Carlsmed, a commercial-stage medtech company specializing in AI-driven personalized spine surgery solutions, priced its initial public offering (IPO) at $15.00 per share. The offering included 6.7 million shares of common stock and began trading on the Nasdaq Global Select Market under the ticker symbol “CARL” on July 23, 2025.
The IPO closed on July 24, raising approximately $100.5 million in gross proceeds before underwriting discounts and other expenses. The company also granted underwriters a 30-day option to purchase up to an additional 1,005,000 shares at the same price.
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Carlsmed develops surgical solutions for spine procedures that prioritize personalization and precision. Its core product, the aprevo platform, combines AI with 3D printing to create custom spinal implants and detailed surgical plans tailored to each patient’s anatomy. It aims to overcome limitations of traditional spine fusion procedures, which typically use stock implants that may not align with an individual patient’s anatomy.
The aprevo platform generates personalized surgical plans and 3D-printed implants based on each patient’s spinal pathology and bone structure. “aprevo” refers to the patient-specific interbody implant, while the “aprevo platform” encompasses the full system: AI-based planning software, surgical visualization tools, custom implants and disposable instruments.
Using standard medical imaging and AI algorithms, it produces detailed alignment strategies for spine fusion.
The platform is currently used in lumbar spine surgeries (lower back) and is being adapted for cervical spine procedures (neck), where precise alignment is especially critical.
The company currently markets the system for lumbar procedures and is developing a cervical application, which it plans to launch in 2026, pending additional FDA clearances.
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Spinal fusion is often used when damaged or misaligned parts of the spine cause persistent back or neck pain. It’s commonly recommended for conditions like degenerative disc disease, spinal instability or scoliosis — where fusing vertebrae can relieve pressure on nerves and correct spinal alignment.
Scoliosis affects approximately 2% to 3% of the US population (about 7 million people), and is the most common spinal condition in school‑aged children. Similarly, by age 50, around 80% of people in the US show disc degeneration on spine imaging — even when they are not experiencing pain.
The aprevo technology supports spinal alignment in three dimensions — coronal, sagittal and axial (side-to-side, front-to-back and top-to-bottom) — helping reduce complications and the need for revision surgeries. Poor alignment during surgery can lead to complications and repeat procedures, which may cost more than $100,000 per case.
The titanium implants are printed with a lattice structure to promote fusion and are delivered sterile to hospitals within 10 business days of plan approval. Post-operative imaging is collected to compare outcomes to the surgical plan, continuously refining the system through data feedback.
Carlsmed recently completed the first personalized cervical spine surgery using the aprevo platform on July 14, 2025. This marks a key step in expanding its capabilities beyond lumbar fusion. The company has received FDA Breakthrough Device designation for the cervical version and anticipates US commercialization in 2026.
Proceeds from the IPO will support the expansion of commercial operations, as well as continued investment in R&D, regulatory submissions and clinical data generation.
Carlsmed is also targeting international markets and the cervical fusion space, aiming to build clinical evidence.
The company estimates a $13.4 billion addressable market in the US for lumbar spine fusion, based on approximately 445,000 annual procedures and the average selling price of its full aprevo system.
With a focus on AI-guided planning and custom spinal implants, Carlsmed is entering a space dominated by established players like Medtronic, Stryker, Zimmer Biomet and Globus Medical.
What could set it apart is its ability to create surgical plans and implants tailored to each patient, using real-world data to inform future procedures.
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