Carlsmed Aims for $103M IPO to Fuel Growth in Custom Spine Surgery Market

Carlsmed, a rapidly growing player in the custom spine surgery market, has set its sights on raising up to $103.3 million through an initial public offering (IPO) to support the development and commercialization of its innovative spine surgery platform. The company plans to offer 6.7 million shares of common stock at an expected range of $14 to $16 per share, with an additional option for underwriters to purchase over 1 million shares.

AI-Enabled Platform Challenges Traditional Spine Fusion Procedures

Carlsmed's platform utilizes artificial intelligence-enabled software, custom implants, and single-use instruments to address limitations in traditional spine fusion procedures. The company targets a $13.4 billion addressable market by focusing on improving pre-operative planning, enhancing implant fit, and streamlining surgical workflows.

The platform's approach involves using diagnostic imaging and AI algorithms to develop personalized digital surgical plans and design custom interbody implants for each patient. Carlsmed also collects real-world, post-operative data to continually refine its planning process.

Promising Clinical Outcomes and Rapid Revenue Growth

Early clinical data suggests Carlsmed's custom devices may offer advantages over stock implants. An interim analysis of 67 adult spinal deformity patients in a registry study found a revision surgery rate of just 1.5% due to mechanical complications after a mean follow-up of 14.7 months. This compares favorably to a one-year revision rate of 8.7% observed in a separate study of stock implants.

The company has experienced substantial revenue growth, with sales increasing by almost 100% in 2024 to reach $27.2 million. This momentum has continued into 2025, with Carlsmed reporting sales of approximately $22.2 million in the first half of the year. The number of surgeons using the platform has also grown significantly, rising from 103 in March 2024 to 199 by June 2025.

Challenges and Competition in a Growing Market

Despite its rapid growth, Carlsmed faces challenges as it scales operations. The company's net loss increased to $24.2 million last year, and its reliance on a limited number of contract manufacturing organizations (CMOs) has impacted margins. Delays in surgical plan approvals or late changes to surgery dates have resulted in expedite fees from CMOs, though the company expects these fees to decrease as it improves operational processes and procedural workflows.

Carlsmed's custom implants compete with stock spine implants from industry giants such as Medtronic, Johnson & Johnson, and Globus Medical. While the company is significantly smaller than these established players, its rapid growth and innovative approach position it as a potential disruptor in the spine surgery market.

As Carlsmed prepares to list on Nasdaq, its IPO adds to a recent uptick in medtech public offerings. The success or failure of companies like Carlsmed could influence whether the IPO window opens further for other medical technology firms waiting in the wings.