; and (iii) up to 6,686,090 shares of common stock subject to awards outstanding under the 2018 Plan as of July 26, 2023 but only to the extent such awards are subsequently forfeited, cancelled, expire, or otherwise terminate without the issuance of such shares of common stock after such date.

Total stock-based compensation expense recognized for employees and directors was $0.6 million and $1.1 million for the three months ended September 30, 2025 and 2024, respectively, and $2.2 million and $3.3 million for the nine months ended September 30, 2025 and 2024, respectively, and was recognized as general and administrative expense.

Stock Options

Stock option activity, including options granted under the 2023 Plan and the 2018 Plan, was as follows for the nine months ended September 30, 2025 and 2024:

Schedule of Stock Options Activity

	2025							2024
	Shares			Weighted Average Exercise Price		Weighted Average Remaining Contract Term (years)		Shares			Weighted Average Exercise Price		Weighted Average Remaining Contract Term (years)
Outstanding at January 1		3,925,403			1.29				4,875,828		$	1.31
Granted		—			—				—			—
Exercised		—			—				(19,858	)		0.64
Cancelled or expired		(164,931	)		1.19				(397,032	)	$	1.16
Outstanding at September 30		3,760,472			1.30		6.11		4,458,938		$	1.32		6.6
Exercisable at September 30		3,006,140			1.34		5.77		2,279,049		$	1.41		5.9

As of September 30, 2025, there was approximately $0.6 million of total unrecognized compensation expense related to unvested stock options. These costs are expected to be recognized over a weighted-average period of 1.8 years.

Deferred Stock Units and Restricted Stock Units

Deferred stock unit and restricted stock unit activity for awards granted under the 2023 Plan and the 2018 Plan was as follows for the nine months ended September 30, 2025 and 2024:

	2025					2024
	Shares			Weighted Average Fair Value at Grant Date Per Share		Shares			Weighted Average Fair Value at Grant Date Per Share
Outstanding at January 1		5,455,472		$	0.90		3,524,675		$	1.07
Granted		100,000			0.62		4,195,363		$	0.84
Vested		(1,154,820	)		0.67		(1,482,056	)	$	1.08
Cancelled		(80,116	)		0.98		(675,820	)	$	0.90
Outstanding at September 30		4,320,536		$	0.96		5,562,162		$	0.91

Total compensation expense related to unvested deferred stock units and restricted stock units not yet recognized was $2.0 million as of September 30, 2025, which is expected to be allocated to expenses over a weighted-average period of 2.4 years.

Performance Stock Units

In April 2024, the Company began awarding performance stock units, or PSUs, under the 2023 Plan to certain executive officers and key employees. The Company has awarded an aggregate of 1,772,217 PSUs, assuming target performance, and each PSU award can be earned and vested at the end of a three-year performance period based on the total stockholder return, or TSR, of the Company’s common stock price relative to a group of peer companies and subject to continued service to the Company. The number of shares of the Company’s common stock to be issued upon vesting and settlement of the PSUs range from 0% to 200% of the target number of shares underlying the award, depending on the Company’s TSR performance against the group of peer companies. The fair value of the PSUs was estimated using the Monte Carlo simulation model and the following assumptions: the volatility of the peer companies was unique to each company used in simulation, Company volatility of 93.34%, risk-free interest rate of 4.53%, correlation with index of 0.06, and dividend yield of 0%.

There was no change in shares outstanding for PSU awards granted under the 2023 Plan during the three and nine months ended September 30, 2025.

The total compensation cost related to unvested PSUs was $1.2 million as of September 30, 2025, which expense is expected to be allocated to expenses over a weighted-average period of 1.4 years.

Condensed Consolidated Statements of Comprehensive Income (Loss) (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2025	Sep. 30, 2024	Sep. 30, 2025	Sep. 30, 2024
Income Statement [Abstract]
Net Income (Loss)	$ 1,308	$ (5,024)	$ 4,916	$ (13,284)
Other Comprehensive Income (Loss)
Foreign currency translation adjustments	(13)	229	455	25
Comprehensive Income (Loss)	$ 1,295	$ (4,795)	$ 5,371	$ (13,259)

- Definition

Amount after tax of increase (decrease) in equity from transactions and other events and circumstances from net income and other comprehensive income, attributable to parent entity. Excludes changes in equity resulting from investments by owners and distributions to owners.

+ References + Details

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

Intangible Assets (Tables)

9 Months Ended

Sep. 30, 2025

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Intangible of Assets

The following table sets forth information regarding intangible assets (in thousands):

Schedule of Intangible of Assets

September 30, 2025:	Weighted Average Life	Cost		Accumulated Amortization			Net
Patents	11 years	$	2,777	$	(1,155	)	$	1,622
Customer List	6 years		8,000		(3,445	)		4,555
Tradenames	10 years		1,190		(307	)		883
		$	11,967	$	(4,907	)	$	7,060

December 31, 2024:	Weighted Average Life	Cost		Accumulated Amortization			Net
Patents	11 years	$	2,777	$	(948	)	$	1,829
Customer List	6 years		8,000		(2,445	)		5,555
Tradenames	10 years		1,190		(218	)		972
		$	11,967	$	(3,611	)	$	8,356

Condensed Consolidated Statements of Equity (Unaudited) (Parenthetical) $ in Thousands	3 Months Ended
	Sep. 30, 2024 USD ($)
Statement of Cash Flows [Abstract]
Net issuance costs	$ 191

Accrued Liabilities

9 Months Ended

Sep. 30, 2025

Payables and Accruals [Abstract]

Accrued Liabilities

(8) Accrued Liabilities

Accrued liabilities consist of the following (in thousands):

Schedule of Accrued Liabilities

	September 30, 2025		December 31, 2024
Cash compensation/commissions payable	$	7,537	$	5,565
Other accrued liabilities		3,998		2,206
Accrued liabilities	$	11,535	$	7,771

Commitments and Contingencies (Details Narrative) $ in Millions	9 Months Ended
	Sep. 30, 2025 USD ($)
Loss Contingencies [Line Items]
Lease option to extend	We have the option to extend certain leases to five or ten-year term(s) and we have the right of first refusal on any sale.
Operating lease weighted-average remaining lease term	4 years 9 months 18 days
Lease expense related to operating leases	$ 0.9
Minimum [Member]
Loss Contingencies [Line Items]
Operating lease weighted-average discount rate	10.93%
Maximum [Member]
Loss Contingencies [Line Items]
Operating lease weighted-average discount rate	12.46%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 275
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482861/275-10-50-9

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
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-URI https://asc.fasb.org/1943274/2147483076/450-20-50-4

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/1943274/2147483359/720-20-50-1

Reference 5: http://www.xbrl.org/2003/role/exampleRef
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-Name Accounting Standards Codification
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-Paragraph 27
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Paragraph 9
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/1943274/2147483076/450-20-50-4

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/1943274/2147482425/460-10-50-3

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 450
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-URI https://asc.fasb.org/1943274/2147483076/450-20-50-1

+ Details

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Sep. 30, 2025	Jun. 30, 2025	Mar. 31, 2025	Sep. 30, 2024	Jun. 30, 2024	Mar. 31, 2024	Sep. 30, 2025	Sep. 30, 2024
Pay vs Performance Disclosure [Table]
Net Income (Loss)	$ 1,308	$ 3,550	$ 58	$ (5,024)	$ (3,861)	$ (4,400)	$ 4,916	$ (13,284)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

Stock-Based Compensation (Tables)

9 Months Ended

Sep. 30, 2025

Share-Based Payment Arrangement [Abstract]

Schedule of Stock Options Activity

Stock option activity, including options granted under the 2023 Plan and the 2018 Plan, was as follows for the nine months ended September 30, 2025 and 2024:

Schedule of Stock Options Activity

	2025							2024
	Shares			Weighted Average Exercise Price		Weighted Average Remaining Contract Term (years)		Shares			Weighted Average Exercise Price		Weighted Average Remaining Contract Term (years)
Outstanding at January 1		3,925,403			1.29				4,875,828		$	1.31
Granted		—			—				—			—
Exercised		—			—				(19,858	)		0.64
Cancelled or expired		(164,931	)		1.19				(397,032	)	$	1.16
Outstanding at September 30		3,760,472			1.30		6.11		4,458,938		$	1.32		6.6
Exercisable at September 30		3,006,140			1.34		5.77		2,279,049		$	1.41		5.9

Schedule of Deferred Stock Units and Restricted Stock Activity

Deferred stock unit and restricted stock unit activity for awards granted under the 2023 Plan and the 2018 Plan was as follows for the nine months ended September 30, 2025 and 2024:

	2025					2024
	Shares			Weighted Average Fair Value at Grant Date Per Share		Shares			Weighted Average Fair Value at Grant Date Per Share
Outstanding at January 1		5,455,472		$	0.90		3,524,675		$	1.07
Granted		100,000			0.62		4,195,363		$	0.84
Vested		(1,154,820	)		0.67		(1,482,056	)	$	1.08
Cancelled		(80,116	)		0.98		(675,820	)	$	0.90
Outstanding at September 30		4,320,536		$	0.96		5,562,162		$	0.91

Condensed Consolidated Statements of Operations (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2025	Sep. 30, 2024	Sep. 30, 2025	Sep. 30, 2024
Revenue
Total Revenue	$ 33,255	$ 27,937	$ 101,570	$ 85,754
Cost of Sales	11,263	11,630	35,051	33,562
Gross Profit	21,992	16,307	66,519	52,192
Operating Expenses
General and administrative	7,071	7,493	22,082	22,991
Sales and marketing	11,746	11,890	34,566	37,530
Research and development	634	701	1,643	1,863
Total Operating Expenses	19,451	20,084	58,291	62,384
Income (Loss) from Operations	2,541	(3,777)	8,228	(10,192)
Other (Expense) Income
Interest expense	(904)	(1,199)	(2,953)	(3,026)
Unrealized foreign currency translation (loss) gain	(56)	27	146	106
Other expense	(16)	(13)	(18)	(6)
Total Other Expense	(976)	(1,185)	(2,825)	(2,926)
Net Income (Loss) from Operations Before Provision for Income Taxes	1,565	(4,962)	5,403	(13,118)
Provision for Income Taxes Current and Deferred	(257)	(62)	(487)	(166)
Net Income (Loss)	$ 1,308	$ (5,024)	$ 4,916	$ (13,284)
Net Income (Loss) Per Share:
Basic	$ 0.01	$ (0.04)	$ 0.04	$ (0.10)
Dilutive	$ 0.01	$ (0.04)	$ 0.03	$ (0.10)
Shares used in the computation:
Basic	139,712,969	135,100,233	139,366,489	131,881,302
Dilutive	150,377,234	135,100,233	149,912,292	131,881,302
Product [Member]
Revenue
Total Revenue	$ 27,772	$ 27,937	$ 87,492	$ 85,754
License [Member]
Revenue
Total Revenue	$ 5,483		$ 14,078

Commitments and Contingencies

9 Months Ended

Sep. 30, 2025

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

(13) Commitments and Contingencies

Operating Leases

We currently lease various office facilities and equipment. These leases are under non-cancelable operating lease agreements with expiration dates from 2026 to 2030. We have the option to extend certain leases to five or ten-year term(s) and we have the right of first refusal on any sale.

The Company records lease liabilities within current liabilities or long-term liabilities based upon the length of time associated with the lease payments. The Company records its long-term operating leases as right-of-use assets. Upon initial adoption, using the modified retrospective transition approach, no leases with terms less than 12 months have been capitalized to the consolidated balance sheet consistent with ASC 842. Instead, these leases are recognized in the consolidated statement of operations on a straight-line expense throughout the lives of the leases. No Company leases contain common area maintenance or security agreements.

As of September 30, 2025, the weighted-average remaining lease term was 4.8 years. Lease expense related to operating leases was $0.9 million for the nine months ended September 30, 2025. The Company’s lease agreements do not provide a readily determinable implicit rate nor is it available to the Company from its lessors. Instead, during the period ended September 30, 2025, the Company estimates the weighted-average discount rate for its operating leases to be between 10.93% and 12.46% to discount future cash flows to present value based on the incremental borrowing rate.

Future minimum payments as of September 30, 2025 under these long-term operating leases are as follows (in thousands):


Remainder of 2025	$	305
2026		1,035
2027		925
2028		893
2029		874
Thereafter		689
Total future minimum lease payments		4,721
Less: amount representing interest		(1,012	)
Present value of obligations under operating leases		3,709
Less: current portion		(760	)
Long-term operating lease obligations	$	2,949

Litigation

We are subject to potential liabilities under government regulations and various claims and legal actions that are pending or may be asserted from time to time. These matters arise in the ordinary course and conduct of our business and may include, for example, commercial, product liability, intellectual property, and employment matters. We intend to continue to defend the Company vigorously in such matters and, when warranted, take legal action against others. Furthermore, we regularly assess contingencies to determine the degree of probability and range of possible loss for potential accrual in our financial statements. An estimated loss contingency is accrued in our financial statements if it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. Based on our assessment, we have adequately accrued an amount for contingent liabilities currently in existence. We do not accrue amounts for liabilities that we do not believe are probable or that we consider immaterial to our overall financial position. Litigation is inherently unpredictable, and unfavorable resolutions could occur. As a result, assessing contingencies is highly subjective and requires judgment about future events. While we do not believe that the ultimate resolution of any claims and lawsuits will have a material adverse effect upon our consolidated financial position, results of operations or cash flows, it is possible that the amount of ultimate loss may exceed our current accruals and that our cash flows or results of operations could be materially affected in any particular period by the unfavorable resolution of one or more of these contingencies.

Cover - $ / shares	9 Months Ended
Cover - $ / shares	Sep. 30, 2025	Nov. 07, 2025
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Sep. 30, 2025
Document Fiscal Period Focus	Q3
Document Fiscal Year Focus	2025
Current Fiscal Year End Date	--12-31
Entity File Number	001-34951
Entity Registrant Name	XTANT MEDICAL HOLDINGS, INC.
Entity Central Index Key	0001453593
Entity Tax Identification Number	20-5313323
Entity Incorporation, State or Country Code	DE
Entity Address, Address Line One	664 Cruiser Lane
Entity Address, City or Town	Belgrade
Entity Address, State or Province	MT
Entity Address, Postal Zip Code	59714
City Area Code	(406)
Local Phone Number	388-0480
Title of 12(b) Security	Common stock, par value $0.000001 per share
Trading Symbol	XTNT
Security Exchange Name	NYSEAMER
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		140,004,240
Entity Listing, Par Value Per Share	$ 0.000001

Pending Sale of Coflex/CoFix Assets and International Hardware Business

9 Months Ended

Sep. 30, 2025

Business Combination, Asset Acquisition, Transaction between Entities under Common Control, and Joint Venture Formation [Abstract]

Pending Sale of Coflex/CoFix Assets and International Hardware Business

(2) Pending Sale of Coflex/CoFix Assets and International Hardware Business

On July 7, 2025, the Company, and Surgalign SPV, Inc., a wholly owned subsidiary of the Company (together with the Company, the “Seller”), entered into an Asset Purchase Agreement (the “Coflex/CoFix Agreement”) with Companion Spine, LLC, a company to whom the Company has sold certain of its Coflex and CoFix products from time to time in the ordinary course of business (“Companion”), or its affiliate designee (together with Companion, the “Buyer”). Pursuant to and subject to the terms and conditions of the Coflex/CoFix Agreement, the Seller agreed to sell and assign to the Buyer certain assets relating to the Seller’s Coflex and CoFix products in the United States (the “Coflex/CoFix Business” and such assets, the “Coflex/CoFix Assets” ) and the Buyer agreed to assume certain liabilities in connection therewith (such transaction, the “Coflex/CoFix Transaction”) for a total purchase price of $17.5 million, subject to a closing inventory valuation adjustment set forth in the Coflex/CoFix Agreement (the “Coflex/CoFix Purchase Price”). Concurrently with the execution and delivery of the Coflex/CoFix Agreement, $2.5 million of the Coflex/CoFix Purchase Price was paid to the Seller as a cash deposit that is non-refundable, except in the event the Coflex/CoFix Agreement is terminated by the Buyer due to certain breaches by Seller under the Coflex/CoFix Agreement. Completion of the Coflex/CoFix Transaction is subject to the Buyer obtaining financing. Under the Coflex/CoFix Agreement, the Buyer had the ability to pay the Seller up to two additional $2.5 million cash deposits in the event the Buyer required additional time to obtain financing. On each of September 4, 2025 and November 3, 2025, pursuant to the terms of the Coflex/CoFix Agreement, the Buyer paid the Seller an additional $2.5 million cash deposit to provide additional time for the Buyer to obtain financing. If the Buyer obtains financing and the closing of the Coflex/CoFix Transaction occurs, the remaining balance of the Coflex/CoFix Purchase Price will be required to be paid by the Seller to the Company at the closing and will consist of a cash payment of $1.8 million and a $8.2 million unsecured promissory note to be issued by the Buyer to the Seller. The promissory note will mature on December 31, 2025.

Also, on July 7, 2025, the Company, Paradigm Spine GmbH, a wholly owned subsidiary of the Company engaged in the operation of the Company’s hardware business outside of the United States (“Paradigm”), simultaneously entered into an Equity Purchase Agreement (the “Paradigm Agreement” and together with the Coflex/CoFix Agreement, the “Agreements”), with Companion, pursuant to which and subject to the terms and conditions thereof, the Company agreed to sell to Companion all of its shares of equity securities of Paradigm, which constitute 100% of the issued and outstanding shares of equity securities of Paradigm (the “Paradigm Shares” and such transaction the “Paradigm Transaction” and together with the Coflex/CoFix Transaction, the “Transactions”) for a total purchase price of $1.7 million, subject to certain cash, indebtedness and net working capital adjustments set forth in the Paradigm Agreement (the “Paradigm Purchase Price”). As with the Coflex/CoFix Transaction, completion of the Paradigm Transaction is subject to Companion obtaining financing.

The completion of the Transactions is expected to occur in the fourth quarter of 2025, although no assurance can be provided that the Seller will obtain financing to fund the Transactions, that the closings will not be delayed or that the closings will occur. The closing of each of the Transactions is contingent on the other closing at the same time. The Agreements contain certain termination rights for the respective parties, including the right to terminate the Coflex/CoFix Agreement and Paradigm Agreement if the Coflex/CoFix Transaction or Paradigm Transaction, respectively, is not consummated by December 31, 2025.

The Coflex/CoFix Agreement and the Paradigm Agreement contain customary representations, warranties and covenants of the parties, and the completion of each of the Transactions is subject to a number of customary conditions set forth in the Agreements, which, among others, include the performance by each party of its obligations under the respective Agreement and the accuracy of the representations in each respective Agreement. Subject to certain limitations, the respective parties to the Agreements have agreed to indemnify the other party for certain matters, including breaches of representations, warranties and covenants, subject in certain cases to a $250,000 deductible and $2.0 million cap.

In addition, on July 7, 2025, the Company and certain of its subsidiaries entered into a Limited Consent and Amendment No. 3 to Amended and Restated Credit, Security and Guaranty Agreement (Term Loan) (the “Term Loan Limited Consent”) with MidCap Financial Trust and a Limited Consent and Amendment No. 3 to Amended and Restated Credit, Security and Guaranty Agreement (Revolving Loan) (the “Revolving Loan Limited Consent” and together with the Term Loan Limited Consent, the “Limited Consent Agreements”) with MidCap Funding IV Trust (collectively, with MidCap Financial Trust, “MidCap”). Under the Limited Consent Agreements, MidCap agreed, subject to the terms and conditions set forth in the Limited Consent Agreements, to, among other things, consent to the Company entering into the Coflex/CoFix Agreement and Paradigm Agreement and the consummation of the Transactions in accordance with the terms and subject to the conditions set forth therein, including the prepayment in accordance with the Term Loan Credit Agreement of $9.6 million to MidCap from the proceeds of the transactions contemplated by the Coflex/CoFix Agreement and Paradigm Agreement, $7.5 million of which has been already prepaid from the $7.5 million in non-refundable deposits previously paid to the Company.

The Company determined that the pending Transactions do not meet the criteria for classification as held for sale or discontinued operations for accounting purposes. As a result, all historical operating results for the Coflex/CoFix assets and international hardware business are reflected within the consolidated statements of operations in the condensed consolidated financial statements.

With respect to the cash deposits received by the Company in connection with the pending Coflex/CoFix Transaction which are non-refundable, except in the event the Coflex/CoFix Agreement is terminated by the Buyer due to certain breaches by Seller under the Coflex/CoFix Agreement, they are reflected in the “Advances from pending sale of Coflex/CoFix assets and international hardware business” line item on the condensed consolidated balance sheet as of September 30, 2025.

- Definition

The entire disclosure for business combination.

+ References

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+ Details

Segment and Geographic Information

9 Months Ended

Sep. 30, 2025

Segment Reporting [Abstract]

Segment and Geographic Information

(17) Segment and Geographic Information

The Company operates as one reportable and operating segment based upon the Company’s organization structure and the way in which the operations and investments are managed and evaluated by the chief operating decision maker (“CODM”), who is the Company’s Chief Executive Officer. The CODM uses consolidated net income (loss) as the primary measure of segment profit or loss to monitor performance and allocate resources.

The measure of segment assets is reported on the balance sheet as total assets. The CODM does not review segment assets at a level other than that presented in the Company’s consolidated balance sheets.

	2025			2024			2025			2024
	Three Months Ended September 30,						Nine Months Ended September 30,
	2025			2024			2025			2024
Revenue	$	33,255		$	27,937		$	101,570		$	85,754
Less cost of sales		11,263			11,630			35,051			33,562
Gross Profit		21,992			16,307			66,519			52,192
Gross Margin		66.1	%		58.4	%		65.5	%		60.9	%
Less:
General and administrative		7,071			7,493			22,082			22,991
Sales and marketing		11,746			11,890			34,566			37,530
Research and development		634			701			1,643			1,863
Interest expense		904			1,199			2,953			3,026
Unrealized foreign currency translation loss (gain)		56			(27	)		(146	)		(106	)
Other expense		16			13			18			6
Provision for income taxes		257			62			487			166
Net Income (Loss)	$	1,308		$	(5,024	)	$	4,916		$	(13,284	)

The Company attributes revenues to geographic areas based on the location of the customer. Approximately 91% of revenue was in the United States for both the three months ended September 30, 2025 and 2024, and 91% of revenue was in the United States for both the nine months ended September 30, 2025 and 2024. Total revenue by major geographic area is as follows (in thousands):

	2025		2024
	Three Months Ended September 30,
	2025		2024
United States	$	30,312	$	25,342
Rest of world		2,943		2,595
Total revenue	$	33,255	$	27,937

	2025		2024
	Nine Months Ended September 30,
	2025		2024
United States	$	92,561	$	76,752
Rest of world		9,009		9,002
Total revenue	$	101,570	$	85,754

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

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+ Details

Receivables

9 Months Ended

Sep. 30, 2025

Credit Loss [Abstract]

Receivables

(4) Receivables

The Company’s provision for current expected credit loss is determined based on historical collection experience adjusted for current economic conditions affecting collectability. Actual customer collections could differ from estimates. Account balances are charged to the allowance after all means of collection have been exhausted and the potential for recovery is considered remote. Provisions to the allowance for credit losses are charged to expense.