Snapshot
Globus Medical Inc reported $760M of revenue in Q1 2026, up 27.0% year over year, with diluted EPS of $0.90 and an operating margin of 19.8%.
- Revenue
- $760M
- YoY growth
- +27.0%
- Diluted EPS
- $0.90
- Operating margin
- 19.8%
What management said
- •Our first quarter results demonstrate our ongoing focus as we continue to scale and capture share while maintaining operational discipline, driving margin expansion, favorably impacting Q1 and our full-year results looking ahead.
- •As we progress through 2026, look for market share taking top-line growth coupled with exciting product launches while increasing gross margins and driving meaningful earnings expansion.
- •We sit here today debt-free, generating significant free cash, and have launched over 30 new products during this timeframe.
- •Turning attention to our top-level performance, Q1 revenue totaled $759.9 million, growing 27% as reported and 25.5% on a constant currency basis.
- •Fully diluted non-GAAP earnings per share was $1.12, growing 64.7% over the prior year quarter.
- •Digging further into US Spine, this business continues to show strength and resilience as it grew 10% in Q1 versus the prior year quarter, marking the third consecutive quarter of 10% growth.
- •We've seen this momentum continue and are now sitting at 58 weeks of consecutive growth.
- •Cross-selling, competitive recruiting, and robotics pull-through are key to this strategy as we continue to capture volume and drive meaningful share growth across the category.
- •Robotics pull-through remains a key driver, and as we demonstrate greater flexibility in how customers acquire capital, we seek to more aggressively drive the recurring revenue, whether through implants, disposables, service, or case coverage.
- •Our first quarter saw Enabling Technologies post revenue of $26.9 million, growing 21% over the prior year quarter.
- •However, the mix of pipeline deals is shifting with a greater focus on leases and rentals compared to the historical mix of outright sales, which historically resulted in higher upfront revenue recognition.
- •Our international spine business grew 16.4% as reported and 9.8% on a constant currency basis, as we did not repeat the supply chain disruptions which occurred in the first quarter of the prior year.
What went well
- •Q1 revenue totaled $759.9 million, growing 27% as reported and 25.5% on a constant currency basis, with base business revenue of $677.2 million growing 13.2%.
- •Fully diluted non-GAAP earnings per share was a record Q1 $1.12, growing 64.7% over the prior year quarter.
- •U.S. Spine grew 10% versus the prior year quarter, marking the third consecutive quarter of 10% growth, with the company now at 58 weeks of consecutive growth.
- •Adjusted gross profit margin reached 69.2%, up from 67.3% in the prior year quarter, and was maintained from Q4 2025 despite the normal sequential step down in revenue.
- •Trauma grew 30.4% and Enabling Technologies grew 21% over the prior year quarter, while international spine grew 16.4% as reported.
- •Early in Q2 the company received two FDA 510(k) clearances for its patient-specific SCRIPT spacer system and SCRIPT rods, positioning it to be the only company offering a complete portfolio of patient-specific lumbar interbody spacers and rods integrated with its enabling technology.
What went wrong
- •Nevro revenue finished at $82.7 million, declining $17.1 million or 17.1% sequentially from Q4 2025, driven by structural changes made within Nevro sales and marketing at the tail end of 2025.
- •Enabling Technologies saw a sequential step down in Q1 consistent with history, and the pipeline mix is shifting toward leases and rentals, which historically resulted in lower upfront revenue recognition than outright sales.
Guidance changes
| Metric | Period | Previous | Current | Change |
|---|---|---|---|---|
| Adjusted gross profit margin | FY2026 | 69%-70% (reiterated) | 69%-70% | reiterated |
| R&D expense | FY2026 | 5%-6% of net sales | 5%-6% of net sales | reiterated |
| Non-GAAP EPS | FY2026 | raised | raised again (third time this year per analyst) | raised |
| Total revenue | FY2026 | prior guidance | reiterated | reiterated |
Performance breakdown
| Metric | YoY change | Reason |
|---|---|---|
| Total revenue | +27% as reported (+25.5% constant currency) | Strength across substantially all underlying businesses plus Nevro contribution |
| Base business revenue | +13.2% as reported | Led by U.S. Spine, with improved Enabling Technologies and international spine |
| U.S. Spine | +9.6% as reported (~10%) | Cross-selling, competitive recruiting, and robotics pull-through driving share gains |
| Trauma | +30.4% | Core trauma share taking plus Precice limb lengthening, with ANTHEM elbow plating exceeding expectations |
| Enabling Technologies | +21.1% as reported | Bounce back in sales dollars and units versus a softer Q1 2025, primarily cash sales |
| International spine | +16.4% as reported (+9.8% constant currency) | Did not repeat prior-year Q1 supply chain disruptions; strength in EMEA and LATAM |
| Adjusted gross profit margin | 69.2% vs 67.3% | Fixed cost leverage from higher sales, favorable mix, and synergy execution |
Earnings call themes & trends
| Topic | Previous mention | Current period | Trend |
|---|---|---|---|
| Enabling Technologies capital strategy | Focus on outright robot sales with higher upfront revenue recognition | Greater flexibility with higher mix of leases and rentals to drive implant pull-through | shifting |
| U.S. Spine momentum | Two prior quarters of 10% growth | Third consecutive quarter of 10% growth, 58 weeks of consecutive growth | sustained |
| Gross margin trajectory | Sequential improvement each quarter from Q3 2024 | Maintained 69.2% from Q4 to Q1, targeting mid-70s long term | improving |
| Nevro integration | Cost actions drove EPS accretion in first three quarters of ownership | Cost control sustained but revenue declined as anticipated; expected to worsen before improving and return toward historical norms late in 2H | lumpy |
Q&A summary
Are there incremental headwinds to revenue versus when guidance was set, or is the reiteration conservatism?
Kyle Kline said the company feels confident in its numbers and the full year, noting U.S. Spine up 10%, international spine up 10% constant currency, and the expected Nevro lumpiness from Q4 into Q1 that was built into expectations.
Why raise EPS by so much but not raise the top line given the revenue beat and momentum?
Keith Pfeil said it is still early in the year, and the Enabling Technologies approach shift and Nevro lumpiness could affect revenue. On EPS, durable manufacturing and supply chain savings plus ongoing synergy actions and scale leverage support taking the bottom line up.
Does Nevro get worse before it gets better, and can you give the prior-year Q1 number?
Kyle Kline declined to give the prior-year number and said his expectation is Nevro will likely get a little worse before it gets better, pointing to Keith's remarks about getting back toward historical norms late in the back half of the year.
Is the mid-70s gross margin opportunity purely cost, or do you need price?
Kyle Kline said it is some of each, with manufacturing and supply chain initiatives on COGS plus launching differentiated products for pricing premiums. Keith Pfeil added that the majority of getting to mid-70s comes from driving cost efficiency, as they model roughly net 1% price erosion.
How much of U.S. Spine growth comes from market share gains versus market growth?
Keith Pfeil said the majority of growth is coming from share gains, estimating the market is growing roughly 3%, with Globus growing well in excess of that.
Any change in competitive dynamics from larger or smaller spine players?
Keith Pfeil said they compete mainly against Medtronic; more competitors entering has elongated deal closing as hospitals review all offerings, but he believes ExcelsiusGPS remains very well positioned given its ground-up design and broad FDA clearances.