0001493152-26-013792 | 10-K | XBRL Viewer | Xtant Medical Holdings INC

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Schedule of Components of Income Tax (Provision) Benefit (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Income Tax Disclosure [Abstract]
Federal	$ (1,490)
State	(575)	(113)
Foreign	(1)	(53)
Total current	(2,066)	(166)
Federal	10	(7)
State	28	(14)
Total deferred	38	(21)
Total (provision) benefit for income taxes current and deferred	$ (2,028)	$ (187)

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

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+ Details

Summary of Revenues from Product Lines (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenue	$ 133,927	$ 117,267
Percentage of total revenue	100.00%	100.00%
Orthobiologics [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenue	$ 72,892	$ 66,419
Percentage of total revenue	54.00%	57.00%
Spinal Implant [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenue	$ 42,312	$ 49,346
Percentage of total revenue	32.00%	42.00%
License Revenue [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Total revenue	$ 18,723	$ 1,502
Percentage of total revenue	14.00%	1.00%

- 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

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Pay vs Performance Disclosure [Table]
Net Income (Loss)	$ 4,973	$ (16,449)

- Definition

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

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Reference 44: http://www.xbrl.org/2003/role/disclosureRef
-Topic 205
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 7
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483499/205-20-50-7

Reference 45: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 230
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 28
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482740/230-10-45-28

Reference 46: http://www.xbrl.org/2003/role/disclosureRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 1A
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482790/220-10-45-1A

Reference 47: http://www.xbrl.org/2003/role/disclosureRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 1B
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482790/220-10-45-1B

Reference 48: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 65
-Paragraph 4
-Subparagraph (f)(4)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481538/470-20-65-4

Reference 49: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 942
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-04(22))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478524/942-220-S99-1

+ Details

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Operating activities:
Net income (loss)	$ 4,973	$ (16,449)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and amortization	5,223	4,224
Non-cash interest	537	522
Loss (gain) on sale of fixed assets	251	(264)
Stock-based compensation	2,892	4,117
Provision for reserve on accounts receivable	1,404	823
Provision for excess and obsolete inventory	3,669	485
Gain on divestiture	(3,281)
Other	(76)	(5)
Changes in operating assets and liabilities:
Trade accounts receivable	(591)	(755)
Inventories	(1,999)	(2,494)
Prepaid and other assets	(1,537)	(218)
Accounts payable	(3,117)	1,033
Accrued liabilities	4,198	(2,915)
Net cash provided by (used in) operating activities	12,546	(11,896)
Investing activities:
Purchases of property and equipment	(2,382)	(4,113)
Proceeds from sale of fixed assets	232	383
Proceeds from divestiture	10,049
Net cash provided by (used in) investing activities	7,899	(3,730)
Financing activities:
Borrowings on line of credit	100,066	112,640
Repayments on line of credit	(101,329)	(105,142)
Payments on long-term debt	(8,000)
Payments on financing leases	(67)	(65)
Proceeds from private placement, net of issuance costs	(65)	4,456
Proceeds from issuance of long-term debt		5,000
Debt issuance costs	(49)	(651)
Payment of taxes from withholding of common stock upon vesting and settlement of restricted stock units	(126)	(178)
Proceeds from exercise of stock-based compensation		13
Net cash (used in) provided by financing activities	(9,570)	16,073
Effect of exchange rate changes on cash and cash equivalents and restricted cash	232	(149)
Net change in cash and cash equivalents and restricted cash	11,107	298
Cash and cash equivalents and restricted cash at beginning of year	6,221	5,923
Cash and cash equivalents and restricted cash at end of year	17,328	6,221
Reconciliation of cash and cash equivalents and restricted cash reported in the consolidated balance sheets
Cash and cash equivalents	17,053	6,199
Restricted cash	275	22
Total cash and cash equivalents and restricted cash reported in the consolidated balance sheets	$ 17,328	$ 6,221

Schedule of Calculation of Consolidated Net (Loss) Income (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Segment Reporting [Abstract]
Revenue	$ 133,927	$ 117,267
Less cost of sales	49,654	49,051
Gross Profit	$ 84,273	$ 68,216
Gross Margin	62.90%	58.20%
General and administrative	$ 29,375	$ 28,691
Sales and marketing	45,512	49,214
Research and development	2,102	2,385
Interest expense	3,671	4,160
Interest income	(94)
Unrealized foreign currency translation loss (gain)	60	(5)
Gain on divestiture	(3,281)
Other (income) expense	(73)	33
Provision (benefit) for income taxes	2,028	187
Net Income (Loss)	$ 4,973	$ (16,449)

Schedule of Stock Options Activity (Details) - Share-Based Payment Arrangement, Option [Member] - 2023 and 2018 Equity Incentive Plan [Member] - $ / shares	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
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, Exercised		(19,858)
Shares, Cancelled or expired	(164,931)	(930,567)
Weighted Average Exercise Price, Cancelled or expired	$ 1.19	$ 1.38
Shares, Outstanding, Ending balance	3,760,472	3,925,403
Weighted Average Exercise Price, Outstanding, Ending balance	$ 1.30	$ 1.29
Weighted Average Remaining Contract Term (Years) Outstanding	5 years 10 months 6 days	6 years 7 months 20 days
Shares, Exercisable, Ending balance	3,210,536	2,947,725
Weighted Average Exercise Price, Exercisable, Ending balance	$ 1.33	$ 1.36
Weighted Average Remaining Contract Term (years), Exercisable	5 years 6 months 25 days	6 years 29 days

Schedule of Future Minimum Payments for Operating Leases (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
2026	$ 927
2027	845
2028	857
2029	874
2030	689
Total future minimum lease payments	4,192
Less: amount representing interest	(905)
Present value of obligations under operating leases	3,287
Less: current portion	(622)	$ (703)
Long-term operating lease obligations	$ 2,665	$ 166

Schedule of Income Taxes Paid or Refunded (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Effective Income Tax Rate Reconciliation [Line Items]
Federal
State
Foreign
Total income taxes paid (refunded):	121	$ 70
TEXAS
State
Other	70
NEW YORK
State
Other	17
TENNESSEE
State
Other	9
Other [Member]
State
Other	$ 25

Business Description and Summary of Significant Accounting Policies (Details Narrative) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Trade accounts receivable	$ 20,000	$ 22,100
Trade accounts receivable	17,803	20,660	$ 21,700
Allowance for credit losses, net	2,165	$ 1,437	$ 900
Contract liability within accrued liabilities	1,500
Revenue contract liability	1,500
Licensing Agreement [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Cash payment received	1,500
Royalty payments received	3,750
Bill And Hold Transactions [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Revenue	$ 400
Computers and Equipment [Member] \| Minimum [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Property and equipment, estimated useful lives	3 years
Computers and Equipment [Member] \| Maximum [Member]
Collaborative Arrangement and Arrangement Other than Collaborative [Line Items]
Property and equipment, estimated useful lives	7 years

Trade Accounts Receivable, Net

12 Months Ended

Dec. 31, 2025

Credit Loss [Abstract]

Trade Accounts Receivable, Net

(3) Trade Accounts Receivable, Net

Trade accounts receivable is reduced by an estimated allowance for credit losses based on historical collection experience adjusted for current economic conditions affecting collectability and reasonable and supportable forecasts concerning the future. 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. Activity within the allowance for credit losses consist of the following (in thousands):

Schedule of Allowance for Credit Losses

	December 31, 2025			December 31, 2024
Balance at January 1	$	1,437		$	920
Provision for current expected credit losses		1,229			823
Write-offs against allowance		(218	)		(306	)
Divested allowance for credit losses		(283	)		—
Balance at December 31	$	2,165		$	1,437

Net Income (Loss) Per Share

12 Months Ended

Dec. 31, 2025

Net Income (Loss) Per Share:

Net Income (Loss) Per Share

(14) 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 year ended December 31, 2024, as shares issuable upon the exercise of stock options and warrants were anti-dilutive as a result of the net loss incurred for the period.

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

	2025		2024
	Year Ended December 31,
	2025		2024
Numerator:
Net income (loss)	$	4,973	$	(16,449	)
Denominator:
Basic – weighted average shares outstanding		139,531,791		133,665,075
Effect of dilutive securities:
Employee restricted stock units, deferred stock units and performance stock units		5,434,407		—
Warrants		5,076,358		—
Diluted – weighted average shares outstanding		150,042,556		133,665,075
Basic earnings per share		0.04		(0.12	)
Diluted earnings per share		0.03		(0.12	)

For the years ended December 31, 2025 and 2024, 16,496,429 and 21,952,434 stock options, restricted stock units, deferred stock units, performance stock units and warrants were excluded for the diluted earnings per share calculation as they were anti-dilutive.

Immaterial Out-of-Period Adjustment

12 Months Ended

Dec. 31, 2025

Immaterial Out-of-period Adjustment

Immaterial Out-of-Period Adjustment

(19) Immaterial Out-of-Period Adjustment

During the preparation of the Company’s annual financial statements for the year ended December 31, 2025, management identified errors in amounts recorded in the first, second, and third quarters of the year ended December 31, 2025. Management evaluated each of these items individually and in the aggregate and determined that the errors were not material to any previously issued interim financial statements or to the full fiscal year. However, the aggregate effect of correcting these items in the fourth quarter of 2025 was material to the Company’s results of operations for that period.

The adjustment related to two items. The first adjustment reflects management’s estimates of net realizable value of the hardware product line at each interim balance sheet date in 2025. Subsequent to the commercial launch of the hardware product line in the fourth quarter of 2024, the Company accumulated inventory quantities in excess of anticipated sales demand, requiring recognition of additional cost of sales expense for reserves of excess inventory.

Second, the Company recorded an adjustment related to the amortization of leasehold improvements. Upon further evaluation of the applicable accounting guidance under ASC 842, Leases, management determined that certain leasehold improvements had been amortized over their estimated useful lives rather than over the shorter of their useful lives or the related lease terms, as required. Accordingly, the carrying value of Property and equipment, net-was overstated in prior interim periods.

The Company considered both the quantitative and qualitative factors in accordance with ASC 250-10-S99, Materiality, and evaluated the errors using both the rollover and iron curtain methods. Based on this evaluation, the Company concluded that the errors were not material to previously issued financial statements and recorded the aggregate correction as an out-of-period adjustment in the fourth quarter of fiscal 2025. The Company has not revised previously issued interim financial statements.

The adjustment resulted in a decrease to Inventories of $1.0 million, a decrease to Property and equipment, net of $0.9 million, an increase to General and administrative expenses of $0.1 million and an increase to Cost of sales of $1.8 million in the fourth quarter of 2025.

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2025

Income Tax Disclosure [Abstract]

Schedule of Components of Loss Before Provision for Income Tax

The components of income (loss) from operations before provision for income taxes consist of the following (in thousands):

	2025			2024
	Year Ended December 31,
	2025			2024
United States	$	9,553		$	(13,835	)
Foreign	$	(2,552	)	$	(2,427	)
Total	$	7,001		$	(16,262	)

Schedule of Components of Income Tax (Provision) Benefit

The components of the (provision) benefit for income taxes current and deferred are as follows (in thousands):

	2025			2024
	Year Ended December 31,
	2025			2024
Current:
Federal	$	(1,490	)	$	—
State		(575	)		(113	)
Foreign		(1	)		(53	)
Total current		(2,066	)		(166	)

Deferred:
Federal		10			(7	)
State		28			(14	)
Total deferred		38			(21	)

Total (provision) benefit for income taxes current and deferred	$	(2,028	)	$	(187	)

Schedule of Effective Income Tax Rate Reconciliation

The reconciliation of income tax benefit (expense) attributable to operations computed at the U.S. Federal statutory income tax rate of 21% to income tax expense is as follows (in thousands):

	Year Ended December 31, 2024
Statutory Federal tax rate	$	3,415
Valuation allowance		(3,163	)
State income taxes, net of Federal benefit		636
Permanent differences		(62	)
Change in state income tax rate		(42	)
Stock compensation adjustment		(210	)
Attribute expiration		(280	)
Return to provision and other adjustments		(444	)
Foreign rate differential		134
Nondeductible executive compensation		(171	)

Total (provision) benefit for income taxes current and deferred	$	(187	)

I		(
	Year Ended December 31, 2025
Income tax at statutory tax rate	$	(1,470	)	21.0	%
State and local income tax, net of federal income tax effect*		(432	)	6.2	%
Foreign tax effects
Germany
Changes in valuation allowance		4,115		(58.8	)%
Reduction in deferred tax assets due to disposal		(4,648	)	66.4	%
Other adjustments		183		(2.6	)%
United Kingdom
Other adjustments		(158	)	2.3	%
Other foreign jurisdictions		(4	)	0.1	%
Changes in valuation allowance		4,688		(67.0	)%
Nontaxable or nondeductible items
Share-based payment awards		(146	)	2.1	%
Executive compensation		(195	)	2.8	%
Other		(13	)	0.2	%
Other adjustments
Return to provision		659		(9.4	)%
Gain on sale of investments		(931	)	13.3	%
Reduction in deferred tax assets due to 382 limitations		(3,734	)	53.3	%
Other adjustments		58		(0.8	)%
Total (provision) benefit for income taxes current and deferred	$	(2,028	)	29.0	%

State taxes in California, New York and Texas made up the majority (greater than 50%) of the tax effect in this category.

Schedule of Deferred Tax Assets and Liabilities

Deferred tax components are as follows (in thousands):

	2025			2024
	At December 31,
	2025			2024
Deferred tax assets:
Accrued liability for vacation	$	141		$	173
Accrued commissions and bonuses / compensation		432			115
Accrued contingencies		317			78
Amortization		122			518
Bad debt reserve		553			326
Capitalized R&D expenses		—			850
Charitable contributions carryforward		—			15
Lease liability		851			261
Interest expense		3,660			4,092
Inventory reserve		3,010			2,834
Net operating loss carryovers		8,814			19,160
Stock option compensation		1,230			1,022
UNICAP		142			115
Other		157			103
Total deferred tax assets		19,429			29,662

Deferred tax liabilities:
Depreciation		(370	)		(470	)
Right of use asset		(815	)		(220	)
Prepaids		(72	)		(65	)
Total deferred tax liabilities		(1,257	)		(755	)

Valuation allowance		(18,177	)		(28,949	)

Net deferred tax liabilities	$	(5	)	$	(42	)

Schedule of Income Taxes Paid or Refunded

Income taxes paid or refunded are as follows (in thousands):

	Year Ended December 31, 2025
Federal	$	—
State
Texas		70
New York		17
Tennessee		9
Other		25

Foreign		—

Total income taxes paid (refunded):		121

Inventories (Tables)

12 Months Ended

Dec. 31, 2025

Inventory Disclosure [Abstract]

Schedule of Inventories

Inventories consist of the following (in thousands):

Schedule of Inventories

	December 31, 2025		December 31, 2024
Raw materials	$	5,689	$	6,622
Work in process		4,799		2,812
Finished goods		19,775		29,200
Total	$	30,263	$	38,634

Stock-Based Compensation (Tables)

12 Months Ended

Dec. 31, 2025

Share-Based Payment Arrangement [Abstract]

Schedule of Stock Options Activity

Stock option activity, including options granted under the 2023 Plan, the 2018 Plan and the prior plan was as follows:

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
Exercised		—			—				(19,858	)		0.64
Cancelled or expired		(164,931	)		1.19				(930,567	)		1.38
Outstanding at December 31		3,760,472			1.30		5.85		3,925,403			1.29		6.64
Exercisable at December 31		3,210,536			1.33		5.57		2,947,725			1.36		6.08

Schedule of Restricted Stock Activity

Under our non-employee director compensation program, non-employee directors may elect to receive deferred stock units, or DSUs, in lieu of their annual restricted stock units, or RSUs. In addition, certain officers have received DSUs instead of RSUs for their annual equity awards in 2025 and 2024. Each RSU or DSU represents the right to receive one share of our common stock. DSU and RSU activity for awards granted under the 2023 Plan and 2018 Plan was as follows:

Schedule of Restricted Stock Activity

	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		3,497,772			0.65		4,195,363			0.84
Vested		(1,203,987	)		0.89		(1,310,937	)		1.13
Cancelled		(80,116	)		0.98		(953,629	)		0.92
Outstanding at December 31		7,669,141			0.79		5,455,472			0.90

Schedule of PSU Awards Activity

Activity for PSU awards granted under the 2023 Plan, assuming target performance, was as follows for the years ended December 31, 2025 and 2024:

Schedule of PSU Awards Activity

	2025				2024
	Shares		Weighted Average Fair Value		Shares			Weighted Average Fair Value
Outstanding at January 1		1,640,709		1.49		—			—
Granted		1,699,402		0.84		1,894,985			1.49
Forfeited		—		—		(254,276	)		1.49
Outstanding at December 31		3,340,111		1.16		1,640,709			1.49

Schedule of Fair Value of Simulation Model

The fair value of the PSUs was estimated using a Monte Carlo simulation model and the following assumptions:

	2025			2024
Company volatility		78	%		93.34	%
Risk-free interest rate		3.58	%		4.53	%
Initial stock price	$	0.6521			Not applicable
Correlation with index		Not applicable			0.06
Dividend yield		0	%		0	%
Volatility of peer companies		Not applicable			unique to each company in the simulation

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2025

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Carrying Amount of Goodwill

The change in the carrying amount of goodwill during the year ended December 31, 2025 included the following (in thousands):

December 31, 2024	$	7,302
Divestiture		(1,228	)
December 31, 2025		6,074

Schedule of Intangible of Assets

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

Schedule of Intangible of Assets

December 31, 2025:

Weighted

Average Life

Cost

Accumulated

Amortization

Net

Patents

13 years

1,027

(728

)

299

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

Schedule of Future Amortization Expense for Intangible Assets


2026		86
2027		52
2028		52
2029		46
2030		33
Thereafter		30
Total	$	299

Property and Equipment, Net (Tables)

12 Months Ended

Dec. 31, 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

	December 31, 2025			December 31, 2024
Equipment	$	7,346		$	7,239
Computer equipment		1,252			1,254
Computer software		361			361
Leasehold improvements		4,483			4,356
Surgical instruments		14,070			15,798
Assets not yet in service		897			960
Total cost		28,409			29,968
Property and equipment, gross		28,409			29,968
Less: accumulated depreciation		(22,207	)		(19,837	)
Property and equipment, net	$	6,202		$	10,131

Schedule of Basic and Diluted Earnings Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Net Income (Loss) Per Share:
Net income (loss)	$ 4,973	$ (16,449)
Basic – weighted average shares outstanding	139,531,791	133,665,075
Employee restricted stock units, deferred stock units and performance stock units	5,434,407
Warrants	5,076,358
Diluted – weighted average shares outstanding	150,042,556	133,665,075
Basic earnings per share	$ 0.04	$ (0.12)
Diluted earnings per share	$ 0.03	$ (0.12)

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 260
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482662/260-10-50-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (c)(2)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483443/250-10-50-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (c)(1)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483443/250-10-50-1

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 4
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483443/250-10-50-4

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 105
-SubTopic 10
-Name Accounting Standards Codification
-Section 65
-Paragraph 9
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479343/105-10-65-9

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 65
-Paragraph 17
-Subparagraph (d)(1)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480336/718-10-65-17

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483443/250-10-50-6

Reference 8: http://www.xbrl.org/2003/role/exampleRef
-Topic 260
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 52
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482635/260-10-55-52

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 805
-SubTopic 60
-Name Accounting Standards Codification
-Section 65
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The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

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+ Details

- Definition

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

+ References

+ Details

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Dec. 31, 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

Business Description and Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2025

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Summary of Revenues from Product Lines

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 years ended December 31, 2025 and 2024 (in thousands):

Summary of Revenues from Product Lines

	Year Ended December 31, 2025		Percentage of Total Revenue			Year Ended December 31, 2024		Percentage of Total Revenue
Orthobiologics	$	72,892		54	%	$	66,419		57	%
Spinal implant		42,312		32	%		49,346		42	%
License revenue		18,723		14	%		1,502		1	%
Total revenue	$	133,927		100	%	$	117,267		100	%

Warrants (Tables)

12 Months Ended

Dec. 31, 2025

Warrants

Schedule of Warrant Activity

Warrant activity was as follows for the years ended December 31, 2025 and 2024:

Schedule of Warrant Activity

	Common Stock Warrants		Weighted Average Exercise Price
Outstanding as of December 31, 2023		12,187,470		1.53
Issued		50,000		0.82
Outstanding as of December 31, 2024		12,237,470		1.53
Issued		—		—
Outstanding as of December 31, 2025		12,237,470		1.53

Segment and Geographic Information (Tables)

12 Months Ended

Dec. 31, 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
	Year Ended December 31,
	2025			2024
Revenue	$	133,927		$	117,267
Less cost of sales		49,654			49,051
Gross Profit		84,273			68,216
Gross Margin		62.9	%		58.2	%
Less:
General and administrative		29,375			28,691
Sales and marketing		45,512			49,214
Research and development		2,102			2,385
Interest expense		3,671			4,160
Interest income		(94	)		—
Unrealized foreign currency translation loss (gain)		60			(5	)
Gain on divestiture		(3,281	)		—
Other (income) expense		(73	)		33
Provision (benefit) for income taxes		2,028			187
Net Income (Loss)	$	4,973		$	(16,449	)

Schedule of Revenues by Geographic Region

	2025		2024
	Year Ended December 31,
	2025		2024
United States	$	122,448	$	105,519
Rest of World		11,479		11,748
Total	$	133,927	$	117,267

Segment and Geographic Information

12 Months Ended

Dec. 31, 2025

Segment Reporting [Abstract]

Segment and Geographic Information

(18) 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 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
	Year Ended December 31,
	2025			2024
Revenue	$	133,927		$	117,267
Less cost of sales		49,654			49,051
Gross Profit		84,273			68,216
Gross Margin		62.9	%		58.2	%
Less:
General and administrative		29,375			28,691
Sales and marketing		45,512			49,214
Research and development		2,102			2,385
Interest expense		3,671			4,160
Interest income		(94	)		—
Unrealized foreign currency translation loss (gain)		60			(5	)
Gain on divestiture		(3,281	)		—
Other (income) expense		(73	)		33
Provision (benefit) for income taxes		2,028			187
Net Income (Loss)	$	4,973		$	(16,449	)

The Company attributes revenues to geographic areas based on the location of the customer. Approximately 91% and 90% of revenue was in the United States for the years ended December 31, 2025 and 2024, respectively. Total revenue by major geographic area is as follows (in thousands):

	2025		2024
	Year Ended December 31,
	2025		2024
United States	$	122,448	$	105,519
Rest of World		11,479		11,748
Total	$	133,927	$	117,267

- 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.

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-URI https://asc.fasb.org/1943274/2147482810/280-10-50-41

+ Details

Equity (Details Narrative) - USD ($) $ / shares in Units, $ in Thousands		12 Months Ended
	Aug. 07, 2024	Dec. 31, 2025	Dec. 31, 2024
Subsidiary, Sale of Stock [Line Items]
Net proceeds		$ (65)	$ 4,456
Private Placement [Member]
Subsidiary, Sale of Stock [Line Items]
Common stock shares	7,812,500
Price per share	$ 0.64
Gross proceeds from private placement	$ 5,000
Net proceeds	$ 4,500

Schedule of Fair Value of Simulation Model (Details) - Performance Shares [Member] - $ / shares	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Company volatility	78.00%	93.34%
Risk-free interest rate	3.58%	4.53%
Initial stock price	$ 0.6521
Correlation with index		$ 0.06
Dividend yield	0.00%	0.00%

- 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.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (f)(2)
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-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
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-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Subparagraph (f)(2)(i)
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (f)(2)(iii)
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-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
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-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Section 50
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-Subparagraph (d)(1)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
-SubTopic 10
-Name Accounting Standards Codification
-Section 35
-Paragraph 1D
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480483/718-10-35-1D

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Section 35
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-URI https://asc.fasb.org/1943274/2147480483/718-10-35-3

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Section 50
-Paragraph 2
-Subparagraph (a)(2)
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Section 50
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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Reference 16: http://www.xbrl.org/2003/role/disclosureRef
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Reference 17: http://www.xbrl.org/2003/role/disclosureRef
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Reference 18: http://www.xbrl.org/2003/role/disclosureRef
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Reference 19: http://www.xbrl.org/2003/role/disclosureRef
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Reference 20: http://www.xbrl.org/2003/role/disclosureRef
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Reference 22: http://www.xbrl.org/2003/role/disclosureRef
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Reference 24: http://www.xbrl.org/2003/role/disclosureRef
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Reference 25: http://www.xbrl.org/2003/role/disclosureRef
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Reference 27: http://www.xbrl.org/2003/role/disclosureRef
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Reference 28: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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Reference 29: http://www.xbrl.org/2003/role/disclosureRef
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Reference 30: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

+ Details

Income Taxes

12 Months Ended

Dec. 31, 2025

Income Tax Disclosure [Abstract]

Income Taxes

(13) Income Taxes

The Company’s (provision) benefit for income taxes differs from applying the statutory U.S. Federal income tax rate to income before taxes. The primary difference results from providing for state income taxes and from deducting certain expenses for financial statement purposes but not for federal income tax purposes.

The components of income (loss) from operations before provision for income taxes consist of the following (in thousands):

	2025			2024
	Year Ended December 31,
	2025			2024
United States	$	9,553		$	(13,835	)
Foreign	$	(2,552	)	$	(2,427	)
Total	$	7,001		$	(16,262	)

The components of the (provision) benefit for income taxes current and deferred are as follows (in thousands):

	2025			2024
	Year Ended December 31,
	2025			2024
Current:
Federal	$	(1,490	)	$	—
State		(575	)		(113	)
Foreign		(1	)		(53	)
Total current		(2,066	)		(166	)

Deferred:
Federal		10			(7	)
State		28			(14	)
Total deferred		38			(21	)

Total (provision) benefit for income taxes current and deferred	$	(2,028	)	$	(187	)

The reconciliation of income tax benefit (expense) attributable to operations computed at the U.S. Federal statutory income tax rate of 21% to income tax expense is as follows (in thousands):

	Year Ended December 31, 2024
Statutory Federal tax rate	$	3,415
Valuation allowance		(3,163	)
State income taxes, net of Federal benefit		636
Permanent differences		(62	)
Change in state income tax rate		(42	)
Stock compensation adjustment		(210	)
Attribute expiration		(280	)
Return to provision and other adjustments		(444	)
Foreign rate differential		134
Nondeductible executive compensation		(171	)

Total (provision) benefit for income taxes current and deferred	$	(187	)

I		(
	Year Ended December 31, 2025
Income tax at statutory tax rate	$	(1,470	)	21.0	%
State and local income tax, net of federal income tax effect*		(432	)	6.2	%
Foreign tax effects
Germany
Changes in valuation allowance		4,115		(58.8	)%
Reduction in deferred tax assets due to disposal		(4,648	)	66.4	%
Other adjustments		183		(2.6	)%
United Kingdom
Other adjustments		(158	)	2.3	%
Other foreign jurisdictions		(4	)	0.1	%
Changes in valuation allowance		4,688		(67.0	)%
Nontaxable or nondeductible items
Share-based payment awards		(146	)	2.1	%
Executive compensation		(195	)	2.8	%
Other		(13	)	0.2	%
Other adjustments
Return to provision		659		(9.4	)%
Gain on sale of investments		(931	)	13.3	%
Reduction in deferred tax assets due to 382 limitations		(3,734	)	53.3	%
Other adjustments		58		(0.8	)%
Total (provision) benefit for income taxes current and deferred	$	(2,028	)	29.0	%

State taxes in California, New York and Texas made up the majority (greater than 50%) of the tax effect in this category.

Deferred tax components are as follows (in thousands):

	2025			2024
	At December 31,
	2025			2024
Deferred tax assets:
Accrued liability for vacation	$	141		$	173
Accrued commissions and bonuses / compensation		432			115
Accrued contingencies		317			78
Amortization		122			518
Bad debt reserve		553			326
Capitalized R&D expenses		—			850
Charitable contributions carryforward		—			15
Lease liability		851			261
Interest expense		3,660			4,092
Inventory reserve		3,010			2,834
Net operating loss carryovers		8,814			19,160
Stock option compensation		1,230			1,022
UNICAP		142			115
Other		157			103
Total deferred tax assets		19,429			29,662

Deferred tax liabilities:
Depreciation		(370	)		(470	)
Right of use asset		(815	)		(220	)
Prepaids		(72	)		(65	)
Total deferred tax liabilities		(1,257	)		(755	)

Valuation allowance		(18,177	)		(28,949	)

Net deferred tax liabilities	$	(5	)	$	(42	)

Income taxes paid or refunded are as follows (in thousands):

	Year Ended December 31, 2025
Federal	$	—
State
Texas		70
New York		17
Tennessee		9
Other		25

Foreign		—

Total income taxes paid (refunded):		121

The ultimate realization of deferred tax assets is dependent upon the existence, or generation, of taxable income in the periods when those temporary differences and net operating loss carryovers are deductible. Management considers the scheduled reversal of deferred tax liabilities, taxes paid in carryover years, projected future taxable income, available tax planning strategies, and other factors in making this assessment. Based on available evidence, management does not believe it is more likely than not that all of the deferred tax assets will be realized. Accordingly, the Company has established a valuation allowance equal to the realizable deferred tax assets. The valuation allowance decreased by $10.8 million in 2025 and increased by $3.2 million in 2024.

At December 31, 2025, the Company had total domestic Federal, state and foreign net operating loss carryovers of approximately $34.1 million, $36.7 million and $0.0 million, respectively. Federal net operating losses generated prior to 2018 and State net operating loss carryovers expire at various dates between 2026 and 2045. Federal net operating losses generated after 2017 have an indefinite carryforward and are only available to offset 80% taxable income beginning in 2021. Foreign net operating losses carry forward indefinitely.

The Company has completed studies to assess whether an ownership change, as defined by Section 382 of the Code, had occurred from the Company’s formation through December 31, 2025. Based upon these studies, the Company determined that ownership changes occurred during 2018 and 2025. Accordingly, the Company reduced its deferred tax assets related to the federal NOL carryforwards that are anticipated to expire unused as a result of these ownership changes. These tax attributes were excluded from deferred tax assets with a corresponding reduction of the valuation allowance with no net effect on income tax expense or the effective tax rate. Future ownership changes may further limit the Company’s ability to utilize its remaining tax attributes.

The 2023 through 2025 tax years remain open to examination by the Internal Revenue Service and various other state and foreign tax agencies. These taxing authorities have the authority to examine those tax years until the applicable statute of limitations expire. Foreign tax years remain open from 2022 to 2025.

As of December 31, 2025, we have no unrecognized tax benefits in long-term liabilities.

The Company did not recognize any material interest or penalties related to income taxes for the years ended December 31, 2025 and 2024.

- 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
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477617/942-740-50-1

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

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 944
-SubTopic 740
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478822/944-740-50-1

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-12

Reference 5: http://www.xbrl.org/2003/role/exampleRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 231
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482663/740-10-55-231

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12C
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-12C

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12B
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-12B

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 270
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477891/740-270-50-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 6.I.5.Q1)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479360/740-10-S99-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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-SubTopic 20
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-13

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
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-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-1

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org/740/tableOfContent

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-14

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
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-Section 50
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-21

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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-SubTopic 10
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-Section 50
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-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-17

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
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-Name Accounting Standards Codification
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Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
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-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482603/740-30-50-2

+ Details

Debt (Tables)

12 Months Ended

Dec. 31, 2025

Debt Disclosure [Abstract]

Schedule of Long-term Debt

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

Schedule of Long-term Debt

	December 31, 2025			December 31, 2024
Amounts due under the Term Facility	$	14,000		$	22,000
Accrued end-of-term payments		817			465
Less: unamortized debt issuance costs		(291	)		(427	)
Less: Current portion of long-term debt		(3,500	)		—
Long-term debt, less issuance costs	$	11,026		$	22,038

Schedule of Principal Payments

Period	Scheduled Quarterly Payments		Annually
2026	$	1,167	$	3,500
2027		1,167		4,667
2028		1,167		4,667
2029		1,167		1,167

Schedule of Restricted Stock Activity (Details) - Deferred Stock Units and Restricted Stock Units [Member] - 2023 and 2018 Equity Incentive Plan [Member] - $ / shares	12 Months Ended
	Dec. 31, 2025	Dec. 31, 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 Per Share, Outstanding, Beginning balance	$ 0.90	$ 1.07
Shares, Granted	3,497,772	4,195,363
Weighted Average Fair Value at Grant Date Per Share, Granted	$ 0.65	$ 0.84
Shares, Vested	(1,203,987)	(1,310,937)
Weighted Average Fair Value at Grant Date Per Share, Vested	$ 0.89	$ 1.13
Shares, Cancelled	(80,116)	(953,629)
Weighted Average Fair Value at Grant Date Per Share, Cancelled	$ 0.98	$ 0.92
Shares Outstanding, Ending balance	7,669,141	5,455,472
Weighted Average Fair Value at Grant Date Per Share, Outstanding, Ending balance	$ 0.79	$ 0.90

Sale of Coflex/CoFix Assets and International Hardware Business (Details Narrative) - USD ($) $ in Thousands			12 Months Ended
	Feb. 27, 2026	Dec. 01, 2025	Dec. 31, 2025	Dec. 31, 2024
Business Combination [Line Items]
issued and outstanding shares of equity securities		100.00%
Gain on sale of divestitures			$ 3,281
Coflex/CoFix Agreement [Member] \| Companion Spine Llc [Member]
Business Combination [Line Items]
Future proceeds to be received		$ 17,500
Aggregate purchase price in cash		7,500
Cash payments		1,800
Unsecured promissory note		8,200
total purchase price			21,400
Gain on sale of divestitures			3,300
Accumulated other comprehensive income from currency translation adjustment		400
Goodwill			$ 1,200
Coflex/CoFix Agreement [Member] \| Companion Spine Llc [Member] \| Forecast [Member]
Business Combination [Line Items]
Payment of unsecured promissory note plus accrued interest	$ 8,500
Coflex/CoFix Agreement [Member] \| Paradigm Spine Gmbh [Member]
Business Combination [Line Items]
Aggregate purchase price in cash		1,700
total purchase price		$ 3,900
Coflex/CoFix Agreement [Member] \| Paradigm Spine Gmbh [Member] \| Forecast [Member]
Business Combination [Line Items]
Aggregate purchase price in cash	$ 2,200

Goodwill and Intangible Assets

12 Months Ended

Dec. 31, 2025

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

(6) Goodwill and Intangible Assets

The results of the Company’s annual goodwill impairment tests for the years ended December 31, 2025 and 2024 indicated that no goodwill impairment existed as of the test date.

The change in the carrying amount of goodwill during the year ended December 31, 2025 included the following (in thousands):

December 31, 2024	$	7,302
Divestiture		(1,228	)
December 31, 2025		6,074

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

Schedule of Intangible of Assets

December 31, 2025:

Weighted

Average Life

Cost

Accumulated

Amortization

Net

Patents

13 years

1,027

(728

)

299

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 $1.6 million and $1.7 million for the years ended December 31, 2025 and 2024. The following is a summary of estimated future amortization expense for intangible assets as of December 31, 2025 (in thousands):


2026		86
2027		52
2028		52
2029		46
2030		33
Thereafter		30
Total	$	299

Net Income (Loss) Per Share (Tables)

12 Months Ended

Dec. 31, 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 per share (in thousands, except per share data):

	2025		2024
	Year Ended December 31,
	2025		2024
Numerator:
Net income (loss)	$	4,973	$	(16,449	)
Denominator:
Basic – weighted average shares outstanding		139,531,791		133,665,075
Effect of dilutive securities:
Employee restricted stock units, deferred stock units and performance stock units		5,434,407		—
Warrants		5,076,358		—
Diluted – weighted average shares outstanding		150,042,556		133,665,075
Basic earnings per share		0.04		(0.12	)
Diluted earnings per share		0.03		(0.12	)

Schedule of Long-term Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Debt Disclosure [Abstract]
Amounts due under the Term Facility	$ 14,000	$ 22,000
Accrued end-of-term payments	817	465
Less: unamortized debt issuance costs	(291)	(427)
Less: Current portion of long-term debt	(3,500)
Long-term debt, less issuance costs	$ 11,026	$ 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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- Definition

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.

+ References + Details

Property and Equipment, Net (Details Narrative) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Property, Plant and Equipment [Abstract]
Depreciation expenses	$ 3.6	$ 2.5

Goodwill and Intangible Assets (Details Narrative) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense	$ 1.6	$ 1.7

- 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.

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+ Details

Schedule of Inventories (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Inventory Disclosure [Abstract]
Raw materials	$ 5,689	$ 6,622
Work in process	4,799	2,812
Finished goods	19,775	29,200
Total	$ 30,263	$ 38,634

Property and Equipment, Net

12 Months Ended

Dec. 31, 2025

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

(5) Property and Equipment, Net

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

Schedule of Property and Equipment, Net

	December 31, 2025			December 31, 2024
Equipment	$	7,346		$	7,239
Computer equipment		1,252			1,254
Computer software		361			361
Leasehold improvements		4,483			4,356
Surgical instruments		14,070			15,798
Assets not yet in service		897			960
Total cost		28,409			29,968
Property and equipment, gross		28,409			29,968
Less: accumulated depreciation		(22,207	)		(19,837	)
Property and equipment, net	$	6,202		$	10,131

Depreciation expense related to property and equipment, including property under finance lease, for the years ended December 31, 2025 and 2024 was $3.6 million and $2.5 million, respectively.

Cover - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
Cover - USD ($) $ / shares in Units, $ in Millions	Dec. 31, 2025	Mar. 25, 2026	Jun. 30, 2025
Cover [Abstract]
Document Type	10-K
Amendment Flag	false
Document Annual Report	true
Document Transition Report	false
Document Period End Date	Dec. 31, 2025
Document Fiscal Period Focus	FY
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 Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
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 Public Float			$ 45.0
Entity Common Stock, Shares Outstanding		140,068,260
Documents Incorporated by Reference [Text Block]	None
ICFR Auditor Attestation Flag	false
Document Financial Statement Error Correction [Flag]	false
Entity Listing, Par Value Per Share	$ 0.000001
Auditor Firm ID	248
Auditor Opinion [Text Block]	We have audited the accompanying consolidated balance sheets of Xtant Medical Holdings, Inc. (a Delaware corporation) and subsidiaries (the “Company”) as of December 31, 2025 and 2024, the related consolidated statements of operations, comprehensive income (loss), changes in shareholders’ equity, and cash flows for each of the two years in the period ended December 31, 2025 and 2024, and the related notes (collectively referred to as the “consolidated financial statements”). In our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 2025 and 2024, and the results of its operations and its cash flows for each of the two years in the period ended December 31, 2025 and 2024, in conformity with accounting principles generally accepted in the United States of America.
Auditor Name	GRANT THORNTON LLP
Auditor Location	Minneapolis, Minnesota

Schedule of the Assets and Liabilities of the Disposal Group (Details) - USD ($) $ in Thousands	Dec. 01, 2025	Dec. 31, 2024
ASSETS
Trade accounts receivable, net of allowances for credit losses	$ 2,032	$ 2,026
Inventories	7,223	5,097
Prepaid and other current assets	653	769
Property and equipment, net	2,367	2,031
Right of use asset, net	281	229
Intangible assets, net	6,465	7,957
Other assets	203	11
Total Assets	19,224	18,120
LIABILITIES
Accounts payable	1,289	3,851
Accrued liabilities	1,286	920
Lease liability	281	229
Total Liabilities	$ 2,856	$ 5,000

Debt

12 Months Ended

Dec. 31, 2025

Debt Disclosure [Abstract]

Debt

(8) Debt

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

Schedule of Long-term Debt

	December 31, 2025			December 31, 2024
Amounts due under the Term Facility	$	14,000		$	22,000
Accrued end-of-term payments		817			465
Less: unamortized debt issuance costs		(291	)		(427	)
Less: Current portion of long-term debt		(3,500	)		—
Long-term debt, less issuance costs	$	11,026		$	22,038

As of December 31, 2025, scheduled principal payments for the term credit agreement are as follows (in thousands):

Schedule of Principal Payments

Period	Scheduled Quarterly Payments		Annually
2026	$	1,167	$	3,500
2027		1,167		4,667
2028		1,167		4,667
2029		1,167		1,167

On March 7, 2024, the Company’s term credit agreement was amended and restated to, among other things, extend the maturity date to March 1, 2029. An additional $10.0 million tranche, available solely at the discretion of MidCap Financial Trust and the lenders, was added to the term credit agreement and the applicable margin used to determine the per annum interest rate was reduced from 7.00% to 6.50%. The date of certain fees payable in connection with optional prepayments were also reset by the amendment to be determined based on the date the amendment. The Company’s revolving credit agreement was also amended and restated on March 7, 2024, to among other things, increase the commitment amount from $8.0 million to $17.0 million. The maturity of the revolving credit agreement was also extended to March 1, 2029. Minimum revenue requirements specified in the credit agreements were reset and minimum adjusted EBITDA requirements were removed.

On May 14, 2024, the term credit agreement was amended to increase the amount of term loans that may be borrowed by $5.0 million to a maximum of $22.0 million, which were fully drawn as of May 14, 2024. In addition, the amendments to the term credit agreement and revolving credit agreement re-set the date certain fees payable in connection with optional prepayments are determined to May 14, 2024 and consequently extend such fees’ original expiration. The exit fees were increased by 2.50% to 6.50% of the principal amount borrowed pursuant to the term credit agreement. The terms of borrowing under the term credit agreement and revolving credit agreement otherwise remain materially unchanged.

On July 7, 2025, we 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 us entering into the Coflex/CoFix Agreement and Paradigm Agreement and the consummation of the Divestitures in accordance with the terms and subject to the conditions set forth therein.

On March 26, 2026, we entered into Amendment No. 4 to Amended and Restated Credit, Security and Guaranty Agreement (Term Loan) with MidCap Financial Trust and Amendment No. 4 to Amended and Restated Credit, Security and Guaranty Agreement (Revolving Loan) with MidCap Funding IV Trust (collectively, the “Amendment No. 4s”) pursuant to which we eliminated the requirement to comply with the minimum net revenue covenant for fourth quarter of 2025, adjusted the amortization of the term loan to have amortization calculated off the amount of principal outstanding when amortization payments start instead of the original principal amount of the term loan, and revised the minimum net revenue covenant to align solely with revenue generated from the orthobiologics products and correspondingly adjust the minimum net revenue amounts.

As of December 31, 2025, the effective rate of the term loan under the term credit agreement, inclusive of authorization of debt issuance costs and accretion of the final payment, was 14.08%, and the effective rate of the revolving loan under the revolving credit agreement was 8.49%. As of December 31, 2025, the Company had $10.9 million outstanding and $3.8 million of availability under the Revolving Credit Facility.

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, and change the nature of their businesses. 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 December 31, 2025, the Company was in compliance with all applicable covenants under the credit agreements. As of December 31, 2025, our credit agreements included a minimum net revenue covenant, however, pursuant to the Amendment No. 4s executed in March 2026, we were not required to comply with the minimum net revenue covenant for the quarter ended December 31, 2025. Under the covenant terms in effect prior to the Amendment No. 4s, we would not have been in compliance with the minimum net revenue requirement for that quarter.

Each of the Borrowers, and the Company, as guarantor, are jointly and severally liable for all of the obligations under the facilities on the terms set forth in the 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.

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-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1I

Reference 23: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1I

+ Details

Schedule of Supplemental Cash Flow Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Supplemental Cash Flow Elements [Abstract]
Interest	$ 3,134	$ 3,638
Income taxes paid, net	121	70
Operating leases	796	658
Operating lease liabilities arising from obtaining right-of-use assets in operating activities	3,219	111
Note receivable in investing activities	$ 10,368

Schedule of Allowance for Credit Losses (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Credit Loss [Abstract]
Beginning balance	$ 1,437	$ 920
Provision for current expected credit losses	1,229	823
Write-offs against allowance	(218)	(306)
Divested allowance for credit losses	(283)
Ending balance	$ 2,165	$ 1,437

Commitments and Contingencies

12 Months Ended

Dec. 31, 2025

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

(12) Commitments and Contingencies

Operating Leases

We currently lease various office facilities. These leases are under non-cancelable operating lease agreements with expiration dates in 2030. We have the option for certain leases to extend for one or two five-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.

We have made certain assumptions and judgments when applying ASC 842, the most significant of which is that we elected the package of practical expedients available for transition, which allow us to not reassess whether expired or existing contracts contain leases under the new definition of a lease, lease classification for expired or existing leases, and whether previously capitalized initial direct costs would qualify for capitalization under ASC 842. Additionally, we did not elect to use hindsight when considering judgments and estimates such as assessments of lessee options to extend or terminate a lease or purchase the underlying asset.

As of December 31, 2025, the weighted-average remaining lease term was 4.9 years. Lease expense related to operating leases was $1.2 million and $0.9 million for the years ended December 31, 2025 and 2024. The Company’s lease agreements do not provide a readily determinable implicit rate nor is one available to the Company from its lessors. Instead, during the year ended December 31, 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 December 31, 2025 under these long-term operating leases are as follows (in thousands):


2026	$	927
2027		845
2028		857
2029		874
2030		689
Total future minimum lease payments		4,192
Less: amount representing interest		(905	)
Present value of obligations under operating leases		3,287
Less: current portion		(622	)
Long-term operating lease obligations	$	2,665

Litigation

We may be subject to potential liabilities under government regulations and various claims and legal actions that are pending but we believe are immaterial at this time or may be asserted in the future 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. The amount of ultimate loss may exceed the Company’s current accruals, and it is possible that its 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.

Indemnifications

Our indemnification arrangements generally include limited warranties and certain provisions for indemnifying customers against liabilities if our products or services infringe a third-party’s intellectual property rights. To date, we have not incurred any material costs as a result of such warranties or indemnification provisions and have not accrued any liabilities related to such obligations in the accompanying consolidated financial statements.

We have also agreed to indemnify our directors and executive officers for costs associated with any fees, expenses, judgments, fines, and settlement amounts incurred by any of these persons in any action or proceeding to which any of those persons is, or is threatened to be, made a party by reason of the person’s service as a director or officer, including any action by us, arising out of that person’s services as our director or officer or that person’s services provided to any other company or enterprise at our request.

Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2025

Commitments and Contingencies Disclosure [Abstract]

Schedule of Future Minimum Payments for Operating Leases

Future minimum payments as of December 31, 2025 under these long-term operating leases are as follows (in thousands):


2026	$	927
2027		845
2028		857
2029		874
2030		689
Total future minimum lease payments		4,192
Less: amount representing interest		(905	)
Present value of obligations under operating leases		3,287
Less: current portion		(622	)
Long-term operating lease obligations	$	2,665

Supplemental Disclosure of Cash Flow Information (Tables)

12 Months Ended

Dec. 31, 2025

Supplemental Cash Flow Elements [Abstract]

Schedule of Supplemental Cash Flow Information

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

	2025		2024
	Year Ended December 31,
	2025		2024
Cash paid during the period for:
Interest	$	3,134	$	3,638
Income taxes paid, net	$	121	$	70
Operating leases	$	796	$	658
Non-cash activities:
Operating lease liabilities arising from obtaining right-of-use assets in operating activities	$	3,219	$	111
Note receivable in investing activities	$	10,368	$	—

Equity

12 Months Ended

Dec. 31, 2025

Equity [Abstract]

Equity

(9) Equity

Private Placement

On August 7, 2024, we entered into a securities purchase agreement pursuant to which we issued an aggregate of 7,812,500 shares of common stock to accredited investors in a private placement at a per share purchase price of $0.64 at a closing held on August 9, 2024. The gross proceeds to us from the private placement were $5.0 million, before deducting estimated offering fees and expenses payable by us. We expect to use the net proceeds of $4.5 million from the private placement for working capital and other general corporate purposes.

- Definition

The entire disclosure for equity.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 8A
-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/1943274/2147481112/505-10-50-14

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
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-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
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-Name Accounting Standards Codification
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
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-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480237/815-40-50-6

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-URI https://asc.fasb.org/1943274/2147480008/505-10-S99-1

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
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-URI https://asc.fasb.org/505/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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Reference 16: http://www.xbrl.org/2003/role/disclosureRef
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Reference 18: http://www.xbrl.org/2003/role/disclosureRef
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Reference 19: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Business Description and Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2025

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Business Description

The accompanying consolidated financial statements include the accounts of Xtant Medical Holdings, Inc., 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 products serve the combined specialized needs of orthopedic and neurological surgeons, including orthobiologics for the promotion of bone healing, implants and instrumentation for the treatment of spinal disease, tissue grafts for the treatment of orthopedic disorders to promote healing following spine, cranial and foot surgeries and the development, manufacturing and sale of medical devices for use in orthopedic spinal surgeries.

Use of Estimates

The preparation of the 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 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; allowance for credit losses for trade receivables; valuation allowances for 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 consolidated balance sheets are restricted as to withdrawal or use under the terms of certain contractual agreements. The December 31, 2025 balance 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.

Trade Accounts Receivable and Allowances

Accounts receivable represents amounts due from customers for which revenue has been recognized. Normal terms on trade accounts receivable are net 30 days, and some customers are offered discounts for early pay. The Company performs credit evaluations when considered necessary, but generally does not require collateral to extend credit. The Company applies the practical expedient for contacts with payment terms of one year or less which does not consider the effect of the time value of money.

The allowance for credit losses is the Company’s best estimate of the amount of probable credit losses in the Company’s existing receivables. The Company determines the allowance based on factors such as historical collection experience, customers’ current creditworthiness, customer concentration, age of accounts receivable balance, general economic conditions that may affect a customer’s ability to pay, and management judgment. In addition, we include provision for current expected credit loss based on historical collection experience adjusted for current economic conditions affecting collectability and reasonable and supportable forecast concerning the future. 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. The Company does not have any off-balance sheet credit exposure related to its customers. As of December 31, 2025, 2024, and 2023 trade accounts receivable were $20.0 million, $22.1 million, and $21.7 million, respectively, and are presented net of an allowance for credit losses of $2.2 million, $1.4 million, and $0.9 million, respectively.

Inventories

Inventories are stated at the lower of cost or net realizable value. Cost is determined using the specific identification method in the case of biologics and weighted average cost in the case of hardware and includes materials, labor and overhead. The Company calculates an inventory reserve for estimated obsolescence and excess inventory based on historical usage and sales, as well as assumptions about future demand for its products. These estimates for excess and obsolete inventory are reviewed and updated on a quarterly basis. Increases in the inventory reserves result in a corresponding expense, which is recorded to cost of sales.

Property and Equipment

Property and equipment are stated at cost less accumulated depreciation. Depreciation is computed using the straight-line method over the estimated useful lives of the assets, generally three3 to seven years for computers and equipment and five years for surgical instruments. Leasehold improvements are depreciated over the shorter of their estimated useful life or the remaining term of the lease. Repairs and maintenance are expensed as incurred.

Intangible Assets

Intangible assets with estimable useful lives are amortized over their respective estimated useful lives to their estimated residual values and reviewed for impairment whenever events or circumstances indicate their carrying amount may not be recoverable. Intangible assets include tradenames, customer relationships and patents. Intangible assets are carried at cost less accumulated amortization. The Company amortizes these assets on a straight-line basis over their estimated useful lives.

Other Assets

Other assets consist of inventory receivable and the short-term and the long-term portion of prepaid expenses and security deposits.

Long-Lived Asset Impairment

Long-lived assets, including property and equipment and intangible assets, are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. Recoverability of assets to be held and used is measured by a comparison of the carrying amount of an asset to future undiscounted cash flows expected to be generated by the asset. If such assets are considered to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount of the assets exceeds the estimated fair value of the assets.

Goodwill

Goodwill represents the excess of costs over fair value of assets of businesses acquired. Goodwill and intangible assets acquired in a 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. The Company conducts its impairment test on an annual basis and reviews the assumptions on a quarterly basis. We test goodwill for impairment at the reporting unit level, which is an operating segment or one level below an operating segment, referred to as a component. A component of an operating segment is a reporting unit if the component constitutes a business for which discrete financial information is available and segment management regularly reviews the operating results of that component.

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 share-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.

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.

Revenue Recognition

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 at a point in time upon utilization of the 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 December 31, 2025, $0.4 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. During the year ended December 31, 2025, the Company received a $1.5 million upfront payment from a customer, which was recorded as a contract liability within accrued liabilities on the consolidated balance sheet. The contract liability was recognized as revenue as control of the underlying goods transferred to the customer. As of December 31, 2025, the full $1.5 million had been recognized as revenue, and no related contract liability remained outstanding.

License revenue

License 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 is 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 that this agreement 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 included 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 aggregated to $3.75 million during 2025. Due to anticipated policy changes by CMS that would affect guaranteed quarterly minimums per the agreement, revenue associated with these quarterly minimums past the fourth quarter of 2025 were considered constrained and, therefore, not recognized when the performance obligation was satisfied as it was not probable as of December 31, 2025 that there would not be a significant reversal of cumulative revenue. Such CMS policy changes went into effect on January 1, 2026.

Disaggregation of revenue

Summary of Revenues from Product Lines

	Year Ended December 31, 2025		Percentage of Total Revenue			Year Ended December 31, 2024		Percentage of Total Revenue
Orthobiologics	$	72,892		54	%	$	66,419		57	%
Spinal implant		42,312		32	%		49,346		42	%
License revenue		18,723		14	%		1,502		1	%
Total revenue	$	133,927		100	%	$	117,267		100	%

Research and Development

Research and development costs, which are principally related to internal costs for the development of new products, are expensed as incurred.

Net Income (Loss) Per Share

Fair Value of Financial Instruments

The carrying values of financial instruments, including trade accounts receivable, note receivable, accounts payable, accrued liabilities and long-term debt, approximate their fair values based on terms and related interest rates.

The Company follows a framework for measuring fair value. The framework provides a fair value hierarchy that prioritizes the inputs to valuation techniques used to measure fair value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level 1) and the lowest priority to unobservable inputs (Level 3). The three levels of the fair value hierarchy are described below:

Level 1: Inputs to the valuation methodology are unadjusted quoted prices for identical assets or liabilities in active markets.

Level 2: Inputs to the valuation methodology include quoted prices for similar assets and liabilities in active markets, and inputs that are observable for the asset or liability, either directly or indirectly, for substantially the full term of the financial instrument.

Level 3: Inputs to the valuation methodology are unobservable and significant to the fair value measurement.

A financial instrument’s level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. During the years ended December 31, 2025 and 2024, there was no reclassification in financial assets or liabilities between Level 1, 2 or 3 categories.

Recently Issued Accounting Pronouncements

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.

Adoption of New Accounting Standard

On December 31, 2025, the Company adopted the Financial Accounting Standards Board issued 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 adopted the ASU prospectively for the period ending December 31, 2025. It affects only our disclosures and does not impact our results of operations or financial condition.

Business Description and Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2025

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Business Description and Summary of Significant Accounting Policies

(1) Business Description and Summary of Significant Accounting Policies

Business Description

All intercompany balances and transactions have been eliminated in consolidation.

Use of Estimates

Cash, Cash Equivalents, and Restricted Cash

Trade Accounts Receivable and Allowances

Inventories

Property and Equipment

Intangible Assets

Other Assets

Other assets consist of inventory receivable and the short-term and the long-term portion of prepaid expenses and security deposits.

Long-Lived Asset Impairment

Goodwill

Stock-Based Compensation

Foreign Currency

Revenue Recognition

License revenue

Disaggregation of revenue

Summary of Revenues from Product Lines

	Year Ended December 31, 2025		Percentage of Total Revenue			Year Ended December 31, 2024		Percentage of Total Revenue
Orthobiologics	$	72,892		54	%	$	66,419		57	%
Spinal implant		42,312		32	%		49,346		42	%
License revenue		18,723		14	%		1,502		1	%
Total revenue	$	133,927		100	%	$	117,267		100	%

Research and Development

Research and development costs, which are principally related to internal costs for the development of new products, are expensed as incurred.

Net Income (Loss) Per Share

Fair Value of Financial Instruments

Level 1: Inputs to the valuation methodology are unadjusted quoted prices for identical assets or liabilities in active markets.

Level 3: Inputs to the valuation methodology are unobservable and significant to the fair value measurement.

Recently Issued Accounting Pronouncements

Adoption of New Accounting Standard

Schedule of PSU Awards Activity (Details) - Performance Shares [Member] - 2023 Equity Incentive Plan [Member] - $ / shares	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Shares Outstanding, Beginning balance	1,640,709
Weighted Average Fair Value at Grant Date Per Share, Outstanding, Beginning balance	$ 1.49
Shares, Granted	1,699,402	1,894,985
Weighted Average Fair Value, Granted	$ 0.84	$ 1.49
Shares, Forfeited		(254,276)
Weighted Average Fair Value, Forfeited		$ 1.49
Shares Outstanding, Ending balance	3,340,111	1,640,709
Weighted Average Fair Value at Grant Date Per Share, Outstanding, Ending balance	$ 1.16	$ 1.49

- 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

+ Details

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	48.80%
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.

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+ Details

Segment and Geographic Information (Details Narrative) - Segment	12 Months Ended
	Dec. 31, 2025	Dec. 31, 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%	90.00%

- 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

Schedule of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 28,409	$ 29,968
Less: accumulated depreciation	(22,207)	(19,837)
Property and equipment, net	6,202	10,131
Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	7,346	7,239
Computer Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	1,252	1,254
Computer Softwares [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	361	361
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	4,483	4,356
Surgical Instruments [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	14,070	15,798
Assets Not Yet In Service [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 897	$ 960

Stock-Based Compensation (Details Narrative) - USD ($) $ in Thousands		12 Months Ended
	Jul. 26, 2023	Dec. 31, 2025	Dec. 31, 2024
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Stock-based compensation expense		$ 2,892	$ 4,117
Share-Based Payment Arrangement, Option [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Unvested employee stock options not yet recognized		$ 500
Weighted-average period		1 year 7 months 6 days
Deferred Stock Units and Restricted Stock Units [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Weighted-average period		2 years 6 months
Compensation cost related to unvested stock units		$ 3,800
Performance Shares [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Weighted-average period		2 years 2 months 12 days
Compensation cost related to unvested stock units		$ 2,400
Employees and Directors [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Stock-based compensation expense		$ 2,900	$ 4,100
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, as increased by an amendment approved by our stockholders on November 7, 2025, is (i) 17,800,000 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
Maximum number of common stock available for issuance	17,800,000
Number of shares available for grant		12,966,721
2023 Equity Incentive Plan [Member] \| Performance Shares [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Number of shares awarded		1,699,402	1,894,985
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%	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%	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 Carrying Amount of Goodwill (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2025 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
December 31, 2024	$ 7,302
Divestiture	(1,228)
December 31, 2025	$ 6,074

- Definition

Amount, after accumulated impairment loss, of 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.

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+ Details

Schedule of Intangible of Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Finite-Lived Intangible Assets [Line Items]
Intangible assets, gross		$ 11,967
Accumulated amortization		(3,611)
Intangible assets, net	$ 299	$ 8,356
Patents [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted avereage life	13 years	11 years
Intangible assets, gross	$ 1,027	$ 2,777
Accumulated amortization	(728)	(948)
Intangible assets, net	$ 299	$ 1,829
Customer Relationships [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted avereage life		6 years
Intangible assets, gross		$ 8,000
Accumulated amortization		(2,445)
Intangible assets, net		$ 5,555
Trade Names [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted avereage life		10 years
Intangible assets, gross		$ 1,190
Accumulated amortization		(218)
Intangible assets, net		$ 972

- Definition

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-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483154/926-20-50-5

+ Details

Consolidated Statements of Operations - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Revenue
Total Revenue	$ 133,927	$ 117,267
Cost of Sales	49,654	49,051
Gross Profit	84,273	68,216
Operating Expenses
General and administrative	29,375	28,691
Sales and marketing	45,512	49,214
Research and development	2,102	2,385
Total Operating Expenses	76,989	80,290
Income (Loss) from Operations	7,284	(12,074)
Other (Expense) Income
Interest expense	(3,671)	(4,160)
Interest income	94
Unrealized foreign currency translation (loss) gain	(60)	5
Gain on divestiture	3,281
Other income (expense)	73	(33)
Total Other (Expense) Income	(283)	(4,188)
Net Income (Loss) from Operations Before Provision for Income Taxes	7,001	(16,262)
Provision for Income Taxes Current and Deferred	(2,028)	(187)
Net Income (Loss)	$ 4,973	$ (16,449)
Net Income (Loss) Per Share:
Basic	$ 0.04	$ (0.12)
Dilutive	$ 0.03	$ (0.12)
Shares used in the computation:
Basic	139,531,791	133,665,075
Dilutive	150,042,556	133,665,075
Product [Member]
Revenue
Total Revenue	$ 115,204	$ 115,765
License [Member]
Revenue
Total Revenue	$ 18,723	$ 1,502

Schedule of Accrued Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Payables and Accruals [Abstract]
Wages/commissions payable	$ 6,726	$ 5,565
Taxes payable	2,183	403
Other accrued liabilities	1,717	1,803
Accrued liabilities	$ 10,626	$ 7,771

Warrants (Details Narrative)	12 Months Ended
Warrants (Details Narrative)	Dec. 31, 2025
Warrant [Member]
WarrantsLineItems [Line Items]
Weighted average remaining contractual term	9 months 18 days

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Current Assets:
Cash and cash-equivalents	$ 17,053	$ 6,199
Restricted cash	275	22
Trade accounts receivable, net of allowance for credit losses of $2,165 and $1,437, respectively	17,803	20,660
Inventories	30,263	38,634
Note receivable	10,462
Prepaid and other current assets	2,389	1,601
Total current assets	78,245	67,116
Property and equipment, net	6,202	10,131
Right of use asset, net	3,192	829
Goodwill	6,074	7,302
Intangible assets, net	299	8,356
Other assets	133	103
Total Assets	94,145	93,837
Current Liabilities:
Accounts payable	3,844	7,918
Accrued liabilities	10,626	7,771
Current portion long-term debt	3,500
Current portion of lease liability	622	703
Current portion of finance lease obligations	35	69
Line of credit	10,857	12,120
Total current liabilities	29,484	28,581
Long-term Liabilities:
Lease liability, net	2,665	166
Financing lease obligations, net	12	47
Long-term debt, plus premium and less issuance costs	11,026	22,038
Deferred tax liability	5	42
Total Liabilities	43,192	50,874
Commitments and Contingencies (Note 12)
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; 140,039,557 and 139,045,664 shares issued and outstanding as of December 31, 2025 and 2024, respectively
Additional paid-in capital	305,439	302,738
Accumulated other comprehensive income		(316)
Accumulated deficit	(254,486)	(259,459)
Total Stockholders’ Equity	50,953	42,963
Total Liabilities & Stockholders’ Equity	$ 94,145	$ 93,837

Inventories

12 Months Ended

Dec. 31, 2025

Inventory Disclosure [Abstract]

Inventories

(4) Inventories

Inventories consist of the following (in thousands):

Schedule of Inventories

	December 31, 2025		December 31, 2024
Raw materials	$	5,689	$	6,622
Work in process		4,799		2,812
Finished goods		19,775		29,200
Total	$	30,263	$	38,634

Schedule of Effective Income Tax Rate Reconciliation (Details) - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2025

Dec. 31, 2024

Effective Income Tax Rate Reconciliation [Line Items]

Income tax at statutory tax rate

$ (1,470)

$ 3,415

Changes in valuation allowance

3,163

State and local income tax, net of federal income tax effect

(432)

^[1]

636

Permanent differences

(62)

Change in state income tax rate

(42)

Stock compensation adjustment

(210)

Attribute expiration

(280)

Return to provision

659

(444)

Foreign rate differential

134

Executive compensation

(195)

(171)

Total (provision) benefit for income taxes current and deferred

$ (2,028)

$ (187)

Income tax at statutory tax rate

21.00%

Income tax at statutory tax rate

^[1]

6.20%

Other adjustments

$ 58

Income tax at statutory tax rate

(0.80%)

Share-based payment awards

$ (146)

Income tax at statutory tax rate

2.10%

Income tax at statutory tax rate

2.80%

Other

$ (13)

Income tax at statutory tax rate

0.20%

Income tax at statutory tax rate

(9.40%)

Gain on sale of investments

$ (931)

Income tax at statutory tax rate

13.30%

Reduction in deferred tax assets due to 382 limitations

$ (3,734)

Income tax at statutory tax rate

53.30%

Income tax at statutory tax rate

29.00%

Foreign Tax Jurisdiction [Member]

Effective Income Tax Rate Reconciliation [Line Items]

Changes in valuation allowance

$ 4,115

Income tax at statutory tax rate

(58.80%)

Reduction in deferred tax assets due to disposal

$ (4,648)

Income tax at statutory tax rate

66.40%

Other adjustments

$ 183

Income tax at statutory tax rate

(2.60%)

Domestic Tax Jurisdiction [Member]

Effective Income Tax Rate Reconciliation [Line Items]

Changes in valuation allowance

$ 4,688

Income tax at statutory tax rate

^[1]

(67.00%)

Other adjustments

$ (158)

Income tax at statutory tax rate

2.30%

Other foreign jurisdictions

$ (4)

Income tax at statutory tax rate

0.10%

[1]	State taxes in California, New York and Texas made up the majority (greater than 50%) of the tax effect in this category.

Net Income (Loss) Per Share (Details Narrative) - shares	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Net Income (Loss) Per Share:
Total number of stock options, RSU, DSU, PSU and warrants excluded for diluted earnings per share	16,496,429	21,952,434

Sale of Coflex/CoFix Assets and International Hardware Business

12 Months Ended

Dec. 31, 2025

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

Sale of Coflex/CoFix Assets and International Hardware Business

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

On December 1, 2025, we completed the sale of certain assets relating to our Coflex and CoFix products (the “Coflex/CoFix Divestiture”) to Companion Spine, LLC and one of its affiliates, Companion Spine SAS (collectively, “Companion Spine”), pursuant to an Asset Purchase Agreement dated July 7, 2025 (the “Coflex/CoFix Agreement”). The total purchase price of the Coflex/CoFix Divestiture was $17.5 million (subject to a closing inventory valuation adjustment set forth in the Coflex/CoFix Agreement). Of the total purchase price, an aggregate of $7.5 million was previously paid to us in cash as non-refundable deposits during third and fourth quarters of 2025, $1.8 million was paid to us in cash at the closing, and $8.2 million was paid to us as an unsecured promissory note issued by Companion Spine to us the closing (the “Companion Spine Note”). Pursuant to subsequent amendments to the Coflex/CoFix Agreement, the maturity date of the Companion Spine Note was extended to January 31, 2026. The outstanding principal balance of the Companion Spine Note, together with the related accrued interest, totaling $8.5 million, was paid to us on February 27, 2026.

Also, on December 1, 2025, we completed the sale of all of our shares of equity securities of Paradigm Spine GmbH, one of our then wholly owned subsidiaries engaged in the operation of our hardware business outside of the United States (“Paradigm”), which constituted 100% of the issued and outstanding shares of equity securities of Paradigm (the “Paradigm Divestiture” and together with the Coflex/CoFix Divestiture, the “Divestitures”), to Companion Spine pursuant to an Equity Purchase Agreement dated July 7, 2025 between us, Paradigm and Companion Spine (the “Paradigm Agreement” and together with the Coflex/CoFix Agreement, the “Divestiture Agreements”). The total purchase price of the Paradigm Divestiture was $3.9 million, $1.7 million of which was paid to us in cash at the closing of the Paradigm Divestiture and $2.2 million of which was paid to us on February 27, 2026 in settlement of the net working capital and other purchase price adjustments.

The aggregate purchase price associated with the two Divestitures was $21.4 million.

The Company determined that the Divestitures do not meet the criteria for classification as 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 consolidated financial statements.

The Company recognized a gain on sale of $3.3 million in connection with the Divestitures during the year ended December 31, 2025. The gain on sale included the divestiture of $0.4 million accumulated other comprehensive income from currency translation adjustment recorded through December 1, 2025. Goodwill of $1.2 million was allocated to the disposal group based on the relative fair values of the divested assets and liabilities and retained assets and liabilities. The assets and liabilities of the disposal group at the December 1, 2025 date of sale and at December 31, 2024 were:

	December 1, 2025		December 31, 2024
ASSETS
Trade accounts receivable, net of allowances for credit losses	$	2,032	$	2,026
Inventories		7,223		5,097
Prepaid and other current assets		653		769
Property and equipment, net		2,367		2,031
Right of use asset, net		281		229
Intangible assets, net		6,465		7,957
Other assets		203		11
Total Assets	$	19,224	$	18,120

LIABILITIES
Accounts payable	$	1,289	$	3,851
Accrued liabilities		1,286		920
Lease liability		281		229
Total Liabilities	$	2,856	$	5,000

- Definition

The entire disclosure for business combination.

+ References

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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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Reference 30: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Warrants

12 Months Ended

Dec. 31, 2025

Warrants

Warrants

(11) Warrants

Warrant activity was as follows for the years ended December 31, 2025 and 2024:

Schedule of Warrant Activity

	Common Stock Warrants		Weighted Average Exercise Price
Outstanding as of December 31, 2023		12,187,470		1.53
Issued		50,000		0.82
Outstanding as of December 31, 2024		12,237,470		1.53
Issued		—		—
Outstanding as of December 31, 2025		12,237,470		1.53

As of December 31, 2025, the weighted average remaining contractual term of outstanding warrants was 0.8 years.

Debt (Details Narrative) - USD ($) $ in Millions	May 14, 2024	May 13, 2024	Mar. 07, 2024	Dec. 31, 2025	Mar. 06, 2024
Term Credit Agreement [Member]
Line of Credit Facility [Line Items]
Maturity date			Mar. 01, 2029
Line of credit facility, additional borrowing capacity			$ 10.0
Effective interest rate			6.50%	14.08%	7.00%
Maximum borrowing capacity amount	$ 22.0
Increase in term loan	$ 5.0
Exit fees	6.50%	2.50%
Term Credit Agreement [Member] \| Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
outstanding line of credit				$ 10.9
Line of credit facility, remaining borrowing capacity				$ 3.8
Revolving Credit Agreement [Member]
Line of Credit Facility [Line Items]
Maturity date			Mar. 01, 2029
Effective interest rate				8.49%
Maximum borrowing capacity amount			$ 17.0		$ 8.0

Accrued Liabilities (Tables)

12 Months Ended

Dec. 31, 2025

Payables and Accruals [Abstract]

Schedule of Accrued Liabilities

Accrued liabilities consist of the following (in thousands):

Schedule of Accrued Liabilities

	December 31, 2025		December 31, 2024
Wages/commissions payable	$	6,726	$	5,565
Taxes payable		2,183		403
Other accrued liabilities		1,717		1,803
Accrued liabilities	$	10,626	$	7,771

Trade Accounts Receivable, Net (Tables)

12 Months Ended

Dec. 31, 2025

Credit Loss [Abstract]

Schedule of Allowance for Credit Losses

	December 31, 2025			December 31, 2024
Balance at January 1	$	1,437		$	920
Provision for current expected credit losses		1,229			823
Write-offs against allowance		(218	)		(306	)
Divested allowance for credit losses		(283	)		—
Balance at December 31	$	2,165		$	1,437

Schedule of Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Income Tax Disclosure [Abstract]
Accrued liability for vacation	$ 141	$ 173
Accrued commissions and bonuses / compensation	432	115
Accrued contingencies	317	78
Amortization	122	518
Bad debt reserve	553	326
Capitalized R&D expenses		850
Charitable contributions carryforward		15
Lease liability	851	261
Interest expense	3,660	4,092
Inventory reserve	3,010	2,834
Net operating loss carryovers	8,814	19,160
Stock option compensation	1,230	1,022
UNICAP	142	115
Other	157	103
Total deferred tax assets	19,429	29,662
Depreciation	(370)	(470)
Right of use asset	(815)	(220)
Prepaids	(72)	(65)
Total deferred tax liabilities	(1,257)	(755)
Valuation allowance	(18,177)	(28,949)
Net deferred tax liabilities	$ (5)	$ (42)

Schedule of Principal Payments (Details) $ in Thousands	12 Months Ended
Schedule of Principal Payments (Details) $ in Thousands	Dec. 31, 2025 USD ($)
2026 [Member]
Short-Term Debt [Line Items]
Scheduled quarterly payments	$ 1,167
Annually	3,500
2027 [Member]
Short-Term Debt [Line Items]
Scheduled quarterly payments	1,167
Annually	4,667
2028 [Member]
Short-Term Debt [Line Items]
Scheduled quarterly payments	1,167
Annually	4,667
2029 [Member]
Short-Term Debt [Line Items]
Scheduled quarterly payments	1,167
Annually	$ 1,167

Employee Benefit Plans (Details Narrative) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Retirement Benefits [Abstract]
Discretionary match	100.00%
Contribution limit, description	wage deferrals not in excess of 4% of their wages.
Employer contributed amount	$ 0.6	$ 0.7

Cybersecurity Risk Management and Strategy Disclosure

12 Months Ended

Dec. 31, 2025

Cybersecurity Risk Management, Strategy, and Governance [Abstract]

Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]

Background

Cybersecurity, data privacy, and data protection are critical to our business. In the ordinary course of our business, we collect and store certain confidential information such as information about our employees, contractors, vendors, customers, suppliers, independent sales agents and distributors. We have processes in place for assessing, identifying, and managing material risks from cybersecurity threats, and we monitor the Company’s overall security score to assess performance and identify areas for improvement. In recent years, we have installed a new firewall to better protect from network intrusions, hired a Network and Security Administrator, and engaged a third-party service provider to perform an internal penetration test in order to identify and address vulnerabilities. Additionally, we introduced always-on VPN in an effort to better restrict off-campus network access in light of the increase in the number of our employees working remotely in recent years, enhanced our monitoring and control capabilities, and hardened our cloud computing cyber security footprint. Management continually re-assesses the Company’s cybersecurity risk environment based on changing circumstances and new information identified by its monitoring, scanning and testing as well as third party resources.

Risk Management and Strategy

Our processes for assessing, identifying, and managing cybersecurity threats have been integrated into our overall risk management processes. The information provided by these processes facilitates management’s ongoing assessment of our cybersecurity risk environment and provides current and accurate information regarding cybersecurity risks to management, our Audit Committee and Board of Directors to allow appropriate management of such risks through remediation or other risk mitigation activities.

We maintain a cybersecurity program that is designed to identify, protect from, detect, respond to, and recover from cybersecurity threats and risks, and protect the confidentiality, integrity, and availability of its information systems, including the information residing on such systems. The National Institute of Standards and Technology Cybersecurity Framework helps us inform our cybersecurity agenda and prioritize our cybersecurity activities. We take a risk-based approach to cybersecurity, which begins with the identification and evaluation of cybersecurity risks or threats that could affect our operations, finances, legal or regulatory compliance, or reputation. The scope of our evaluation encompasses risks that may be associated with both our internally managed IT systems and key business functions and sensitive data operated or managed by third-party service providers. Once identified, cybersecurity risks and related mitigation efforts are prioritized based on their potential impact, likelihood, velocity, and vulnerability, considering both quantitative and qualitative factors. Risk mitigation strategies are developed and implemented based on the specific nature of each cybersecurity risk. These strategies include, among others, the application of cybersecurity policies and procedures, implementation of administrative, technical, and physical controls, and employee training, education, and awareness initiatives.

Role of Management

Management has implemented risk management structures, policies and procedures and is responsible for our day-to-day cybersecurity risk management. Our Vice President of Information Systems, who has been with Xtant since June 2019, is responsible for our day-to-day assessment and management of cybersecurity risks. He is also the founder of a data privacy consulting company and has over 20 years of experience in the data management space. We have implemented a number of processes which allow our Vice President of Information Systems and his team to be informed about and monitor the prevention, detection, mitigation, and remediation of cybersecurity incidents. These processes include, among other things, system alerts of potential malicious cyber activity, access to real-time dashboards that monitor and assess our systems, status reports provided on a daily, weekly and monthly basis, and regular ongoing communications with service providers regarding potential new attack vectors and vulnerabilities. Our Vice President of Information Systems and his team share such information with our management team and reports information about such risks to our Audit Committee.

Use of Consultants and Advisors

We engage various third-party cybersecurity service providers to assess and enhance our cybersecurity practices and assist with protection and monitoring of our systems and information, including with respect to protection of our e-mail, system access, network monitoring, endpoint protection, vulnerability assessments and penetration testing. We engage cybersecurity consultants, auditors, and other third parties to assess and enhance our cybersecurity practices, such as a third-party consulting firm to perform tabletop exercises and evaluate our cyber processes including an assessment of our incident response procedures.

Board Oversight

The Board of Directors, both directly and through the delegation of responsibilities to the Audit Committee oversees the proper functioning of our cybersecurity risk management program. In particular, the Audit Committee assists the Board of Directors in its oversight of management’s responsibility to assess, manage and mitigate risks associated with the Company’s business and operational activities, to administer the Company’s various compliance programs, in each case including cybersecurity concerns, and to oversee our information technology systems, processes and data. The Audit Committee, which is comprised entirely of independent directors, is responsible for periodically reviewing and assessing with management (i) the adequacy of controls and security for our information technology systems, processes and data, and (ii) our contingency plans in the event of a breakdown or security breach affecting our information technology systems, it being understood that it is not possible to eliminate all such risks and that the Company will necessarily face a variety of risks with respect to information technology in the conduct of its business. The Audit Committee is additionally responsible for reviewing the cybersecurity disclosures required to be included in our filings with the SEC.

The Audit Committee reviews a cybersecurity dashboard at its regularly held meetings, which includes certain information about overall security, employee training, and other statistics. Members of our management team often attend these discussions, and the Audit Committee has requested that our Vice President of Information Systems provide updates at two of its meetings annually. The management team and/or Audit Committee, in turn, regularly provide data protection and cybersecurity reports to the full Board of Directors.

Although none of the members of the Audit Committee has any work experience, degree, or certifications related to information security or cybersecurity, the Audit Committee works closely with members of our employee team with relevant expertise, and we have engaged third-party service providers to further enhance our cybersecurity efforts.

Risks from Material Cybersecurity Threats

Although we have taken steps to prevent and mitigate data security threats, there can be no assurance that our protective measures and those of our third-party service providers will prevent or detect security breaches that could have a significant impact on our business, reputation, operating results and financial condition. We maintain cyber liability insurance; however, this insurance may not be sufficient to cover the financial, legal, business or reputational losses that may result from an interruption or breach of our systems. As of the date of this filing, we have not identified any cybersecurity threats that have materially affected or are reasonably anticipated to have a material effect on our business strategy, results of operations or financial condition. Although we have not experienced cybersecurity incidents that are individually, or in the aggregate, material, we have experienced cyberattacks in the past, which we believe have thus far been mitigated by preventative, detective, and responsive measures we have put in place. See the factors described in the “Part I. Item 1.A. Risk Factors” section of this Form 10-K for further detail about the cybersecurity risks we face. Maintaining a robust information security system is an ongoing priority for us and we plan to continue to identify and evaluate new, emerging risks to data protection and cybersecurity both within our Company and through our engagement of third-party service providers.

Cybersecurity Risk Management Processes Integrated [Flag]

true

Cybersecurity Risk Management Processes Integrated [Text Block]

Cybersecurity Risk Management Third Party Engaged [Flag]

true

Cybersecurity Risk Third Party Oversight and Identification Processes [Flag]

true

Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag]

false

Cybersecurity Risk Board of Directors Oversight [Text Block]

Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block]

The Audit Committee, which is comprised entirely of independent directors, is responsible for periodically reviewing and assessing with management (i) the adequacy of controls and security for our information technology systems, processes and data, and (ii) our contingency plans in the event of a breakdown or security breach affecting our information technology systems, it being understood that it is not possible to eliminate all such risks and that the Company will necessarily face a variety of risks with respect to information technology in the conduct of its business. The Audit Committee is additionally responsible for reviewing the cybersecurity disclosures required to be included in our filings with the SEC.

Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block]

Cybersecurity Risk Role of Management [Text Block]

Cybersecurity Risk Management Positions or Committees Responsible [Flag]

true

Cybersecurity Risk Management Positions or Committees Responsible [Text Block]

Our Vice President of Information Systems, who has been with Xtant since June 2019, is responsible for our day-to-day assessment and management of cybersecurity risks.

Cybersecurity Risk Management Expertise of Management Responsible [Text Block]

He is also the founder of a data privacy consulting company and has over 20 years of experience in the data management space. We have implemented a number of processes which allow our Vice President of Information Systems and his team to be informed about and monitor the prevention, detection, mitigation, and remediation of cybersecurity incidents.

Consolidated Statements of Changes in Stockholders' Equity (Parenthetical) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($)
Statement of Stockholders' Equity [Abstract]
Net issuance costs	$ 544

Consolidated Statements of Changes in Stockholders' Equity - USD ($) $ in Thousands	Common Stock [Member]	Additional Paid-in Capital [Member]	AOCI Attributable to Parent [Member]	Retained Earnings [Member]	Total
Balance at Dec. 31, 2023		$ 294,330	$ 29	$ (243,010)	$ 51,349
Balance, shares at Dec. 31, 2023	130,180,031
Private placement of common stock, net of issuance costs		4,456			4,456
Private placement of common stock, net of issuance costs, shares	7,812,500
Common stock issued upon vesting and settlement of restricted stock units
Common stock issued upon vesting and settlement of restricted stock units, shares	1,314,495
Withholding on common stock upon vesting and settlement of restricted stock units		(178)			(178)
Withholding on common stock upon vesting and settlement of restricted stock units, shares	(281,220)
Stock-based compensation		4,117			4,117
Exercise of stock options		13			13
Exercise of stock options, shares	19,858
Foreign currency translation adjustment			(345)		(345)
Net income (loss)				(16,449)	(16,449)
Balance at Dec. 31, 2024		302,738	(316)	(259,459)	42,963
Balance, shares at Dec. 31, 2024	139,045,664
Common stock issued upon vesting and settlement of restricted stock units
Common stock issued upon vesting and settlement of restricted stock units, shares	1,203,987
Withholding on common stock upon vesting and settlement of restricted stock units		(126)			(126)
Withholding on common stock upon vesting and settlement of restricted stock units, shares	(210,094)
Stock-based compensation		2,892			2,892
Foreign currency translation adjustment			316		316
Net income (loss)				4,973	4,973
Share authorization costs associated with expansion of 2023 equity plan		(65)			(65)
Balance at Dec. 31, 2025		$ 305,439		$ (254,486)	$ 50,953
Balance, shares at Dec. 31, 2025	140,039,557

Schedule of Components of Loss Before Provision for Income Tax (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
IncomeTaxLineItems [Line Items]
Total	$ 7,001	$ (16,262)
UNITED STATES
IncomeTaxLineItems [Line Items]
Total	9,553	(13,835)
Non-US [Member]
IncomeTaxLineItems [Line Items]
Total	$ (2,552)	$ (2,427)

- 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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Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Income Statement [Abstract]
Net Income (Loss)	$ 4,973	$ (16,449)
Other Comprehensive Income (Loss)
Foreign currency translation adjustments	316	(345)
Comprehensive Income (Loss)	$ 5,289	$ (16,794)

- 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.

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- Definition

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

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Related Party Transactions

12 Months Ended

Dec. 31, 2025

Related Party Transactions

(17) Related Party Transactions

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 48.8% 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 Securities and Exchange Commission (“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.

All related party transactions are reviewed and approved by the Audit Committee or the disinterested members of the full Board of Directors.

- 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.

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+ Details

Employee Benefit Plans

12 Months Ended

Dec. 31, 2025

Retirement Benefits [Abstract]

Employee Benefit Plans

(15) Employee Benefit Plans

The Company has a 401(k) plan for our employees. The 401(k) plan is a defined contribution plan covering substantially all of our employees. Employees are eligible to participate in the plan on the first day of any month after starting employment. Employees are allowed to contribute a percentage of their wages to the 401(k) plan, subject to statutorily prescribed limits and are subject to a discretionary employer match of 100% of their wage deferrals not in excess of 4% of their wages. The Company contributed $0.6 million and $0.7 million as part of the employer match program for the years ended December 31, 2025 and 2024, respectively.

Accrued Liabilities

12 Months Ended

Dec. 31, 2025

Payables and Accruals [Abstract]

Accrued Liabilities

(7) Accrued Liabilities

Accrued liabilities consist of the following (in thousands):

Schedule of Accrued Liabilities

	December 31, 2025		December 31, 2024
Wages/commissions payable	$	6,726	$	5,565
Taxes payable		2,183		403
Other accrued liabilities		1,717		1,803
Accrued liabilities	$	10,626	$	7,771

Supplemental Disclosure of Cash Flow Information

12 Months Ended

Dec. 31, 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
	Year Ended December 31,
	2025		2024
Cash paid during the period for:
Interest	$	3,134	$	3,638
Income taxes paid, net	$	121	$	70
Operating leases	$	796	$	658
Non-cash activities:
Operating lease liabilities arising from obtaining right-of-use assets in operating activities	$	3,219	$	111
Note receivable in investing activities	$	10,368	$	—

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Statement of Financial Position [Abstract]
Allowance for credit losses, net	$ 2,165	$ 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	140,039,557	139,045,664
Common stock, shares outstanding	140,039,557	139,045,664

Income Taxes (Details Narrative) - USD ($) $ in Millions	12 Months Ended
Income Taxes (Details Narrative) - USD ($) $ in Millions	Dec. 31, 2025	Dec. 31, 2024
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Federal statutory income tax rate	21.00%	21.00%
Valuation allowance deferred tax asset change in amount	$ 10.8	$ 3.2
Federal, operating loss carryforwards	34.1
State, operating loss carryforwards	$ 36.7
Indefinite carryforward available to offset taxable income percentage	80.00%
Maximum [Member]
Significant Change in Unrecognized Tax Benefits is Reasonably Possible [Line Items]
Foreign, Operating loss carryforwards	$ 0.0

Schedule of Revenues by Geographic Region (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Revenues from External Customers and Long-Lived Assets [Line Items]
Total Revenue	$ 133,927	$ 117,267
UNITED STATES
Revenues from External Customers and Long-Lived Assets [Line Items]
Total Revenue	122,448	105,519
Non-US [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total Revenue	$ 11,479	$ 11,748

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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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-SubTopic 10
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-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-5

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (b)
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-Name Accounting Standards Codification
-Section 50
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-Publisher FASB
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
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-Paragraph 22
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Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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-Section 50
-Paragraph 4
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-4

+ Details

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

12 Months Ended

Dec. 31, 2025

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

Schedule of the Assets and Liabilities of the Disposal Group

	December 1, 2025		December 31, 2024
ASSETS
Trade accounts receivable, net of allowances for credit losses	$	2,032	$	2,026
Inventories		7,223		5,097
Prepaid and other current assets		653		769
Property and equipment, net		2,367		2,031
Right of use asset, net		281		229
Intangible assets, net		6,465		7,957
Other assets		203		11
Total Assets	$	19,224	$	18,120

LIABILITIES
Accounts payable	$	1,289	$	3,851
Accrued liabilities		1,286		920
Lease liability		281		229
Total Liabilities	$	2,856	$	5,000

Commitments and Contingencies (Details Narrative) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Loss Contingencies [Line Items]
Lease option to extend	We have the option for certain leases to extend for one or two five-year term(s) and we have the right of first refusal on any sale.
Operating lease weighted-average remaining lease term	4 years 10 months 24 days
Lease expense related to operating leases	$ 1.2	$ 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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-Name Accounting Standards Codification
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-Paragraph 4
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Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483359/720-20-50-1

Reference 5: http://www.xbrl.org/2003/role/exampleRef
-Topic 460
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-Name Accounting Standards Codification
-Section 55
-Paragraph 27
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482395/460-10-55-27

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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-Section 50
-Paragraph 9
-Subparagraph (b)
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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
-Topic 460
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 450
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483076/450-20-50-1

+ Details

Schedule of Future Amortization Expense for Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
2026	$ 86
2027	52
2028	52
2029	46
2030	33
Thereafter	30
Total	$ 299	$ 8,356

Schedule of Warrant Activity (Details) - Warrant [Member] - $ / shares	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Common Stock Warrants, Outstanding, Beginning balance	12,237,470	12,187,470
Weighted Average Exercise Price, Outstanding, Beginning balance	$ 1.53	$ 1.53
Common Stock Warrants, Issued		50,000
Weighted Average Exercise Price, Issued		$ 0.82
Common Stock Warrants, Outstanding, Ending balance	12,237,470	12,237,470
Weighted Average Exercise Price, Outstanding, Ending balance	$ 1.53	$ 1.53

- 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

+ Details

Immaterial Out-of-Period Adjustment (Details Narrative) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2025	Dec. 31, 2024
Effect of Fourth Quarter Events [Line Items]
Inventories adjustment		$ 1,999	$ 2,494
Property plant and equipment	$ 6,202	6,202	10,131
General administrative expenses		29,375	28,691
Cost of goods sold		49,654	$ 49,051
Year-End Adjustment [Member]
Effect of Fourth Quarter Events [Line Items]
Inventories adjustment	(1,000)
Property plant and equipment	(900)	$ (900)
General administrative expenses	100
Cost of goods sold	$ 1,800

- Definition

The aggregate costs related to goods produced and sold and services rendered by an entity during the reporting period. This excludes costs incurred during the reporting period related to financial services rendered and other revenue generating activities.

+ References + Details

Stock-Based Compensation

12 Months Ended

Dec. 31, 2025

Share-Based Payment Arrangement [Abstract]

Stock-Based Compensation

(10) Stock-Based Compensation

Xtant Medical Holdings, Inc. 2023 Equity Incentive Plan

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 (as amended and restated, 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 2023 Plan is administered by the Compensation Committee of the Board of Directors. The Compensation Committee or 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, as increased by an amendment approved by our stockholders on November 7, 2025, is (i) 17,800,000 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. As of December 31, 2025, 12,966,721 shares remained available for grant under the 2023 Plan. Under the 2023 Plan, shares of our common stock related to awards granted under the plan that terminate by expiration, forfeiture, cancellation, or otherwise without the issuance of the shares become available again for grant under the plan.

Total stock-based compensation expense recognized for employees and directors was $2.9 million and $4.1 million for the years ended December 31, 2025 and 2024, respectively, and was recognized as general and administrative expense.

Stock Options

Stock options granted under the 2023 Plan may be either incentive stock options to employees, as defined in Section 422A of the Internal Revenue Code of 1986, or non-qualified stock options. The exercise price of all stock options granted under the 2023 Plan must be at least equal to the fair market value of the shares of common stock on the date of the grant. Stock options granted under the 2023 Plan are generally not transferable, vest in installments over the requisite service period, and are exercisable during the stated contractual term of the option only by the optionee.

Stock option activity, including options granted under the 2023 Plan, the 2018 Plan and the prior plan was as follows:

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
Exercised		—			—				(19,858	)		0.64
Cancelled or expired		(164,931	)		1.19				(930,567	)		1.38
Outstanding at December 31		3,760,472			1.30		5.85		3,925,403			1.29		6.64
Exercisable at December 31		3,210,536			1.33		5.57		2,947,725			1.36		6.08

As of December 31, 2025, total compensation expense related to unvested employee stock options not yet recognized was $0.5 million, which is expected to be allocated to expenses over a weighted-average period of 1.6 years. There was no intrinsic value associated with options exercisable at December 31, 2025. The estimated fair value of stock options granted is determined using the Black-Scholes-Merton method applied to individual grants. There were no stock options granted during the years ended December 31, 2025 and 2024.

Deferred Stock Units and Restricted Stock Units

Schedule of Restricted Stock Activity

	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		3,497,772			0.65		4,195,363			0.84
Vested		(1,203,987	)		0.89		(1,310,937	)		1.13
Cancelled		(80,116	)		0.98		(953,629	)		0.92
Outstanding at December 31		7,669,141			0.79		5,455,472			0.90

Total compensation expense related to unvested DSUs and RSUs not yet recognized was $3.8 million as of December 31, 2025, which is expected to be allocated to expenses over a weighted-average period of 2.5 years.

Performance Stock Units

During 2024, the Company awarded performance stock units, or PSUs, under the 2023 Plan to certain executive officers and key employees. The Company has awarded an aggregate of 1,894,985 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 performance against the group of peer companies.

During 2025, the Company awarded PSUs under the 2023 Plan to certain executive officers and key employees. The Company awarded 1,699,402 PSUs, assuming target performance, and each PSU award can be earned at the end of each of the three one-year performance periods based on stock appreciation goals and subject to continued service to the Company. After each one-year performance period, the amount earned in that period will vest equally over the remaining service periods. The number of shares of the Company’s common stock or DSUs 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 performance against the stock appreciation goals set forth in the awards.

Activity for PSU awards granted under the 2023 Plan, assuming target performance, was as follows for the years ended December 31, 2025 and 2024:

Schedule of PSU Awards Activity

	2025				2024
	Shares		Weighted Average Fair Value		Shares			Weighted Average Fair Value
Outstanding at January 1		1,640,709		1.49		—			—
Granted		1,699,402		0.84		1,894,985			1.49
Forfeited		—		—		(254,276	)		1.49
Outstanding at December 31		3,340,111		1.16		1,640,709			1.49

The fair value of the PSUs was estimated using a Monte Carlo simulation model and the following assumptions:

	2025			2024
Company volatility		78	%		93.34	%
Risk-free interest rate		3.58	%		4.53	%
Initial stock price	$	0.6521			Not applicable
Correlation with index		Not applicable			0.06
Dividend yield		0	%		0	%
Volatility of peer companies		Not applicable			unique to each company in the simulation

The total compensation cost related to unvested PSUs was $2.4 million as of December 31, 2025, which is expected to be allocated to expenses over a weighted-average period of 2.2 years.