0001459839-25-000036 | 10-K | XBRL Viewer

Income Taxes - Narrative (Details) - USD ($)	12 Months Ended
Income Taxes - Narrative (Details) - USD ($)	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Line Items]
Provision for income taxes (benefit)	$ 0	$ 0	$ 0
Limited net operating loss carryforwards	1,400,000
Accrued interest related to unrecognized tax benefits	0	$ 0
Federal
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	350,500,000
Credit carryforwards	5,500,000
State
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	271,600,000
Credit carryforwards	$ 4,400,000

- Definition

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

+ References

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+ Details

Balance Sheet Components - Property and Equipment, Net (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Property and Equipment, Net
Property and equipment, gross	$ 39,915	$ 31,246
Less: Accumulated depreciation and amortization	(19,541)	(15,246)
Property and equipment, net	20,374	16,000
Instrument trays
Property and Equipment, Net
Property and equipment, gross	23,158	18,205
Machinery and equipment
Property and Equipment, Net
Property and equipment, gross	3,188	3,067
Construction in progress
Property and Equipment, Net
Property and equipment, gross	6,212	3,856
Computer and office equipment
Property and Equipment, Net
Property and equipment, gross	3,098	1,856
Leasehold improvements
Property and Equipment, Net
Property and equipment, gross	3,873	3,873
Furniture and fixtures
Property and Equipment, Net
Property and equipment, gross	$ 386	$ 389

Balance Sheet Components - Narrative (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Inventory, finished goods, gross	$ 24,000	$ 1,400
Inventory, work in process, gross	3,100	18,800
Property and equipment, gross	39,915	31,246
Depreciation expense	4,400	$ 5,400	$ 3,400
Construction in progress, surgical placement instrument set
Property, Plant and Equipment [Line Items]
Property and equipment, gross	5,600
Construction in progress, software costs
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 600

Balance Sheet Components

12 Months Ended

Dec. 31, 2024

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Balance Sheet Components

Inventory

As of December 31, 2024, inventory consisted of finished goods of $24.0 million and work-in-progress and components of $3.1 million. As of December 31, 2023, inventory consisted of finished goods of $18.8 million and work-in-progress and components of $1.4 million.

Property and Equipment, net:


	December 31, 2024		December 31, 2023
	(in thousands)
Instrument trays	$	23,158	$	18,205
Machinery and equipment	3,188		3,067
Construction in progress	6,212		3,856
Computer and office equipment	3,098		1,856
Leasehold improvements	3,873		3,873
Furniture and fixtures	386		389
	39,915		31,246
Less: Accumulated depreciation and amortization	(19,541)		(15,246)
	$	20,374	$	16,000

As of December 31, 2024, construction in progress pertains to cost of individual components of an instrument tray used for surgical placement of the Company's products that have not yet been placed into service of $5.6 million and software costs of $0.6 million. Depreciation expense was $4.4 million, $5.4 million and $3.4 million for the years ended December 31, 2024, 2023, and 2022, respectively.

Accrued Liabilities and Other:


	December 31, 2024		December 31, 2023
	(in thousands)
Accrued compensation and related expenses	$	13,914	$	13,464


Accrued royalty	2,054		1,360
Accrued professional services	1,202		929
Accrued rebates	1,384		687

Others	938		1,012
	$	19,492	$	17,452

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
CURRENT ASSETS
Cash and cash equivalents	$ 34,948	$ 33,271
Short-term investments	115,094	132,748
Accounts receivable, net of allowance for credit losses of $588 and $1,118, respectively	27,459	21,953
Inventory	27,074	20,249
Prepaid expenses and other current assets	3,204	3,173
Total current assets	207,779	211,394
Property and equipment, net	20,374	16,000
Operating lease right-of-use assets	1,984	2,706
Other non-current assets	300	325
TOTAL ASSETS	230,437	230,425
CURRENT LIABILITIES
Accounts payable	6,488	4,588
Accrued liabilities and other	19,492	17,452
Operating lease liabilities, current portion	1,152	1,416
Total current liabilities	27,132	23,456
Long-term borrowings	35,452	36,065
Operating lease liabilities, net of current portion	879	1,511
Other long-term liabilities	10	18
TOTAL LIABILITIES	63,473	61,050
Commitments and contingencies (Note 6)
STOCKHOLDERS’ EQUITY
Preferred stock, $0.0001 par value; 5,000,000 shares authorized; no shares issued and outstanding	0	0
Common stock, $0.0001 par value; 100,000,000 shares authorized; 42,086,477 and 40,693,299 shares issued and outstanding, respectively	4	4
Additional paid-in capital	598,070	569,477
Accumulated other comprehensive income	244	335
Accumulated deficit	(431,354)	(400,441)
TOTAL STOCKHOLDERS’ EQUITY	166,964	169,375
TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY	$ 230,437	$ 230,425

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Cash flows from operating activities
Net loss	$ (30,913)	$ (43,336)	$ (61,256)
Adjustments to reconcile net loss to net cash used in operating activities
Stock-based compensation	25,869	24,057	23,061
Depreciation and amortization	4,379	5,428	3,452
Accounts receivable credit losses	470	761	150
Inventory reserve	1,300	1,709	319
Accretion (amortization) of discount and premium on marketable securities	(5,440)	(4,009)	229
Amortization of debt issuance costs	153	208	198
Loss on disposal of property and equipment	1,877	1,302	153
Changes in operating assets and liabilities
Accounts receivable	(5,840)	(2,122)	(6,479)
Inventory	(8,047)	(4,719)	(6,028)
Prepaid expenses and other assets	(2)	(762)	810
Accounts payable	1,861	(1,118)	2,529
Accrued liabilities and other	1,908	3,888	1,207
Net cash used in operating activities	(12,425)	(18,713)	(41,655)
Cash flows from investing activities
Maturities of marketable securities	228,500	137,500	126,200
Purchases of marketable securities	(205,380)	(189,499)	(119,508)
Purchases of property and equipment	(10,497)	(7,799)	(9,507)
Net cash provided by (used in) investing activities	12,623	(59,798)	(2,815)
Cash flows from financing activities
Proceeds from follow-on public offering, net of underwriting discounts, commissions and offering costs	0	83,671	0
Proceeds from debt financing	36,000	36,000	0
Repayments of debt financing	(36,000)	(35,275)	0
Payments of debt issuance costs	(46)	(40)	0
Final payment fee related to debt	(720)	0	0
Proceeds from the exercise of common stock options	570	4,386	379
Proceeds from issuance of common stock under employee stock purchase plan	2,154	2,191	1,818
Net cash provided by financing activities	1,958	90,933	2,197
Effect of exchange rate changes on cash and cash equivalents	(479)	132	(429)
Net increase (decrease) in cash and cash equivalents	1,677	12,554	(42,702)
Cash and cash equivalents at
Beginning of year	33,271	20,717	63,419
End of year	34,948	33,271	20,717
Supplemental disclosure of cash flow information
Cash paid for interest	3,346	3,263	2,621
Noncash investing and financing activities
Operating lease right-of-use assets obtained in exchange for operating lease liabilities	449	143	127
Supplemental disclosure of non-cash information
Unpaid purchases of property and equipment	$ 588	$ 501	$ 1,115

Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2024

Commitments and Contingencies Disclosure [Abstract]

Summary of Information Related to Lease Expense and Valuation of Lease Assets and Lease Liabilities

Supplemental information related to lease expense and valuation of the lease assets and lease liabilities are as follows:


	December 31, 2024		December 31, 2023
	(in thousands)
Operating lease expense	$	1,379	$	1,552
Variable lease expense	667		465
Total lease expense	$	2,046	$	2,017

Cash paid for amounts included in the measurement of operating lease liabilities	$	1,558	$	1,632
Leased assets obtained in exchange for new operating lease liabilities	$	449	$	143

Weighted average remaining lease term (in years)	1.76		2.20
Weighted average discount rate	7.15%		5.87%

Schedule of Future Minimum Lease Payments Under Non-Cancelable Operating Leases

Future minimum lease payments under non-cancelable operating leases as of December 31, 2024 was as follows:


Year Ending December 31,	(in thousands)
2025	$	1,238
2026	880
2027	21
2028	11
2029	—
Thereafter	—
Total operating lease payments	$	2,150
Less: imputed interest	(119)
Total operating lease liabilities	$	2,031

Related Party Transactions (Details) - USD ($)	12 Months Ended
Related Party Transactions (Details) - USD ($)	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Related Party Transaction [Line Items]
Research and development	$ 16,560,000	$ 15,028,000	$ 13,627,000
Current liabilities	$ 27,132,000	23,456,000
Related Party
Related Party Transaction [Line Items]
Research and development		0	38,725
Term of product royalty sales period	10 years
Royalties		300,000	$ 0
Current liabilities	$ 200,000	$ 100,000

- Definition

Total obligations incurred as part of normal operations that are expected to be paid during the following twelve months or within one business cycle, if longer.

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+ Details

Net Loss Per Share of Common Stock

12 Months Ended

Dec. 31, 2024

Earnings Per Share [Abstract]

Net Loss Per Share of Common Stock

The following table summarizes the computation of basic and diluted net loss per share:


	Year Ended December 31,
	2024		2023		2022
	(in thousands, except share and per share data)
Net loss	$	(30,913)	$	(43,336)	$	(61,256)

Weighted-average shares used to compute basic and diluted net loss per share	41,466,564		38,427,419		34,201,824

Net loss per share, basic and diluted	$	(0.75)	$	(1.13)	$	(1.79)

Because the Company has reported a net loss in all periods presented, outstanding stock options, restricted stock units, ESPP purchase rights and common stock warrants are anti-dilutive and therefore diluted net loss per common share is the same as basic net loss per common share for the periods presented. The following anti-dilutive common stock equivalents were excluded from the computation of diluted net loss per share for the periods presented:


	Year Ended December 31,
	2024	2023	2022
Stock options	1,041,131	1,188,708	1,903,341
Restricted stock units	2,495,181	2,284,912	1,950,524
ESPP purchase rights	145,509	102,172	134,226
Common stock warrants	78,459	85,139	118,122
	3,760,280	3,660,931	4,106,213

Stock-Based Compensation - Narrative (Details) - USD ($)			12 Months Ended				77 Months Ended
	Jan. 01, 2025	Jan. 01, 2024	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2024
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares)			0	0	0
Aggregate intrinsic value of options exercised			$ 1,600,000	$ 11,700,000	$ 1,000,000.0
Unrecognized compensation costs, options			$ 0				$ 0
Issuance of common stock related to employee stock purchase plan (in shares)			176,787	178,918		170,717
Issuance of common stock related to employee stock purchase plan			$ 2,154,000	$ 2,191,000	1,818,000
Stock based compensation expense			$ 25,869,000	24,057,000	23,061,000
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise price of option as percent of fair market value when individual owns more than 10% of shares outstanding			110.00%
Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Percentage of ownership of outstanding shares for alternate terms			10.00%
Stock option term			10 years
Stock option term when grantee holds more than 10% of shares outstanding			5 years
Award vesting period			4 years
Incentive Stock Options \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise price of option as percent of fair market value			100.00%
Nonqualified Stock Options \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Exercise price of option as percent of fair market value			85.00%
Restricted Stock Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost			$ 27,100,000				27,100,000
Unrecognized compensation cost, expected period for recognition			2 years 3 months 18 days
Restricted Stock Units \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period			1 year
Restricted Stock Units \| Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period			4 years
Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost			$ 3,700,000				$ 3,700,000
Unrecognized compensation cost, expected period for recognition			1 year 9 months 18 days
2008 Stock Option Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares)							0
2018 Equity Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Annual increase in shares reserved as percentage of prior year-end shares outstanding (percent)			5.00%				5.00%
Shares available for future grants (in shares)			5,208,332				5,208,332
2018 Equity Incentive Plan \| Subsequent event
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Increase in number of shares reserved for future issuance (in shares)	2,104,324
2018 ESPP
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for future grants (in shares)			1,802,295				1,802,295
Increase in number of shares reserved for future issuance (in shares)		420,865
Unrecognized compensation cost			$ 500,000				$ 500,000
Purchase price of common stock as a percent of fair market value			85.00%
Employees stock purchase program offering period interval			6 months
Accrued compensation and related expenses for employee payroll deductions			$ 300,000	400,000			$ 300,000
Stock based compensation expense			$ 900,000	$ 1,000,000.0	$ 700,000
2018 ESPP \| Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period			3 years

Balance Sheet Components (Tables)

12 Months Ended

Dec. 31, 2024

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of Property and Equipment, Net

All property and equipment is depreciated on a straight-line basis over the estimated useful lives of the assets, which are as follows:


Computer and office equipment			3 – 5 years
Instrument trays			5 years
Machinery and equipment			3 – 5 years
Furniture and fixtures			7 years
Leasehold Improvement			Lesser of estimated useful life or remaining lease term

Property and Equipment, net:


	December 31, 2024		December 31, 2023
	(in thousands)
Instrument trays	$	23,158	$	18,205
Machinery and equipment	3,188		3,067
Construction in progress	6,212		3,856
Computer and office equipment	3,098		1,856
Leasehold improvements	3,873		3,873
Furniture and fixtures	386		389
	39,915		31,246
Less: Accumulated depreciation and amortization	(19,541)		(15,246)
	$	20,374	$	16,000

Schedule of Accrued Liabilities and Other

Accrued Liabilities and Other:


	December 31, 2024		December 31, 2023
	(in thousands)
Accrued compensation and related expenses	$	13,914	$	13,464


Accrued royalty	2,054		1,360
Accrued professional services	1,202		929
Accrued rebates	1,384		687

Others	938		1,012
	$	19,492	$	17,452

Balance Sheet Components - Accrued Liabilities and Other (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Accrued Liabilities and Other
Accrued compensation and related expenses	$ 13,914	$ 13,464
Accrued royalty	2,054	1,360
Accrued professional services	1,202	929
Accrued rebates	1,384	687
Others	938	1,012
Accrued liabilities and other	$ 19,492	$ 17,452

Income Taxes - Reconciliation of Effective Income Tax Rate (Details)	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Effective Income Tax Rate Reconciliation
Tax at statutory federal rate	(21.00%)	(21.00%)	(21.00%)
State tax, net of federal benefit	(3.30%)	(4.30%)	(4.90%)
Tax credits	(2.00%)	(1.30%)	(0.70%)
Change in deferred tax valuation allowance	19.50%	28.70%	26.10%
Stock compensation	2.90%	(3.00%)	0.30%
Foreign rate differences	0.20%	(2.10%)	0.10%
Reversal of nontaxable or nondeductible items	1.30%	2.10%	0.10%
Nondeductible executive compensation	1.30%	0.30%	0.00%
Other	1.10%	0.60%	0.00%
Total income tax expense	0.00%	0.00%	0.00%

Stock-Based Compensation - Valuation Assumptions for ESPP Purchase Rights (Details) - ESPP Purchase Rights	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (years)	6 months	6 months	6 months
Expected volatility of common stock, minimum	41.90%	41.90%	49.50%
Expected volatility of common stock, maximum	57.90%	54.40%	62.10%
Risk-free interest rate, minimum	4.44%	5.26%	0.07%
Risk-free interest rate, maximum	5.41%	5.38%	1.54%
Dividend yield	0.00%	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
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-Name Accounting Standards Codification
-Section 35
-Paragraph 1D
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480483/718-10-35-1D

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Paragraph 3
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-URI https://asc.fasb.org/1943274/2147480483/718-10-35-3

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 718
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-Section 50
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-Subparagraph (a)(1)
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (a)(3)
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: 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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Reference 14: 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 24: http://www.xbrl.org/2003/role/disclosureRef
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Reference 26: http://www.xbrl.org/2003/role/disclosureRef
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Reference 28: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/1943274/2147480429/718-10-50-2

+ Details

Warrants - Schedule of Warrants Issued and Outstanding (Details) - $ / shares	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023
Class of Warrant or Right [Line Items]
Issuance of common stock upon exercise of warrant, net of shares withheld (in shares)		22,603
Class Of Warrant Or Right [Roll Forward]
Warrants outstanding, beginning balance (in shares)	85,139
Warrants issued (in shares)	0
Warrants exercised (in shares)	0
Warrants expired (in shares)	(6,680)
Warrants outstanding, ending balance (in shares)	78,459	85,139
Warrants Issued 3/1/2017
Class Of Warrant Or Right [Roll Forward]
Warrants outstanding, beginning balance (in shares)	1,388
Warrants price per share (in dollars per share)		$ 5.94
Warrants issued (in shares)	0
Warrants exercised (in shares)	0
Warrants expired (in shares)	0
Warrants outstanding, ending balance (in shares)	1,388	1,388
Warrants Issued 11/26/2014
Class Of Warrant Or Right [Roll Forward]
Warrants outstanding, beginning balance (in shares)	6,680
Warrants price per share (in dollars per share)		$ 16.47
Warrants issued (in shares)	0
Warrants exercised (in shares)	0
Warrants expired (in shares)	(6,680)
Warrants outstanding, ending balance (in shares)	0	6,680
Warrants Issued 10/20/2015
Class Of Warrant Or Right [Roll Forward]
Warrants outstanding, beginning balance (in shares)	41,650
Warrants price per share (in dollars per share)		$ 16.47
Warrants issued (in shares)	0
Warrants exercised (in shares)	0
Warrants expired (in shares)	0
Warrants outstanding, ending balance (in shares)	41,650	41,650
Warrants Issued 11/9/2015
Class Of Warrant Or Right [Roll Forward]
Warrants outstanding, beginning balance (in shares)	25,709
Warrants price per share (in dollars per share)		$ 16.47
Warrants issued (in shares)	0
Warrants exercised (in shares)	0
Warrants expired (in shares)	0
Warrants outstanding, ending balance (in shares)	25,709	25,709
Warrants Issued 12/22/2016
Class Of Warrant Or Right [Roll Forward]
Warrants outstanding, beginning balance (in shares)	9,712
Warrants price per share (in dollars per share)		$ 10.03
Warrants issued (in shares)	0
Warrants exercised (in shares)	0
Warrants expired (in shares)	0
Warrants outstanding, ending balance (in shares)	9,712	9,712

Stock-Based Compensation - Valuation Assumptions for Stock Options (Details) - Performance Shares	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected volatility of common stock, minimum	47.00%	58.00%	48.90%
Expected volatility of common stock, maximum	59.00%	73.00%	58.70%
Expected volatility of peer companies, minimum	29.00%	33.00%	24.20%
Expected volatility of peer companies, maximum	97.00%	141.00%	152.50%
Correlation coefficient of peer companies, minimum	(1.00%)	(15.00%)	(13.00%)
Correlation coefficient of peer companies, maximum	100.00%	100.00%	100.00%
Risk-free interest rate, minimum	4.10%	3.90%	0.40%
Risk-free interest rate, maximum	4.70%	5.00%	1.20%
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Dividend yield	0.60%	0.00%	0.00%
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Dividend yield	4.70%	1.30%	1.00%

Marketable Securities

12 Months Ended

Dec. 31, 2024

Investments, Debt and Equity Securities [Abstract]

Marketable Securities

All of the Company's marketable securities were available-for-sale debt securities and were classified based on their maturities. Marketable securities with remaining maturities at the date of purchase of three months or less are classified as cash equivalents. Short-term investments are securities that original maturity or remaining maturity is greater than three months and not more than twelve months. Long-term investments are securities for which the original maturity or remaining maturity is greater than twelve months.

The table below summarizes the marketable securities:


	December 31, 2024
	Amortized Cost		Unrealized Gains		Unrealized Losses		Aggregate Fair Value
	(in thousands)
Money market funds	$	27,326	$	—	$	—	$	27,326


Cash equivalents	27,326		—		—		27,326

U.S. treasury securities	112,649		91		(2)		112,738
U.S. agency bonds	2,355		1		—		2,356


Short-term investments	115,004		92		(2)		115,094



Total marketable securities	$	142,330	$	92	$	(2)	$	142,420


	December 31, 2023
	Amortized Cost		Unrealized Gains		Unrealized Losses		Aggregate Fair Value
	(in thousands)
Money market funds	$	23,331	$	—	$	—	$	23,331

Cash equivalents	23,331		—		—		23,331

U.S. treasury securities	129,695		67		—		129,762
U.S. agency bonds	2,988		—		(2)		2,986
Short-term investments	132,683		67		(2)		132,748



Total marketable securities	$	156,014	$	67	$	(2)	$	156,079

The amortized cost of the Company's available-for-sale securities approximates their fair value. Unrealized losses are generally due to interest rate fluctuations, as opposed to credit quality. However, the Company reviews individual securities that are in an unrealized loss position in order to evaluate whether or not they have experienced or are expected to experience credit losses. As of December 31, 2024 and 2023, unrealized gains and losses from the investments were not the result of a decline in credit quality. As a result, the Company did not recognize any credit losses related to its investments and that all unrealized gains and losses on available-for-sale securities are recorded in accumulated other comprehensive income (loss) on the consolidated balance sheets during the years ended December 31, 2024 and 2023.

The Company elected to present accrued interest receivable separately from short-term investments on its consolidated balance sheets. Accrued interest receivables were $0.3 million and $0.2 million as of December 31, 2024 and 2023, respectively, and were recorded in prepaid expenses and other current assets. The Company also elected to exclude accrued interest receivable from the estimation of expected credit losses on its marketable securities and reverse accrued interest receivable through interest income (expense) when amounts are determined to be uncollectible. The Company did not write off any accrued interest receivable during the years ended December 31, 2024, 2023, and 2022.

Stock-Based Compensation - Stock-Based Compensation Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock based compensation expense	$ 25,869	$ 24,057	$ 23,061
Cost of goods sold
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock based compensation expense	932	672	484
Sales and marketing
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock based compensation expense	10,654	10,931	11,006
Research and development
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock based compensation expense	3,270	2,933	2,637
General and administrative
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock based compensation expense	$ 11,013	$ 9,521	$ 8,934

- 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

Income Taxes

12 Months Ended

Dec. 31, 2024

Income Tax Disclosure [Abstract]

Income Taxes

The components of the Company’s loss before income taxes are as follows:


	Year Ended December 31,
	2024		2023		2022
	(in thousands)
Domestic	$	(31,082)	$	(43,491)	$	(61,396)
Foreign	169		155		140
Loss before income taxes	$	(30,913)	$	(43,336)	$	(61,256)

There was no provision for income taxes recorded for the years ended December 31, 2024, 2023 and 2022. The Company continues to maintain a full valuation allowance against its net deferred tax assets due to the uncertainty surrounding realization of such assets. The Company periodically evaluates the realizability of its net deferred tax assets based on the expected realization and is dependent on the Company's ability to generate sufficient future taxable income during periods prior to the expiration of tax attributes to fully utilize these assets.

The components of deferred income taxes are as follows:


	Year Ended December 31,
	2024		2023
	(in thousands)
Federal	$	(5,080)	$	(10,606)
State	(1,002)		(1,856)
Foreign	70		28
Total deferred income taxes	(6,012)		(12,434)
Change in deferred tax valuation allowance	6,012		12,434
Net deferred income tax	$	—	$	—

Income tax expense differs from the amount computed by applying the statutory federal income tax rate due to the following:


	Year Ended December 31,
	2024		2023		2022
Tax at statutory federal rate	(21.0)	%	(21.0)	%	(21.0)	%
State tax, net of federal benefit	(3.3)	%	(4.3)	%	(4.9)	%
Tax credits	(2.0)	%	(1.3)	%	(0.7)	%
Change in deferred tax valuation allowance	19.5	%	28.7	%	26.1	%
Stock compensation	2.9	%	(3.0)	%	0.3	%
Foreign rate differences	0.2	%	(2.1)	%	0.1	%
Reversal of nontaxable or nondeductible items	1.3	%	2.1	%	0.1	%
Nondeductible executive compensation	1.3	%	0.3	%	—	%
Other	1.1	%	0.6	%	—	%
Total income tax expense	—	%	—	%	—	%

The tax effects of temporary differences and carryforwards that give rise to significant portions of the deferred tax assets are presented below:


	Year Ended December 31,
	2024		2023
	(in thousands)
Net operating loss carryforwards	$	89,592	$	85,173
Research and development credits	6,279		5,342
Accruals and reserves	4,506		3,698
Interest limitation	2,584		4,378
Depreciation and amortization	144		474
Stock compensation	3,693		3,474
Operating lease liabilities	511		735
Capitalized research and development	6,413		4,614
Total deferred tax assets	113,722		107,888
Operating lease right-of-use assets	(500)		(678)
Total deferred tax liabilities	(500)		(678)
Less: Valuation allowance	(113,222)		(107,210)
Total deferred tax asset, net of valuation allowance	$	—	$	—

The following table summarizes changes in the valuation allowance for the years ended December 31, 2024, 2023, and 2022:


	Year Ended December 31,
	2024		2023		2022
	(in thousands)
Beginning balance	$	107,210	$	94,776	$	78,786
Net changes during the period	6,012		12,434		15,990
Ending balance	$	113,222	$	107,210	$	94,776

As of December 31, 2024, the Company had net operating loss (“NOL”) carryforwards of approximately $350.5 million and $271.6 million available to reduce future taxable income, if any, for federal and state income tax purposes, respectively. If not utilized, the Company’s federal NOL carryforward begins to expire in 2030, and the state NOL carryforward began to expire in 2024.

As of December 31, 2024, the Company had credit carryforwards of approximately $5.5 million and $4.4 million available to reduce future taxable income, if any, for both federal and state income tax purposes, respectively. The federal credits begin to expire in 2029, and the state credits have no expiration date.

The Company updated its Section 382 ownership change analysis through December 31, 2020 and determined that the last ownership change was in February 2020 due to the follow-offering. The analysis concluded that no additional NOL carryforwards will expire due to the Section 382 limitation from the ownership change for both federal and state tax purposes. The Company maintains the reduction of $1.4 million of its NOL carryforwards from the previous ownership change. The Company has reviewed changes in the outstanding number of shares and equity transactions for the period January 1, 2021 through December 31, 2024 to determine if an additional ownership change occurred for Section 382 purposes. The Company reasonably believes no additional ownership change occurred in the current year. The Company will continually assess the need to update its Section 382 ownership change analysis. An ownership change in the future could materially limit the Company’s ability to utilize its NOL carryforwards and other tax attributes.

Under an Organization for Economic Co-operation and Development Inclusive Framework, countries that agreed to enact a two-pillar solution aim to address the challenges arising from the digitalization of the world economy (Pillar Two). Pillar Two sets out a global minimum Effective Tax Rate (ETR) rules to ensure that large multinational businesses with consolidated revenue over €750 million are subject to a minimum ETR of 15% on income arising in low-tax jurisdictions. The Company will continue to monitor the impact of Pillar Two; however, the Pillar Two is currently not applicable as the Company does not meet the threshold of having consolidated revenue over €750 million.

The Company accounts for the uncertainty in income taxes by utilizing a comprehensive model for the recognition, measurement, presentation and disclosure in financial statements of any uncertain tax positions that have been taken or are expected to be taken on an income tax return. The changes in the Company’s uncertain income tax positions for the years ended December 31, 2024, 2023 and 2022 consisted of the following:


	Year ended December 31,
	2024		2023		2022
	(in thousands)
Balance at beginning of the year	$	2,629	$	2,944	$	2,655
Increases related to tax positions taken prior to current year	(43)		$	(726)	$	(12)
Increases related to current year's tax positions	438		411		301
Balance at end of the year	$	3,024	$	2,629	$	2,944

The Company has elected to recognize interest and penalties related to uncertain tax positions as a component of income tax expense. The Company has no accrued interest related to unrecognized tax benefits as of December 31, 2024 and 2023. None of the Company’s unrecognized tax benefits that, if recognized, would affect its effective tax rates for the years ended December 31, 2024, 2023, and 2022. The Company does not anticipate the total amounts of unrecognized tax benefits will significantly increase or decrease in the next 12 months.

The Company currently has no federal, state or foreign tax examinations in progress nor has it had any federal or state examinations since inception. As a result of the Company’s net operating loss carry forwards, all of its tax years are subject to federal and state tax examinations.

- Definition

The entire disclosure for income tax.

+ References

Reference 1: 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 2: http://www.xbrl.org/2003/role/exampleRef
-Topic 740
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-Name Accounting Standards Codification
-Section 55
-Paragraph 231
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482663/740-10-55-231

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
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-Name Accounting Standards Codification
-Section 50
-Paragraph 12C
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-12C

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

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
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-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477891/740-270-50-1

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
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-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 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-13

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
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-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-Name Accounting Standards Codification
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-URI https://asc.fasb.org/740/tableOfContent

Reference 10: 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 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-21

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
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-Subparagraph (b)
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-URI https://asc.fasb.org/1943274/2147482685/740-10-50-17

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479360/740-10-S99-2

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482603/740-30-50-2

+ Details

CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income	Accumulated Deficit
Stockholders' equity, beginning of period (in shares) at Dec. 31, 2021		33,674,085
Stockholders' equity, beginning of period at Dec. 31, 2021	$ 134,420	$ 3	$ 429,914	$ 352	$ (295,849)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock upon exercise of stock options, net of shares withheld (in shares)		80,571
Issuance of common stock upon exercise of stock options, net of shares withheld	379		379
Issuance of common stock related to employee stock purchase plan (in shares)		170,717
Issuance of common stock related to employee stock purchase plan	1,818		1,818
Issuance of common stock upon vesting of restricted stock units (in shares)		806,204
Stock-based compensation	23,061		23,061
Foreign currency translation	(55)			(55)
Net unrealized gain (loss) on marketable securities	(65)			(65)
Net loss	(61,256)				(61,256)
Stockholders' equity, end of period (in shares) at Dec. 31, 2022		34,731,577
Stockholders' equity, end of period at Dec. 31, 2022	98,302	$ 3	455,172	232	(357,105)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock from public offerings, net of underwriting discounts, commissions and offering costs (in shares)		4,068,497
Issuance of common stock from public offerings, net of underwriting discounts, commissions and offering costs	83,672	$ 1	83,671
Issuance of common stock upon exercise of stock options, net of shares withheld (in shares)		698,627
Issuance of common stock upon exercise of stock options, net of shares withheld	$ 4,386		4,386
Issuance of common stock related to employee stock purchase plan (in shares)	178,918	178,918
Issuance of common stock related to employee stock purchase plan	$ 2,191		2,191
Issuance of common stock upon vesting of restricted stock units (in shares)		993,077
Issuance of common stock upon exercise of warrant, net of shares withheld (in shares)	22,603	22,603
Stock-based compensation	$ 24,057		24,057
Foreign currency translation	(63)			(63)
Net unrealized gain (loss) on marketable securities	166			166
Net loss	$ (43,336)				(43,336)
Stockholders' equity, end of period (in shares) at Dec. 31, 2023	40,693,299	40,693,299
Stockholders' equity, end of period at Dec. 31, 2023	$ 169,375	$ 4	569,477	335	(400,441)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock upon exercise of stock options, net of shares withheld (in shares)	143,685	143,685
Issuance of common stock upon exercise of stock options, net of shares withheld	$ 570		570
Issuance of common stock related to employee stock purchase plan (in shares)	176,787	176,787
Issuance of common stock related to employee stock purchase plan	$ 2,154		2,154
Issuance of common stock upon vesting of restricted stock units (in shares)		1,072,706
Stock-based compensation	25,869		25,869
Foreign currency translation	(117)			(117)
Net unrealized gain (loss) on marketable securities	26			26
Net loss	$ (30,913)				(30,913)
Stockholders' equity, end of period (in shares) at Dec. 31, 2024	42,086,477	42,086,477
Stockholders' equity, end of period at Dec. 31, 2024	$ 166,964	$ 4	$ 598,070	$ 244	$ (431,354)

Insider Trading Policies and Procedures	12 Months Ended
Insider Trading Policies and Procedures	Dec. 31, 2024
Insider Trading Policies and Procedures [Line Items]
Insider Trading Policies and Procedures Adopted	true

CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Statement [Abstract]
Revenue	$ 167,178	$ 138,886	$ 106,409
Cost of goods sold	35,057	29,466	15,705
Gross profit	132,121	109,420	90,704
Operating expenses:
Sales and marketing	117,054	110,254	107,726
Research and development	16,560	15,028	13,627
General and administrative	33,755	31,069	28,960
Total operating expenses	167,369	156,351	150,313
Loss from operations	(35,248)	(46,931)	(59,609)
Interest and other income (expense), net:
Interest income	7,848	6,916	1,304
Interest expense	(3,440)	(3,462)	(2,819)
Other income (expense), net	(73)	141	(132)
Net loss	(30,913)	(43,336)	(61,256)
Other comprehensive income (loss):
Unrealized gain (loss) of marketable securities	26	166	(65)
Changes in foreign currency translation	(117)	(63)	(55)
Comprehensive loss	$ (31,004)	$ (43,233)	$ (61,376)
Net loss per share, basic (in dollars per share)	$ (0.75)	$ (1.13)	$ (1.79)
Net loss per share, diluted (in dollars per share)	$ (0.75)	$ (1.13)	$ (1.79)
Weighted-average number of common shares used to compute basic net loss per share (in shares)	41,466,564	38,427,419	34,201,824
Weighted-average number of common shares used to compute diluted net loss per share (in shares)	41,466,564	38,427,419	34,201,824

Common and Preferred Stock	12 Months Ended
Common and Preferred Stock	Dec. 31, 2024
Equity [Abstract]
Common and Preferred Stock	Common and Preferred Stock The Company's amended and restated certificate of incorporation as last amended in June 2024, authorizes the Company to issue 100,000,000 shares of common stock and 5,000,000 shares of preferred stock, each having a par value of $0.0001. Common stock issued and outstanding as of December 31, 2024 and 2023 were 42,086,477 shares and 40,693,299 shares, respectively. As of December 31, 2024 and 2023, there was no preferred stock issued and outstanding. The holders of common stock are entitled to receive dividends whenever funds are legally available, as, when, and if declared by the Board of Directors. There have been no dividends declared to date.

- Definition

The entire disclosure for equity.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Name Accounting Standards Codification
-Section 50
-Paragraph 13
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-14

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

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

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 505
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478448/946-505-50-6

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

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.3-04)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480008/505-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
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-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(e)(1))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-1

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 505
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org/505/tableOfContent

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

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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-Section 50
-Paragraph 13
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-13

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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Reference 17: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
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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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-URI https://asc.fasb.org/1943274/2147481112/505-10-50-18

+ Details

Stock-Based Compensation - Stock Option Activity (Details) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($) $ / shares shares
Number of Shares
Beginning balance (in shares) \| shares	1,188,708
Options exercised (in shares) \| shares	(143,685)
Options canceled and forfeited (in shares) \| shares	(3,892)
Ending balance (in shares) \| shares	1,041,131
Options vested and exercisable (in shares) \| shares	1,041,131
Options vested and expected to vest (in shares) \| shares	1,041,131
Weighted-Average Exercise Price
Beginning balance (in dollars per share) \| $ / shares	$ 10.14
Options exercised (in dollars per share) \| $ / shares	3.96
Options canceled and forfeited (in dollars per share) \| $ / shares	11.97
Ending balance (in dollars per share) \| $ / shares	10.98
Options vested and exercisable (in dollars per share) \| $ / shares	10.98
Options vested and expected to vest (in dollars per share) \| $ / shares	$ 10.98
Weighted-Average Remaining Contractual Life and Aggregate Intrinsic Value
Weighted-average remaining contractual life, options outstanding (in years)	2 years 9 months 29 days
Weighted-average remaining contractual life, options vested and exercisable (in years)	2 years 9 months 29 days
Weighted-average remaining contractual life, options vested and expected to vest (in years)	2 years 9 months 29 days
Aggregate intrinsic value, options outstanding \| $	$ 5,917
Aggregate intrinsic value, options vested and exercisable \| $	5,917
Aggregate intrinsic value, options vested and expected to vest \| $	$ 5,917

Employee Benefit Plan (Details) - 401(k) Plan	12 Months Ended
Employee Benefit Plan (Details) - 401(k) Plan	Dec. 31, 2024 USD ($)
Defined Contribution Plan Disclosure [Line Items]
Employer matching contribution, percentage of eligible compensation	3.00%
Employer matching contribution, maximum amount per employee	$ 1,000

Marketable Securities - Narrative (Details) - USD ($)	12 Months Ended
Marketable Securities - Narrative (Details) - USD ($)	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Investments, Debt and Equity Securities [Abstract]
Credit losses on investments	$ 0	$ 0
Accrued interest receivable	$ 300,000	$ 200,000
Debt Securities, Available-for-Sale, Accrued Interest, after Allowance for Credit Loss, Statement of Financial Position [Extensible Enumeration]	Prepaid expenses and other current assets	Prepaid expenses and other current assets
Accrued interest writeoff	$ 0	$ 0	$ 0

Net Loss Per Share of Common Stock - Antidilutive Common Stock Equivalents Excluded from Computation of Earnings Per Share (Details) - shares	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Common stock equivalents excluded from computation of diluted net loss per share (in shares)	3,760,280	3,660,931	4,106,213
Stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Common stock equivalents excluded from computation of diluted net loss per share (in shares)	1,041,131	1,188,708	1,903,341
Restricted stock units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Common stock equivalents excluded from computation of diluted net loss per share (in shares)	2,495,181	2,284,912	1,950,524
ESPP purchase rights
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Common stock equivalents excluded from computation of diluted net loss per share (in shares)	145,509	102,172	134,226
Common stock warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Common stock equivalents excluded from computation of diluted net loss per share (in shares)	78,459	85,139	118,122

Fair Value Measurement (Details) - Recurring - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Marketable securities
Marketable securities	$ 142,420	$ 156,079
Money market funds
Marketable securities
Marketable securities	27,326	23,331
U.S. treasury securities
Marketable securities
Marketable securities	112,738	129,762
U.S. agency bonds
Marketable securities
Marketable securities	2,356	2,986
Level 1
Marketable securities
Marketable securities	140,064	153,093
Level 1 \| Money market funds
Marketable securities
Marketable securities	27,326	23,331
Level 1 \| U.S. treasury securities
Marketable securities
Marketable securities	112,738	129,762
Level 1 \| U.S. agency bonds
Marketable securities
Marketable securities	0	0
Level 2
Marketable securities
Marketable securities	2,356	2,986
Level 2 \| Money market funds
Marketable securities
Marketable securities	0	0
Level 2 \| U.S. treasury securities
Marketable securities
Marketable securities	0	0
Level 2 \| U.S. agency bonds
Marketable securities
Marketable securities	2,356	2,986
Level 3
Marketable securities
Marketable securities	0	0
Level 3 \| Money market funds
Marketable securities
Marketable securities	0	0
Level 3 \| U.S. treasury securities
Marketable securities
Marketable securities	0	0
Level 3 \| U.S. agency bonds
Marketable securities
Marketable securities	$ 0	$ 0

Cover Page - USD ($) $ in Billions	12 Months Ended
Cover Page - USD ($) $ in Billions	Dec. 31, 2024	Feb. 20, 2025	Jun. 30, 2024
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2024
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-38701
Entity Registrant Name	SI-BONE, Inc.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	26-2216351
Entity Address, Address Line One	471 El Camino Real
Entity Address, Address Line Two	Suite 101
Entity Address, City or Town	Santa Clara
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	95050
City Area Code	408
Local Phone Number	207-0700
Title of 12(b) Security	Common Stock, par value $0.0001 per share
Trading Symbol	SIBN
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Document Financial Statement Error Correction	false
Entity Shell Company	false
Entity Public Float			$ 0.5
Entity Common Stock, Shares Outstanding		42,453,116
Documents Incorporated by Reference	Portions of the Registrant’s Definitive Proxy Statement relating to the Annual Meeting of Shareholders, which will be filed with the Securities and Exchange Commission within 120 days after the end of the Registrant’s fiscal year ended December 31, 2024, are incorporated by reference into Part III of this Report.
Entity Central Index Key	0001459839
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	FY
Amendment Flag	false

Insider Trading Arrangements

3 Months Ended

12 Months Ended

Dec. 31, 2024

Trading Arrangements, by Individual

Material Terms of Trading Arrangement

During the fiscal quarter ended December 31, 2024, the following Section 16 officer and director adopted, modified or terminated a “Rule 10b5-1 trading arrangement” (as defined in Item 408 of Regulation S-K of the Exchange Act) as set forth in the table below.

Type of Trading Arrangement

Name of Position

Action

Adoption/Termination Date

Rule 10b5-1*

Non-Rule 10b5-1**

Total Shares of Common Stock to be Sold

Total Shares of Common Stock to be Purchased

Expiration Date

Laura Francis, Chief Executive Officer

Adoption

December 13, 2024

321,456

(1)

March 31, 2026

Anshul Maheshwari , Chief Financial Officer

Adoption

December 13, 2024

106,670

(2)

March 31, 2026

*Contract, instruction or written plan intended to satisfy the affirmative defense conditions of Rule 10b5-1(c) under the Exchange Act

** “Non-Rule 10b5-1 trading arrangement” as defined in Item 408(c) of Regulation S-K under the Exchange Act.

(1) (a) up to 75,000 shares of common stock held by the David & Laura Francis Joint Rev Trust; (b) up to 60,416 shares of common stock subject to restricted stock unit awards (RSUs) previously granted to Ms. Francis that may vest and be released to her on or before March 31, 2026 upon satisfaction of the applicable service-based vesting conditions, to be reduced by the shares sold to satisfy tax withholding obligations arising from the vesting of such RSUs; and (c) up to 186,040 shares of common stock subject to performance-based restricted stock unit awards (PSUs) previously granted to Ms. Francis that may vest and be released to her on or before March 31, 2026 upon satisfaction of the applicable performance-based vesting conditions, to be reduced by the shares sold to satisfy tax withholding obligations arising from the vesting of such PSUs. The actual number of shares of common stock that may vest and be released to Ms. Francis upon satisfaction of the applicable performance-based vesting conditions pursuant to the PSUs is not yet determinable. Moreover, the actual number of share that will be sold pursuant to the Rule 10b5-1 trading arrangement is not yet determinable.

(2) (a) up to 53,150 shares of common stock held by Mr. Maheshwari; (b) up to 34,028 shares of common stock subject to restricted stock unit awards (RSUs) previously granted to Mr. Maheshwari that may vest and be released to him on or before March 31, 2026 upon satisfaction of the applicable service-based vesting conditions, to be reduced by the shares sold to satisfy tax withholding obligations arising from the vesting of such RSUs; and (c) up to 19,492 shares of common stock subject to performance-based restricted stock unit awards (PSUs) previously granted to Mr. Maheshwari that may vest and be released to him on or before March 31, 2026 upon satisfaction of the applicable performance-based vesting conditions, to be reduced by the shares sold to satisfy tax withholding obligations arising from the vesting of such PSUs. The actual number of shares of common stock that may vest and be released to Mr. Maheshwari upon satisfaction of the applicable performance-based vesting conditions pursuant to the PSUs is not yet determinable. Moreover, the actual number of share that will be sold pursuant to the Rule 10b5-1 trading arrangement is not yet determinable.

Non-Rule 10b5-1 Arrangement Adopted

false

Rule 10b5-1 Arrangement Terminated

false

Non-Rule 10b5-1 Arrangement Terminated

false

Laura Francis [Member]

Trading Arrangements, by Individual

Name

Laura Francis

Title

Chief Executive Officer

Rule 10b5-1 Arrangement Adopted

true

December 13, 2024

March 31, 2026

455 days

321,456

Anshul Maheshwari [Member]

Trading Arrangements, by Individual

Name

Anshul Maheshwari

Title

Chief Financial Officer

Rule 10b5-1 Arrangement Adopted

true

December 13, 2024

March 31, 2026

455 days

106,670

Laura Francis, Trading Arrangement, Common Stock [Member] | Laura Francis [Member]

Trading Arrangements, by Individual

Aggregate Available

75,000

Laura Francis, Trading Arrangement, Restricted Stock Units [Member] | Laura Francis [Member]

Trading Arrangements, by Individual

Aggregate Available

60,416

Laura Francis, Trading Arrangement, Performance Based Restricted Stock Units [Member] | Laura Francis [Member]

Trading Arrangements, by Individual

Aggregate Available

186,040

Anshul Maheshwari, Trading Arrangement, Common Stock [Member] | Anshul Maheshwari [Member]

Trading Arrangements, by Individual

Aggregate Available

53,150

Anshul Maheshwari, Trading Arrangement, Restricted Stock Units [Member] | Anshul Maheshwari [Member]

Trading Arrangements, by Individual

Aggregate Available

34,028

Anshul Maheshwari, Trading Arrangement, Performance Based Restricted Stock Units [Member] | Anshul Maheshwari [Member]

Trading Arrangements, by Individual

Aggregate Available

19,492

Summary of Significant Accounting Policies - Schedule of Revenue by Geography (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Disaggregation of Revenue [Line Items]
Revenue	$ 167,178	$ 138,886	$ 106,409
United States
Disaggregation of Revenue [Line Items]
Revenue	158,416	130,621	98,751
International
Disaggregation of Revenue [Line Items]
Revenue	$ 8,762	$ 8,265	$ 7,658

- 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

- 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.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 41
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-41

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 270
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (i)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482964/270-10-50-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (ee)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-32

Reference 4: http://fasb.org/us-gaap/role/ref/otherTransitionRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-32

Reference 5: http://fasb.org/us-gaap/role/ref/otherTransitionRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-32

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 924
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 11.L)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479941/924-10-S99-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479806/606-10-50-5

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 30
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-30

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 42
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-42

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-22

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 40
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-40

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-22

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

+ Details

Stock-Based Compensation - Outstanding Options and Exercisable Options Information by Range of Exercise Prices (Details)	12 Months Ended
	Dec. 31, 2024 $ / shares shares
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Options outstanding, number of shares (in shares) \| shares	1,041,131
Options outstanding, average remaining contractual life	2 years 9 months 29 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 10.98
Options vested and exercisable, number of shares (in shares) \| shares	1,041,131
Options vested and exercisable, weighted-average exercise price (in dollars per share)	$ 10.98
$3.24-$4.41
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Exercise price, lower limit (in dollars per share)	3.24
Exercise price, upper limit (in dollars per share)	$ 4.41
Options outstanding, number of shares (in shares) \| shares	246,331
Options outstanding, average remaining contractual life	1 year 5 months 12 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 4.31
Options vested and exercisable, number of shares (in shares) \| shares	246,331
Options vested and exercisable, weighted-average exercise price (in dollars per share)	$ 4.31
$4.42-$5.31
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Exercise price, lower limit (in dollars per share)	4.42
Exercise price, upper limit (in dollars per share)	$ 5.31
Options outstanding, number of shares (in shares) \| shares	287,641
Options outstanding, average remaining contractual life	2 years 3 months 21 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 4.68
Options vested and exercisable, number of shares (in shares) \| shares	287,641
Options vested and exercisable, weighted-average exercise price (in dollars per share)	$ 4.68
$5.32-$18.10
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Exercise price, lower limit (in dollars per share)	5.32
Exercise price, upper limit (in dollars per share)	$ 18.10
Options outstanding, number of shares (in shares) \| shares	194,938
Options outstanding, average remaining contractual life	3 years 5 months 1 day
Options outstanding, weighted-average exercise price (in dollars per share)	$ 11.36
Options vested and exercisable, number of shares (in shares) \| shares	194,938
Options vested and exercisable, weighted-average exercise price (in dollars per share)	$ 11.36
$18.11-$20.51
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Exercise price, lower limit (in dollars per share)	18.11
Exercise price, upper limit (in dollars per share)	$ 20.51
Options outstanding, number of shares (in shares) \| shares	16,627
Options outstanding, average remaining contractual life	4 years 1 month 2 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 18.74
Options vested and exercisable, number of shares (in shares) \| shares	16,627
Options vested and exercisable, weighted-average exercise price (in dollars per share)	$ 18.74
$20.52-$22.00
Share-based Payment Arrangement, Option, Exercise Price Range [Line Items]
Exercise price, lower limit (in dollars per share)	20.52
Exercise price, upper limit (in dollars per share)	$ 22.00
Options outstanding, number of shares (in shares) \| shares	295,594
Options outstanding, average remaining contractual life	4 years 14 days
Options outstanding, weighted-average exercise price (in dollars per share)	$ 22.00
Options vested and exercisable, number of shares (in shares) \| shares	295,594
Options vested and exercisable, weighted-average exercise price (in dollars per share)	$ 22.00

Commitments and Contingencies- Supplemental Information Related to Lease Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
Operating lease expense	$ 1,379	$ 1,552
Variable lease expense	667	465
Total lease expense	2,046	2,017
Cash paid for amounts included in the measurement of operating lease liabilities	1,558	1,632
Leased assets obtained in exchange for new operating lease liabilities	$ 449	$ 143	$ 127
Weighted average remaining lease term (in years)	1 year 9 months 3 days	2 years 2 months 12 days
Weighted average discount rate	7.15%	5.87%

Fair Value Measurement (Tables)

12 Months Ended

Dec. 31, 2024

Fair Value Disclosures [Abstract]

Schedule of Marketable Securities Measured at Fair Value on Recurring Basis

The table below summarizes the fair value of the Company’s marketable securities measured at fair value on a recurring basis based on the three-tier fair value hierarchy:


	December 31, 2024
	Level 1		Level 2		Level 3		Total
	(in thousands)
Marketable securities
Money market funds	$	27,326	$	—	$	—	$	27,326
U.S. treasury securities	112,738		—		—		112,738
U.S. agency bonds	—		2,356		—		2,356


Total marketable securities	$	140,064	$	2,356	$	—	$	142,420

	December 31, 2023
	Level 1		Level 2		Level 3		Total
	(in thousands)
Marketable securities
Money market funds	$	23,331	$	—	$	—	$	23,331
U.S. treasury securities	129,762		—		—		129,762
U.S. agency bonds	—		2,986		—		2,986
Total marketable securities	$	153,093	$	2,986	$	—	$	156,079

Net Loss Per Share of Common Stock (Tables)

12 Months Ended

Dec. 31, 2024

Earnings Per Share [Abstract]

Schedule of Computation of Basic and Diluted Net Loss per Share

The following table summarizes the computation of basic and diluted net loss per share:


	Year Ended December 31,
	2024		2023		2022
	(in thousands, except share and per share data)
Net loss	$	(30,913)	$	(43,336)	$	(61,256)

Weighted-average shares used to compute basic and diluted net loss per share	41,466,564		38,427,419		34,201,824

Net loss per share, basic and diluted	$	(0.75)	$	(1.13)	$	(1.79)

Schedule of Anti-dilutive Common Stock Equivalents Excluded from Computation of Diluted Net Loss per Share

The following anti-dilutive common stock equivalents were excluded from the computation of diluted net loss per share for the periods presented:


	Year Ended December 31,
	2024	2023	2022
Stock options	1,041,131	1,188,708	1,903,341
Restricted stock units	2,495,181	2,284,912	1,950,524
ESPP purchase rights	145,509	102,172	134,226
Common stock warrants	78,459	85,139	118,122
	3,760,280	3,660,931	4,106,213

The Company and Nature of Business	12 Months Ended
The Company and Nature of Business	Dec. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
The Company and Nature of Business	The Company and Nature of Business SI-BONE, Inc. (the “Company”) was incorporated in the state of Delaware on March 18, 2008 and is headquartered in Santa Clara, California. The Company is a medical device company that has pioneered a proprietary minimally invasive surgical implant system to fuse the sacroiliac joint for treatment of musculoskeletal disorders of the sacropelvic anatomy. The Company’s products include a series of patented titanium implants and the instruments used to implant them, as well as implantable bone products. Since launching its first generation iFuse in 2009, the Company has launched multiple implant product lines, including iFuse-3D in 2017, iFuse TORQ in 2021, iFuse Bedrock Granite in 2022 and iFuse INTRA, and iFuse TORQ TNT in 2024. In the United States, iFuse, iFuse-3D, iFuse TORQ and iFuse Bedrock Granite have clearances for applications in sacroiliac joint dysfunction, adult spinal deformity and pelvic trauma. iFuse TORQ TNT has clearances for applications in pelvic trauma and sacroiliac joint dysfunction. In May 2023, the Company received a total of $83.7 million of net proceeds after deducting the underwriting discounts and commissions of $5.8 million from the offering of 3,775,000 shares of the Company’s common stock and the exercise of underwriter's option to purchase from the Company an additional 566,250 shares of the Company's common stock, at a public offering price of $22.00 per share. Of these shares, 272,753 shares were offered by a selling stockholder, and the Company did not receive any proceeds from the sale by the selling stockholder. Risks and Uncertainties The Company is subject to uncertainties related to liquidity, the ability to meet covenants and access to funding for its capital needs as the financial service industry has experienced disruptions characterized by the bankruptcy, failure, collapse or sale of various financial institutions. The Company’s cash and cash equivalents are primarily invested in deposits and money market accounts with a single major financial institution in the U.S. Deposits in these banks may exceed the federally insured limits or any other insurance provided on such deposits, if any. As of the date of issuance of these consolidated financial statements, the extent to which the current macroeconomic environment may materially impact the Company's financial condition, liquidity, or results of operations remains uncertain.

Warrants (Tables)

12 Months Ended

Dec. 31, 2024

Other Liabilities Disclosure [Abstract]

Schedule of Warrants Issued and Outstanding

The table below summarizes common stock warrants issued and outstanding as of December 31, 2024 and 2023:


Date		Outstanding Balance at December 31, 2023	Price per Share	Warrants Issued	Warrant Exercised	Warrant Expired	Outstanding Balance at December 31, 2024
Issuance	Expiration
3/1/2017	3/1/2027	1,388	$5.94	—	—	—	1,388
11/26/2014	11/26/2024	6,680	$16.47	—	—	(6,680)	—
10/20/2015	10/20/2025	41,650	$16.47	—	—	—	41,650
11/09/2015	11/09/2025	25,709	$16.47	—	—	—	25,709
12/22/2016	12/22/2026	9,712	$10.03	—	—	—	9,712
		85,139		—	—	(6,680)	78,459

Stock-Based Compensation

12 Months Ended

Dec. 31, 2024

Share-Based Payment Arrangement [Abstract]

Stock-Based Compensation

2008 Stock Option Plan and 2018 Equity Incentive Plan

In April 2008, the Company adopted the 2008 Stock Option Plan (the “2008 SOP”), as amended, under which the Board of Directors may issue incentive and non-qualified stock options to employees, directors and consultants. In October 2018, the Company adopted the 2018 Equity Incentive Plan (the “2018 EIP”), which serves as the successor to the 2008 SOP, under which the Board of Directors may issue incentive and non-qualified stock options, RSUs and PSUs to employees, directors and consultants. No new options have been granted under the 2008 SOP since August 2018. Outstanding options under the 2008 SOP continue to be subject to the terms and conditions of that plan.

The number of shares of common stock reserved for issuance under the 2018 EIP will automatically increase on January 1 of each year, beginning January 1, 2019, and continuing through and including January 1, 2028, by 5% of the total number of shares of the Company's capital stock outstanding on December 31 of the preceding calendar year, or a lesser number of shares determined by the Company's Board of Directors. As of December 31, 2024, a total of 5,208,332 shares of common stock are available for future grants under the 2018 EIP. On January 1, 2025, the total number of shares of common stock reserved for issuance under the 2018 EIP automatically increased by 2,104,324 shares.

The Board of Directors has the authority to determine to whom options will be granted, the number of shares, the term and the exercise price. If an individual owns stock representing more than 10% of the outstanding shares, the price of each share shall be at least 110% of the fair market value, as determined by the Board of Directors. The exercise price of an incentive stock option and a non-qualified stock option shall not be less than 100% and 85%, respectively, of the fair market value on the date of grant.

Options granted have a term of 10 years, except, options granted to individuals holding more than 10% of the outstanding shares have a term of five years. Options generally vest over a four-year period. RSUs granted under the 2018 EIP generally vest over one to four years based upon continued services and are settled at vesting in shares of the Company's common stock.

Stock Options

The following table summarizes stock option activity for the years ended December 31, 2024 and 2023:


	Options Outstanding
	Number of Shares	Weighted-Average Exercise Price	Weighted-Average Contractual Remaining Life (Years)	Aggregate Intrinsic Value (in thousands)



Outstanding as of December 31, 2023	1,188,708	$10.14

Exercised	(143,685)	$3.96
Canceled and forfeited	(3,892)	$11.97
Outstanding as of December 31, 2024	1,041,131	$10.98	2.83	$	5,917
Options vested and exercisable as of December 31, 2024	1,041,131	$10.98	2.83	$	5,917
Options vested and expected to vest as of December 31, 2024	1,041,131	$10.98	2.83	$	5,917

The aggregate intrinsic value of options exercised during the years ended December 31, 2024, 2023 and 2022 amounted to $1.6 million, $11.7 million and $1.0 million, respectively, representing the difference between the fair value of the Company's common stock at the date of exercise and the exercise price paid. The aggregate intrinsic values of options outstanding, options vested and exercisable, and options vested and expected to vest as of December 31, 2024 represents the difference between the exercise price and the closing price of the Company’s common stock on the last trading day of the year.

Outstanding options and exercisable options information by range of exercise prices as of December 31, 2024 was as follows:


Exercise Price			Options Outstanding			Options Vested and Exercisable
			Number of Shares	Average Remaining Contractual Life (Years)	Weighted- Average Exercise Price	Number of Shares	Weighted- Average Exercise Price
$3.24	-	$4.41	246,331	1.45	$4.31	246,331	$4.31
$4.42	-	$5.31	287,641	2.31	$4.68	287,641	$4.68
$5.32	-	$18.10	194,938	3.42	$11.36	194,938	$11.36
$18.11	-	$20.51	16,627	4.09	$18.74	16,627	$18.74
$20.52	-	$22.00	295,594	4.04	$22.00	295,594	$22.00
			1,041,131	2.83	$10.98	1,041,131	$10.98

There were no stock options granted during the years ended December 31, 2024, 2023 and 2022.

As of December 31, 2024, there is no unrecognized compensation cost related to stock options.

Restricted Stock Units

Restricted stock units (“RSUs”) are share awards that entitle the holder to receive freely tradable shares of the Company’s common stock upon vesting. RSUs generally vest over one to four years based upon continued services and are settled at vesting in shares of the Company's common stock. The grant date fair value of the RSUs is equal to the closing price of the Company’s common stock on the grant date.

The Company has granted performance-based restricted stock unit awards subject to market and service vesting conditions to certain executive officers under SI-BONE's 2018 Equity Incentive Plan (“PSUs”). The shares subject to the PSUs vest over a three-year performance period. The actual number of PSUs that will vest in each measurement period will be determined by the Compensation Committee based on the Company’s total shareholder return (“TSR”) relative to the TSR of the Median Peer Companies (as defined in the award agreement). The grant date fair value of each stock award with a market condition was determined using the Monte Carlo valuation model. The table below summarizes the assumptions used to estimate the grant date fair value of the PSUs granted:


	Year Ended December 31,
						2024				2023				2022
Expected volatility of common stock				47.0%	to	59.0%		58.0%	to	73.0%		48.9%	to	58.7%
Expected volatility of peer companies						29.0%	to	97.0%		33.0%	to	141.0%		24.2%	to	152.5%
Correlation coefficient of peer companies				(0.01)	to	1.00		(0.15)	to	1.00		(0.13)	to	1.00
Risk-free interest rate						4.1%	to	4.7%		3.9%	to	5.0%		0.4%	to	1.2%
Dividend yield	0.6%	to	4.7%	—%	to	1.3%		—%	to	1.0%

The following table summarizes RSU and PSU activity for the years ended December 31, 2024 and 2023:


	RSUs		PSUs
	Number of Shares	Weighted- Average Grant Date Fair Value	Number of Shares	Weighted- Average Grant Date Fair Value




Outstanding as of December 31, 2023	1,899,790	$19.93	385,122	$14.74
Granted	1,116,364	$18.11	319,858	$18.48
Vested	(978,267)	$20.95	(94,439)	$16.27
Canceled and forfeited	(153,247)	$18.07	—	—
Outstanding as of December 31, 2024	1,884,640	$18.47	610,541	$16.47

As of December 31, 2024, the unrecognized compensation cost related to the RSUs was $27.1 million, which is expected to be recognized over a period of approximately 2.3 years. As of December 31, 2024, the unrecognized compensation cost related to the PSUs was $3.7 million, which is expected to be recognized over a period of approximately 1.8 years.

Employee Stock Purchase Plan

The Company’s 2018 Employee Stock Purchase Plan (the “ESPP”) allows eligible employees to purchase shares of the Company's common stock through payroll deductions at the price equal to 85% of the lesser of the fair market value of the stock as of the first date or the ending date of each six month offering period. The offering period generally commences in May and November. On March 26, 2020, the Company's Compensation Committee approved the amendment of the terms of future offerings under the ESPP which, among other things, increased the maximum number of shares that may be purchased on any single purchase date and provided for automatic enrollment in a new offering.

As of December 31, 2024, a total of 1,802,295 shares of common stock are available for future grants under the ESPP. On January 1, 2025, the total number of shares of common stock reserved for issuance under the ESPP Plan increased by 420,865 shares.

The fair value of the ESPP shares is estimated using the Black-Scholes option pricing model, which is being amortized over the requisite service period. The Company issued 176,787 shares, 178,918 shares, and 170,717 shares under the ESPP during the years ended December 31, 2024, 2023, and 2022, respectively, representing $2.2 million, $2.2 million, $1.8 million in employee contributions. For each of the years ended December 31, 2024 and 2023, total accumulated ESPP related employee payroll deductions amounted to $0.3 million and $0.4 million, respectively, which were included within accrued compensation and related expenses in the consolidated balance sheets. For the years ended December 31, 2024, 2023, and 2022, the Company recognized $0.9 million, $1.0 million, and $0.7 million, respectively, of stock-based compensation expense related to ESPP. As of December 31, 2024, the unrecognized compensation cost for the ESPP was $0.5 million.

The Company estimated the fair value of ESPP purchase rights during the offering period using a Black-Scholes option pricing model with the following assumptions:


	Year Ended December 31,
	2024			2023			2022
Expected term (years)	0.5			0.5			0.5
Expected volatility	41.9%	to	57.9%	41.9%	to	54.4%	49.5%	to	62.1%
Risk-free interest rate	4.44%	to	5.41%	5.26%	to	5.38%	0.07%	to	1.54%
Dividend yield	—%			—%			—%

Stock-Based Compensation

The following table sets forth stock-based compensation expense recognized for the periods presented:


	Year Ended December 31,
	2024		2023		2022
	(in thousands)
Cost of goods sold	$	932	$	672	$	484
Sales and marketing	$	10,654	10,931		11,006
Research and development	$	3,270	2,933		2,637
General and administrative	$	11,013	9,521		8,934
	$	25,869	$	24,057	$	23,061

Employee Benefit Plan	12 Months Ended
Employee Benefit Plan	Dec. 31, 2024
Retirement Benefits [Abstract]
Employee Benefit Plan	Employee Benefit PlanThe Company sponsors a 401(k) plan covering all employees. Contributions made by the Company are discretionary and are determined annually by the Board of Directors. Effective January 1, 2019, the Company made a discretionary matching contribution equal to dollar for dollar employee contribution, up to 3% eligible compensation of the employee, with a maximum annual contribution from the Company of one thousand dollars per employee. Further, in order for an employee to receive the matching contribution, the employee must be at least 21 years old, work at least 1,000 hours per year, and must be employed by the Company at the beginning through the end of the year.

- Definition

The entire disclosure for retirement benefits.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 70
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480794/715-70-50-1

Reference 2: http://www.xbrl.org/2003/role/exampleRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 17
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480482/715-20-55-17

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)(iv)(03)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480506/715-20-50-1

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)(i)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480506/715-20-50-1

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (q)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480506/715-20-50-1

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (l)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480506/715-20-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org/715/tableOfContent

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)(iii)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480506/715-20-50-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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-Section 50
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-Subparagraph (o)
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-URI https://asc.fasb.org/1943274/2147480506/715-20-50-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
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-Section 50
-Paragraph 1
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480506/715-20-50-1

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (r)(1)
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-URI https://asc.fasb.org/1943274/2147480506/715-20-50-1

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (r)(2)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480506/715-20-50-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480126/715-20-S99-2

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 60
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480266/715-60-50-3

+ Details

Income Taxes - Changes in Valuation Allowance (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Changes in Valuation Allowance
Valuation allowance, beginning balance	$ 107,210	$ 94,776	$ 78,786
Net changes during the period	6,012	12,434	15,990
Valuation allowance, ending balance	$ 113,222	$ 107,210	$ 94,776

Income Taxes - Components of Deferred Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Deferred tax expense:
Federal	$ (5,080)	$ (10,606)
State	(1,002)	(1,856)
Foreign	70	28
Total deferred income taxes	(6,012)	(12,434)
Net changes during the period	6,012	12,434	$ 15,990
Net deferred income tax	$ 0	$ 0

Income Taxes - Temporary Differences and Carryforwards and Deferred Tax Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Deferred Tax Assets
Net operating loss carryforwards	$ 89,592	$ 85,173
Research and development credits	6,279	5,342
Accruals and reserves	4,506	3,698
Interest limitation	2,584	4,378
Depreciation and amortization	144	474
Stock compensation	3,693	3,474
Operating lease liabilities	511	735
Capitalized research and development	6,413	4,614
Total deferred tax assets	113,722	107,888
Operating lease right-of-use assets	(500)	(678)
Total deferred tax liabilities	(500)	(678)
Less: Valuation allowance	(113,222)	(107,210)	$ (94,776)	$ (78,786)
Total deferred tax asset, net of valuation allowance	$ 0	$ 0

Related Party Transactions	12 Months Ended
Related Party Transactions	Dec. 31, 2024
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions On February 24, 2020, the Company entered into a joint development agreement (the “Development Agreement”) with SeaSpine Orthopedics Corporation (“SeaSpine”), which recently merged with Orthofix Medical, Inc. ("Orthofix"), to develop a next generation device for sacropelvic fixation. Mr. Keith Valentine, who serves as the President, Chief Executive Officer and a member of the board of directors of SeaSpine, also serves as a member of the Company's Board of Directors since August 2015. On April 27, 2021, Addendum No.1 to the Development Agreement was entered into by and between the Company and SeaSpine to extend certain obligations as described under the Development Agreement to a consultant of the Company. On October 4, 2023, Keith C. Valentine resigned as a member of the Board of Directors of Orthofix. As such, subsequent to October 4, 2023, SeaSpine is no longer a related party of the Company. Pursuant to the development plan, SeaSpine shall use reasonable efforts to assist in the development of the potential product offering, including licensing certain existing intellectual property to be incorporated into such product. Under the terms of the Development Agreement, the Company agreed to make monthly payments to SeaSpine to reimburse for full time resources employed by SeaSpine responsible to conduct the development activities. For the year ended December 31, 2023, the Company did not incur any reimbursement charges but purchased an immaterial amount of instrument components from Seaspine. For the year ended December 31, 2022, the Company expensed $38,725 of reimbursement charges from SeaSpine. The reimbursement charges were recorded within research and development expense in the consolidated statement of operations. Certain intellectual property developed pursuant to the project plan will be owned by the Company, certain intellectual property developed pursuant to the project plan will be owned by SeaSpine, and other intellectual property developed pursuant to the project plan will be jointly owned by SeaSpine and the Company. The Company also agreed to provide SeaSpine a royalty-free, worldwide, perpetual, non-exclusive license of certain of the Company's intellectual property incorporated into the product to be developed. The Company also agreed to pay SeaSpine a product royalty, in an amount specified in the Development Agreement, for each resulting product sold for a period of 10 years beginning on the initial market launch. The term of the Development Agreement shall continue until the expiration of all royalty terms, unless earlier terminated by either party, as provided for by the Development Agreement. The Company recorded $0.3 million of royalty for the year ended December 31, 2023. The Company recorded an immaterial amount of royalty for the year ended December 31, 2022. The outstanding liability to SeaSpine as of December 31, 2024 and December 31, 2023 was $0.2 million and $0.1 million, respectively, and was recorded within accounts payable and accrued liabilities and other in the consolidated balance sheet.

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480990/946-20-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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-Section 50
-Paragraph 5
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-URI https://asc.fasb.org/1943274/2147480990/946-20-50-5

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/1943274/2147480990/946-20-50-6

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Section 50
-Paragraph 2
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477968/946-235-50-2

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

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(g)(3))
-Publisher FASB
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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-Paragraph 1
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-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

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

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

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
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-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

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

+ Details

Borrowings

12 Months Ended

Dec. 31, 2024

Debt Disclosure [Abstract]

Borrowings

Term Loan

The following table summarizes the outstanding borrowings from the term loan as of the periods presented:


	December 31, 2024		December 31, 2023
	(in thousands)
Principal Outstanding	$	36,000	$	36,000
Final payment fee	—		720
Total Principal outstanding and final payment fee	36,000		36,720
Less: Unamortized debt issuance costs and lender fees	(548)		(655)

Outstanding debt, net of debt issuance costs and unaccreted value of final fee	$	35,452	$	36,065
Classified as:


Long-term borrowings	$	35,452	$	36,065

The outstanding debt is related to a Loan and Security Agreement dated August 12, 2021 (the "Original Loan Agreement") entered into by the Company with Silicon Valley Bank, a California corporation (“SVB”). Pursuant to the Original Loan Agreement, SVB provided a term loan in the aggregate principal amount of $35.0 million to the Company (the “Original Term Loan”).

On January 6, 2023, the Company entered into a First Amendment to Loan and Security Agreement with SVB pursuant to which the Company received a new term loan facility in an aggregate principal amount of $36.0 million (the "First Amendment" and with the Original Loan Agreement, collectively the "Amended Loan Agreement”). Upon entry into the Amended Loan Agreement, the Company borrowed $36.0 million pursuant to the term loan (the "First Amendment Term Loan"), which was substantially used to repay in full the $35.0 million Original Term Loan outstanding under the Original Loan Agreement and the Company obtained a secured revolving credit facility in an aggregate principal amount of up to $15.0 million (the “Revolving Line”). The First Amendment also provided for a final payment fee payable to SVB of 2% of the original principal amount of the First Amendment Term Loan due upon the earlier of the First Amendment Term Loan Maturity Date, termination of the Amended Loan Agreement, acceleration by the Lender following an event of default, or prepayment of the First Amendment Term Loan.

On January 25, 2024, the Company entered into a Second Amendment to Loan and Security Agreement with Silicon Valley Bank, a division of First-Citizens Bank & Trust Company, as successor in interest to SVB ("First Citizens") which amended the Company's Amended Loan Agreement (the “Second Amendment” and together with the Amended Loan Agreement, collectively, the “Second Amended Loan Agreement”). The Second Amendment revised certain provisions related to financial covenants and the periods in which such covenants applied.

On November 8, 2024, the Company entered into a Third Amendment to the Loan and Security Agreement with First-Citizens (the “Third Amendment” and together with the Second Amended Loan Agreement, collectively, the “Third Amended Loan Agreement”), pursuant to which a new term loan in the original aggregate principal amount of $36.0 million was extended by First-Citizens to the Company (the “Third Amendment Term Loan”), which was substantially used to refinance and repay in full the then-outstanding $36.0 million existing First Amendment Term Loan. The Company also paid a final payment fee of $0.7 million due relative to such prior First Amendment Term Loan. The Third Amendment sets the maturity date for the Third Amendment Term Loan as September 1, 2029 (the “Third Amendment Term Loan Maturity Date”), set the first principal repayment due date relative to the Third Amendment Term Loan to October 1, 2027; provided that upon the achievement of the Performance Milestone (as defined in the Third Amendment), the first principal payment shall become due on October 1, 2028. Interest on the Third Amendment Term Loan will be payable monthly at a floating rate per annum equal to the greater of 4.25% and the WSJ Prime Rate minus 0.5%. The Company may elect to prepay the Third Amendment Term Loan in whole prior to the Third Amendment Term Loan Term Loan Maturity Date, subject to a prepayment fee equal to 1.5% of the original principal amount of the Third Amendment Term Loan if the loan is prepaid within 18 months following the closing of the Third Amendment. The Third Amendment further revised certain provisions related to financial covenants and the periods in which such covenants apply.

The Company accounted for the Third Amended Loan Agreement as a debt modification. Accordingly, the remaining unamortized debt issuance costs related to the Second Amended Loan Agreement together with any lender fees incurred in connection with the entry of the Third Amended Loan Agreement are amortized to interest expense using the straight-line method over the new term of the loan through August 2029.

The effective interest rates were 9.1%, 9.0% and 7.8% for the years ended December 31, 2024, 2023, and 2022 respectively.

The table below summarizes the future principal payments under the Third Amendment Term Loan as of December 31, 2024:


Year ending December 31,	(in thousands)
2025	$	—
2026	—
2027	6,000
2028	18,000
2029	12,000
Total principal payments	$	36,000

The Third Amended Loan Agreement includes affirmative and negative covenants applicable to the Company and certain of its foreign subsidiaries. The affirmative covenants include, among others, covenants requiring the Company to maintain its legal existence and governmental compliance, deliver certain financial reports, and maintain insurance coverage. The negative covenants include, among others, restrictions regarding transferring collateral, pledging the Company's intellectual property to other parties, engaging in mergers or acquisitions, paying dividends or making other distributions, incurring indebtedness, transacting with affiliates, and entering into certain investments, in each case subject to certain exceptions. As of December 31, 2024, the Company was in compliance with all debt covenants.

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481544/470-10-50-6

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 10
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-Section 50
-Paragraph 6
-Subparagraph (a)
-Publisher FASB
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477092/405-40-50-1

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (a)(3)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477092/405-40-50-1

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477092/405-40-50-1

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 405
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477092/405-40-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 405
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-Name Accounting Standards Codification
-Section 50
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477092/405-40-50-1

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1B

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(c))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-1

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 470
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org/470/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482925/835-30-45-2

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Section 50
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1B

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1B

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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-Section 50
-Paragraph 1B
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-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1B

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
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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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-Publisher FASB
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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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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1I

+ Details

Commitments and Contingencies - Aggregate Future Minimum Lease Payments (Details) $ in Thousands	Dec. 31, 2024 USD ($)
Aggregate Future Minimum Lease Payments
2025	$ 1,238
2026	880
2027	21
2028	11
2029	0
Thereafter	0
Total operating lease payments	2,150
Less: imputed interest	(119)
Total operating lease liabilities	$ 2,031

Borrowings - Debt Maturity (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Future principal and final fee payments
2025	$ 0
2026	0
2027	6,000
2028	18,000
2029	12,000
Total principal payments	$ 36,000	$ 36,000

Commitments and Contingencies

12 Months Ended

Dec. 31, 2024

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

Operating Leases

The Company has a non-cancelable operating lease for an office building space, located in Santa Clara, California, with an original lease period expiring in May 2025. On July 18, 2024, the Company extended the term of the lease for an additional period of fourteen months commencing on June 1, 2025 and expiring July 31, 2026.

The Company also has non-cancelable leases for a building used for research and development and warehouse space in Santa Clara, California which expires in October 2026, and office building space in Gallarate, Italy which expires in August 2027.

The Company also leases vehicles under operating lease arrangements for certain of its personnel in Europe which expire at various times throughout 2025 to 2028.

Supplemental information related to lease expense and valuation of the lease assets and lease liabilities are as follows:


	December 31, 2024		December 31, 2023
	(in thousands)
Operating lease expense	$	1,379	$	1,552
Variable lease expense	667		465
Total lease expense	$	2,046	$	2,017

Cash paid for amounts included in the measurement of operating lease liabilities	$	1,558	$	1,632
Leased assets obtained in exchange for new operating lease liabilities	$	449	$	143

Weighted average remaining lease term (in years)	1.76		2.20
Weighted average discount rate	7.15%		5.87%

Future minimum lease payments under non-cancelable operating leases as of December 31, 2024 was as follows:


Year Ending December 31,	(in thousands)
2025	$	1,238
2026	880
2027	21
2028	11
2029	—
Thereafter	—
Total operating lease payments	$	2,150
Less: imputed interest	(119)
Total operating lease liabilities	$	2,031

As of December 31, 2024, the Company had no operating lease liabilities that had not commenced.

Purchase Commitments and Obligations

The Company has certain purchase commitments related to its inventory management with certain manufacturing suppliers based on the agreements or blanket purchase orders. The contractual obligations represent future cash commitments and liabilities under agreements with third parties and exclude orders for goods and services entered into in the normal course of business that are not enforceable or legally binding. These outstanding commitments amounted to $0.4 million and $0.4 million as of December 31, 2024 and 2023, respectively.

Indemnification

The Company enters into standard indemnification arrangements in the ordinary course of business. Pursuant to these arrangements, the Company indemnifies, holds harmless, and agrees to reimburse the indemnified parties for losses suffered or incurred by the indemnified party, in connection with any trade secret, copyright, patent or other intellectual property infringement claim by any third-party with respect to the Company’s technology. The term of these indemnification agreements is generally perpetual. The maximum potential amount of future payments the Company could be required to make under these agreements is not determinable because it involves claims that may be made against the Company in the future, but have not yet been made.

The Company has entered into indemnification agreements with its directors and officers that may require the Company to indemnify its directors and officers against liabilities that may arise by reason of their status or service as directors or officers, other than liabilities arising from willful misconduct of the individual.

The Company has not incurred costs to defend lawsuits or settle claims related to these indemnification agreements. No liability associated with such indemnifications has been recorded to date.

Legal Contingencies

In October 2024, the Company received a civil investigative demand (“CID”) from the U.S. Department of Justice, Civil Division, in connection with an investigation under the federal Anti-Kickback Statute and Civil False Claims Act (the “Investigation”). The CID requests information and documents primarily relating to meals and consulting service payments provided to health care professionals. The Company is cooperating with the Investigation but is currently unable to express a view regarding the likely duration, or ultimate outcome, of the Investigation or estimate the possibility of, or amount or range of, any possible financial impact. Depending on how the Investigation progresses, there may be a material impact on the Company’s business, results of operations, or financial condition.

From time to time, the Company may become involved in legal proceedings arising in the ordinary course of its business. Except in regard to the Investigation, the Company is not presently a party to any material legal proceedings that, if determined adversely to the Company, would have a material adverse effect on the Company.

Net Loss Per Share of Common Stock - Computation of Earnings Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Earnings Per Share [Abstract]
Net loss	$ (30,913)	$ (43,336)	$ (61,256)
Weighted-average shares used to compute basic net loss per share (in shares)	41,466,564	38,427,419	34,201,824
Weighted-average shares used to compute diluted net loss per share (in shares)	41,466,564	38,427,419	34,201,824
Net loss per share, basic (in dollars per share)	$ (0.75)	$ (1.13)	$ (1.79)
Net loss per share, diluted (in dollars per share)	$ (0.75)	$ (1.13)	$ (1.79)

- Definition

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

+ References

+ Details

- Definition

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.

+ References

+ Details

- Definition

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

+ References

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+ Details

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2024

Accounting Policies [Abstract]

Basis of Presentation

The accompanying consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“U.S. GAAP”).

Principles of Consolidation

The consolidated financial statements include the Company's accounts, as well as those of the Company's wholly-owned international subsidiaries. All inter-company accounts and transactions have been eliminated.

Use of Estimates and Change in accounting estimate

Use of Estimates

The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. Significant accounting estimates and management judgments reflected in the consolidated financial statements primarily includes the fair value of performance-based restricted stock unit awards. Estimates are based on historical experience, where applicable and other assumptions believed to be reasonable by the management. Actual results could differ from those estimates.

Change in accounting estimate

During the first quarter of 2024, the Company reassessed the useful life of its instrument trays based on a comprehensive evaluation of usage trends and its estimate on the average life of instruments before loss or damage that requires disposal. As a result of this review, the Company determined that extending the useful life of its instrument trays would more accurately reflect its anticipated future economic benefits. Effective January 1, 2024, the Company changed its estimates of the useful lives of instrument trays from three to five years.

Segments

The Company's chief operating decision makers ("CODMs") are the Chief Executive Officer and Chief Financial Officer. The Company has determined that it has a single operating and reportable segment. The CODMs use revenue and net loss at the consolidated level to measure segment profit and loss, allocate resources, monitor plan versus actual results, and manage operations. Significant expenses within net loss include cost of goods sold, sales and marketing, research and development, and general and

administrative at the consolidated level. Other segment items within net loss include interest income, interest expense, and other income (expense), net.

Substantially all of the segment revenue is derived from sales to customers in the United States. Descriptions of segment products are included in Note 1. The Company and Nature of Business. Revenue by geography is based on billing address of the customer. International revenue accounted for less than 10% of the total revenue during the periods presented. Long-lived assets held outside the United States are immaterial.

Foreign Currency

The Company’s foreign subsidiaries use local currency as their functional currency. Assets and liabilities are translated at exchange rates prevailing at the balance sheet dates. Revenue, costs and expenses are translated into U.S. dollars using average exchange rates for the period. Gains and losses from foreign currency translation are recorded as a component of accumulated other comprehensive income (loss). Gains and losses from foreign currency transactions are recognized as a component of other income (expense), net.

Concentration of Credit Risk

Financial instruments that potentially subject the Company to a concentration of credit risk consist of cash and marketable securities. The Company’s cash and marketable securities are deposited with financial institutions in the United States and in Europe. The majority of the Company’s cash and marketable securities are deposited with a single financial institution in the United States. Deposits in this institution exceed the amount of insurance provided on such deposits. The Company has not experienced any net losses on its deposits of cash and marketable securities.

Fair Value of Financial Instruments

Carrying amounts of certain of the Company’s financial instruments, including cash equivalents, accounts receivable, accounts payable, and accrued liabilities, approximate fair value due to their relatively short maturities and market interest rates, if applicable. The Company's marketable securities are classified as Level 1 or Level 2 of the fair value hierarchy as defined below. The carrying value of the Company’s long-term debt also approximates fair value based on management’s estimation that a current interest rate would not differ materially from the stated rate.

The Company discloses and recognizes the fair value of its assets and liabilities using a hierarchy that prioritizes the inputs to valuation techniques used to measure fair value. Fair value is an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, a three-tier value hierarchy has been established, which prioritizes the inputs used in measuring fair value as follows:

Level 1: Quoted prices (unadjusted) in active market that are accessible at measurement date for assets or liabilities. The fair value hierarchy gives the highest priority to Level 1 inputs.

Level 2: Observable prices that are based on inputs not quoted on active markets, but corroborated by market data.

Level 3: Unobservable inputs are used when little or no market data is available. The fair value hierarchy gives the lowest priority to Level 3 inputs.

Assets and liabilities measured at fair value are classified in their entirety based on the lowest level of input that is significant to the fair value measurement. The Company’s assessment of the significance of a particular input to the fair value measurement in its entirety requires management to make judgments and considers factors specific to the asset or liability.

Cash and Cash Equivalents

The Company considers all highly liquid investments with remaining maturities at the date of purchase of three months or less to be cash equivalents.

Marketable Securities

The Company's marketable securities primarily consist of investments in money market funds, U.S. treasury securities and U.S. agency bonds. All of the Company's marketable securities are available-for-sale debt securities and are classified based on their maturities. Marketable securities with remaining maturities at the date of purchase of three months or less are classified as cash equivalents. Short term investments are securities that original or remaining maturity is greater than three months and not more than twelve months. Long-term investments are securities that original or remaining maturity is more than twelve months. All marketable securities are recorded at their estimated fair value. When the fair value of a security is below its amortized cost, the amortized cost will be reduced to its fair value if it is more likely than not that the Company will be required to sell the potentially impaired security before recovery of its amortized cost basis, or the Company has the intention to sell the security. If neither of these conditions are met, the Company determines whether the impairment is due to credit losses by comparing the present value of the expected cash flows of the security with its amortized cost basis. The amount of impairment recognized is limited to the excess of the amortized cost over the fair value of the security. An allowance for credit losses for the excess of amortized cost over the expected cash flows is recorded in other income, net in the consolidated statements of operations. Impairment losses that are not credit-related are included in accumulated other comprehensive income (loss) in stockholders’ equity.

Accounts Receivable and Allowance for Credit Losses

Accounts Receivable and Allowance for Credit LossesTrade accounts receivable are recorded at the invoiced amount, net of allowances for credit losses for any potential uncollectible amounts. The allowance for credit losses is based on our assessment of the collectability of accounts. Management regularly reviews the adequacy of the allowance for credit losses on a collective basis by considering the age of each outstanding invoice, each customer’s expected ability to pay and collection history, current market conditions, and reasonable and supportable forecasts of future economic conditions to determine whether the allowance is appropriate. Accounts receivable are written-off and charged against an allowance for credit losses when the Company has exhausted collection efforts without success.

Inventory

Inventory is stated at lower of cost or net realizable value. The Company establishes the inventory basis by determining the cost based on standard costs approximating the purchase costs on a first-in, first-out basis. The excess and obsolete inventory is estimated based on future demand and market conditions. Inventory write-downs are charged to cost of goods sold.

Property and Equipment

Property and equipment are stated at cost less accumulated depreciation and amortization. All property and equipment is depreciated on a straight-line basis over the estimated useful lives of the assets, which are as follows:


Computer and office equipment			3 – 5 years
Instrument trays			5 years
Machinery and equipment			3 – 5 years
Furniture and fixtures			7 years
Leasehold Improvement			Lesser of estimated useful life or remaining lease term

Construction in progress includes the cost of individual components of an instrument tray used for surgical placement of the Company's products that have not yet been placed into service. Once an instrument tray is placed into service, the Company transfers its carrying value into instrument trays and begins depreciating the cost of the instrument tray over its useful life. Individual components within an instrument tray may require replacement due to normal wear and tear or periodic loss.

When an impairment or disposal of individual components or instrument trays occurs, the cost and related accumulated depreciation are removed from the consolidated balance sheet and the resulting gain or loss is recognized as a component of cost of goods sold in the consolidated statements of operations and comprehensive loss. Maintenance and repairs are charged to operations as incurred.

Impairment of Long-Lived Assets

The Company reviews long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of the assets (or asset group) may not be fully recoverable. Whenever events or changes in circumstances suggest that the carrying amount of long-lived assets may not be recoverable, the Company estimates the future cash flows expected to be generated by the assets (or asset group) from its use or eventual disposition. If the sum of the expected future cash flows is less than the carrying amount of those assets, the Company recognizes an impairment loss based on the excess of the carrying amount over the fair value of the assets. Significant management judgment is required in the grouping of long-lived assets and forecasts of future operating results that are used in the discounted cash flow method of valuation.

Leases

The Company determines if an arrangement is a lease at inception. The classification of leases is evaluated at commencement and, as necessary, at modification. Operating leases are included in operating lease right-of-use assets and operating lease liabilities on the consolidated balance sheets. The Company does not have any material finance leases in any of the periods presented.

Operating lease expense is recognized on a straight-line basis over the term of the lease. Variable lease payments are recognized as operating expenses in the period in which the obligation for those payments is incurred. Variable lease payments primarily include common area maintenance, utilities, real estate taxes and other operating costs that are passed on from the lessor in proportion to the space leased by the Company. The lease term represents the non-cancelable period of the lease. For certain leases, the Company has an option to extend the lease term. These renewal options are not considered in the remaining lease term unless it is reasonably certain that the Company will exercise such options.

The Company elected certain practical expedients which are: (i) to not record leases with an initial term of twelve months or less on the balance sheet; (ii) to combine the lease and non-lease components in determining the lease liabilities and right-of-use assets, and (iii) to carry forward prior conclusions about lease identification and classification. The Company’s lease contracts do not provide an implicit borrowing rate; hence the Company determined the incremental borrowing rate based on information available at lease commencement to determine the present value of lease liability. The Company determines its incremental borrowing rate based on the rate of interest that the Company would have to pay to borrow on a collateralized basis over a similar term, an amount equal to the

lease payments in a similar economic environment. The Company uses its headquarters in the United States ("parent entity")’s incremental borrowing rates as the treasury operations are managed centrally by the parent entity.

Revenue Recognition

The Company’s revenue is derived from the sale of its products to medical groups and hospitals through its direct sales force and third-party sales agents and resellers throughout the United States and Europe. The Company receives payment for its implants consumed during the surgery and does not receive additional or separate consideration for the use of the instrument tray furnished by the Company for the physicians’ use. The Company identifies the instrument trays as a lease component and the implants as a non-lease component in its arrangements with its customers. The Company determines that the non-lease component is qualitatively predominant, and as such, elected the practical expedient to not separate the lease and non-lease components. Therefore, the overall arrangement is accounted for under Accounting Standards Codification (“ASC”) 606, Revenue from Contracts with Customers (“ASC 606”).

In accordance with ASC 606, the Company recognizes revenue when control is transferred to the customer, in an amount that reflects the consideration the Company expects to be entitled to in exchange for the goods or services. Under the revenue recognition standard, the Company applies the following five step approach: (1) identify the contract with a customer, (2) identify the performance obligations in the contract, (3) determine the transaction price, (4) allocate the transaction price to the performance obligations in the contract, and (5) recognize revenue when a performance obligation is satisfied. As it relates to product sales where the Company's sales representative delivers the product at the point of implantation at the hospital or medical facilities, the Company continues to recognize the revenue upon completion of the procedure and authorization by the customer, net of rebates and price discounts. This represents the majority of the Company's consolidated revenue. The Company also generates a small portion of revenue from the sale of products through third-party sales agents and to certain hospital or medical facilities where the products are ordered in advance of a procedure. The performance obligation is the delivery of the products and therefore, revenue is recognized upon shipment to the customers, net of rebates and price discounts. The Company accounts for rebates and price discounts as a reduction to revenue, calculated based on the terms agreed to with the customer. Sales prices are specified in either the customer contract or agreed price list, which is executed prior to the transfer of control to the customer. For certain hospitals and medical facilities, the Company has agreements in place consists of either a master services agreement or an agreed price list, which defines the terms and conditions of the arrangement, including the pricing information, payment terms and pertinent aspects of the relationship between the parties. The Company also has agreements in place with its distributors, which include standard terms that do not allow for payment contingent on resale of the product, obtaining financing, or other terms that could impact the distributor’s payment obligation. The Company's standard payment terms are generally net 30 to 90 days.

Shipping and Handling Costs

Shipping and handling costs are treated as fulfillment costs, which are expensed as incurred and are included in cost of goods sold.

Costs to Obtain Customer Contracts

Sales commissions and related expenses are considered incremental and recoverable costs of acquiring customer contracts. The Company’s sales commissions paid to its sales representatives are generally based on the surgeries performed. The Company applied the practical expedient that permits an entity to expense the cost to obtain a contract as incurred when the expected amortization is one

year or less. The period of benefit is concurrent with when the Company recognizes its revenue and as such, the Company recognizes sales commissions as expense when incurred.

Warranty

The Company has a warranty program that provides a purchaser a one-time replacement of any iFuse implant at no additional cost for a revision procedure within a one-year period following the original procedure and is accounted for as a warranty accrual. The Company also provides a purchaser with a one-time credit equal to the purchase price paid for use on future purchases for any revision procedure within the one-year period following an original procedure where an implant is not required. The warranty is not priced or sold separately and is intended to safeguard the customer against defects and it does not provide incremental service to the customer. As such, it is considered an assurance type warranty and is not accounted as a service type warranty, which could represent a separate performance obligation. The Company accounts for these one-time credits as sales reserves and is included in accrued liabilities and other in the consolidated balance sheets.

Research and Development

Research and development costs are charged to operations as incurred and consist of costs incurred by the Company for the development of the Company’s product which primarily include: (1) employee-related expenses, including salaries, benefits, travel and stock-based compensation expense; (2) external research and development expenses; and (3) other expenses, which include direct and allocated expenses for facilities and other costs.

Advertising Expenditures

The cost of advertising is expensed as incurred and is included under sales and marketing expense in the consolidated statements of operations.

Loss Contingency

The Company is subject to various potential loss contingencies arising in the ordinary course of business. From time to time, the Company may be involved in certain proceedings, legal actions and claims. Such matters are subject to many uncertainties, and the outcomes of these matters are not within the Company's control and may not be known for prolonged periods of time. In some actions, the claimants may seek damages, as well as other relief, including injunctions which may prohibit the Company to engage in certain activities, which, if granted, could require significant expenditures and/or result in lost revenues. The Company records a liability in the consolidated financial statements when a loss is known or considered probable and the amount can be reasonably estimated. If the reasonable estimate of a known or probable loss is a range, and no amount within the range is a better estimate than any other, the minimum amount of the range is accrued. If a loss is reasonably possible but not known or probable, and can be reasonably estimated, the estimated loss or range of loss is disclosed. In most cases, significant judgment is required to estimate the amount and timing of a loss to be recorded.

Stock-Based Compensation

The Company applies the fair value recognition provisions of stock-based compensation. Stock-based compensation expense is recognized over the requisite service period using the straight-line method and is based on the value of the portion of stock-based payment awards that is ultimately expected to vest. As such, the Company’s stock-based compensation is reduced for the estimated forfeitures at the date of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. The Company uses historical data to estimate pre-vesting forfeitures and record stock-based compensation expense only for those awards that are expected to vest. To the extent actual forfeitures differ from the estimates, the difference will be recorded as a cumulative adjustment in the period that the estimates are revised.

The Company estimates the grant date fair value of stock options using the Black-Scholes option valuation model. The model requires management to make a number of assumptions including expected volatility, expected term, risk-free interest rate and expected dividends. A number of these assumptions are subjective, and their determination generally require judgment.

•Expected Term - The expected term represents the period that the share-based awards are expected to be outstanding. The Company uses the simplified method to determine the expected term as permitted by the guidance. The simplified method is calculated as the average of the time to vesting and the contractual life of the options.

•Expected Volatility - The expected volatility is measured using the historical daily changes in the market price of the Company's

common stock over a period consistent with the expected term.

•Risk-Free Interest Rate - The risk-free interest rate is based on the U.S. Treasury zero coupon issued in effect at the time of grant for periods corresponding with the expected term of the option.

•Dividend Yield - The Company has not paid any dividends and has no current plans to pay dividends on its common stock. As such, the Company uses expected dividend yield of zero.

The fair value of the restricted stock unit (“RSU”) grant is based on the market price of the Company’s common stock on the date of grant.

The Company grants restricted stock unit awards subject to market and service vesting conditions to certain executive officers. This type of grant consists of the right to receive shares of common stock, subject to achievement of time-based criteria and certain market-related performance goals over a specified period, as established by the Compensation Committee of the Company’s Board of Directors. For these awards that are subject to market-related performance, the fair value is determined based on the number of shares granted and a Monte Carlo valuation model, which incorporates the probability of the achievement of the market-related performance goals as part of the grant date fair value. If such performance goals are not ultimately met, the expense is not reversed. Stock-based compensation expense is recognized ratably over the requisite service period.

In the event the underlying terms of stock awards are modified on which stock-based compensation was granted, additional expense is recognized for any modification that increases the total fair value of the share-based payment arrangement at the modification date.

Income Taxes

The Company accounts for income taxes under the asset and liability method, whereby deferred tax assets and liabilities are determined based on the difference between the financial statement and tax bases of assets and liabilities using the enacted tax rates in effect for the year in which the differences are expected to affect taxable income. A valuation allowance is established when necessary to reduce deferred tax assets to the amounts expected to be realized.

The Company recognizes uncertain tax positions when it meets a more-likely-than-not threshold. The Company recognizes potential accrued interest and penalties related to unrecognized tax benefits as income tax expense.

Net Loss per Share of Common Stock

Basic net loss per common share is calculated by dividing the net loss by the weighted-average number of common shares outstanding during the period, without consideration for potentially dilutive securities. Diluted net loss per share is computed by dividing the net loss by the weighted-average number of common shares and potentially dilutive securities outstanding for the period. For purposes of the diluted net loss per share calculation, common stock options, restricted stock units, ESPP purchase rights and warrants are considered to be potentially dilutive securities. Because the Company has reported a net loss in all periods presented, common stock options, restricted stock units, ESPP purchase rights and warrants are anti-dilutive, therefore diluted net loss per common share is the same as basic net loss per common share for those periods.

Comprehensive Loss

Comprehensive loss represents changes in the stockholders’ equity except those resulting from distributions to stockholders. The Company’s unrealized foreign currency translation income (losses) and unrealized gains (losses) on marketable securities represent the

two components of other comprehensive income that are excluded from the reported net loss for each of the reporting periods and has been presented in the consolidated statements of operations and comprehensive loss.

Warrants

The Company accounts for warrants for shares of common stock as equity in accordance with the accounting guidance for derivatives. The accounting guidance provides a scope exception from classifying and measuring as a financial liability a contract that would otherwise meet the definition of a derivative if the contract is both (i) indexed to the entity’s own stock and (ii) classified in the stockholders’ equity section of the consolidated balance sheet. The Company determined that the warrants for shares of common stock issued in connection with its prior debt arrangements are required to be classified in equity. Warrants classified as equity are recorded as additional paid-in capital on the consolidated balance sheet and no further adjustments to their valuation are made.

Recently Issued Accounting Standards Not Yet Adopted

In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures ("ASU 2023-09"). ASU 2023-09 requires public business entities to disclose additional information in specified categories with respect to the reconciliation of the effective tax rate to the statutory rate (the rate reconciliation) for federal, state, and foreign income taxes. It also requires greater detail about individual reconciling items in the rate reconciliation to the extent the impact of those items exceeds a specified threshold. ASU 2023-09 is effective for fiscal years beginning after December 15, 2024. The Company is currently evaluating the impacts of ASU 2023-09 on its disclosures.

In November 2024, the FASB issued ASU 2024-03, Income Statement-Reporting Comprehensive Income-Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses (“ASU 2024-03”). ASU 2024-03 requires disclosure in the notes to the financial statements of specified information about certain costs and expenses. ASU 2024-03 is effective for fiscal years beginning after December 15, 2026 and for interim periods within fiscal years beginning after December 15, 2027. ASU 2024-03 should be applied either prospectively to financial statements issued for reporting periods after the effective date of this ASU or retrospectively to any or all prior periods presented in the financial statements. The Company is currently evaluating the impact of ASU 2024-03 on its disclosures.

Income Taxes - Components of Loss Before Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Components of loss before income taxes
Domestic	$ (31,082)	$ (43,491)	$ (61,396)
Foreign	169	155	140
Net loss	$ (30,913)	$ (43,336)	$ (61,256)

- Definition

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

+ References

+ Details

Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2024

Accounting Policies [Abstract]

Schedule of Revenue by Geography

The following table summarizes the Company's revenue by geography:


	Year Ended December 31,
	2024		2023		2022
	(in thousands)
United States	$	158,416	$	130,621	$	98,751
International	8,762		8,265		7,658
	$	167,178	$	138,886	$	106,409

Schedule of Allowance for Credit Losses Movement

The movement in the allowance for credit losses was as follows:


	Year ended December 31,
	2024		2023		2022
	(in thousands)
Balance at beginning of year	$	1,118	$	400	$	264
Provision	470		761		150
Write-offs	(1,000)		(43)		(14)
Balance at end of year	$	588	$	1,118	$	400

Schedule of Property and Equipment

All property and equipment is depreciated on a straight-line basis over the estimated useful lives of the assets, which are as follows:


Computer and office equipment			3 – 5 years
Instrument trays			5 years
Machinery and equipment			3 – 5 years
Furniture and fixtures			7 years
Leasehold Improvement			Lesser of estimated useful life or remaining lease term

Property and Equipment, net:


	December 31, 2024		December 31, 2023
	(in thousands)
Instrument trays	$	23,158	$	18,205
Machinery and equipment	3,188		3,067
Construction in progress	6,212		3,856
Computer and office equipment	3,098		1,856
Leasehold improvements	3,873		3,873
Furniture and fixtures	386		389
	39,915		31,246
Less: Accumulated depreciation and amortization	(19,541)		(15,246)
	$	20,374	$	16,000

Marketable Securities - Schedule of Marketable Securities (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Cash equivalents
Carrying value	$ 27,326	$ 23,331
Short-term investments
Amortized Cost	115,004	132,683
Unrealized Gains	92	67
Unrealized Losses	(2)	(2)
Aggregate Fair Value	115,094	132,748
Total marketable securities, amortized cost	142,330	156,014
Total marketable securities, aggregate fair value	142,420	156,079
Money market funds
Cash equivalents
Carrying value	27,326	23,331
U.S. treasury securities
Short-term investments
Amortized Cost	112,649	129,695
Unrealized Gains	91	67
Unrealized Losses	(2)	0
Aggregate Fair Value	112,738	129,762
U.S. agency bonds
Short-term investments
Amortized Cost	2,355	2,988
Unrealized Gains	1	0
Unrealized Losses	0	(2)
Aggregate Fair Value	$ 2,356	$ 2,986

Summary of Significant Accounting Policies - Schedule of Property and Equipment (Details)	Dec. 31, 2024	Jan. 01, 2024	Dec. 31, 2023
Computer and office equipment \| Minimum
Property, Plant and Equipment [Line Items]
Estimated useful life	3 years
Computer and office equipment \| Maximum
Property, Plant and Equipment [Line Items]
Estimated useful life	5 years
Instrument trays
Property, Plant and Equipment [Line Items]
Estimated useful life	5 years	5 years	3 years
Machinery and equipment \| Minimum
Property, Plant and Equipment [Line Items]
Estimated useful life	3 years
Machinery and equipment \| Maximum
Property, Plant and Equipment [Line Items]
Estimated useful life	5 years
Furniture and fixtures
Property, Plant and Equipment [Line Items]
Estimated useful life	7 years

Audit Information	12 Months Ended
Audit Information	Dec. 31, 2024
Audit Information [Abstract]
Auditor Firm ID	238
Auditor Name	PricewaterhouseCoopers LLP
Auditor Location	San Jose, California

Common and Preferred Stock - Narrative (Details) - $ / shares	12 Months Ended
	Dec. 31, 2024	Jun. 30, 2024	Dec. 31, 2023
Equity [Abstract]
Common stock authorized (in shares)	100,000,000	100,000,000	100,000,000
Preferred stock authorized (in shares)	5,000,000	5,000,000	5,000,000
Common stock, par value (in dollars per share)	$ 0.0001	$ 0.0001	$ 0.0001
Preferred stock, par value (in dollars per share)	$ 0.0001	$ 0.0001	$ 0.0001
Common stock issued (in shares)	42,086,477		40,693,299
Common stock outstanding (in shares)	42,086,477		40,693,299
Preferred stock issued (in shares)	0		0
Preferred stock outstanding (in shares)	0		0
Common stock, dividends declared (in dollars per share)	$ 0

Income Taxes - Uncertain Income Tax Positions (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Uncertain income tax positions [Roll Forward]
Balance at beginning of the year	$ 2,629	$ 2,944	$ 2,655
Increases related to tax positions taken prior to current year	(43)	(726)	(12)
Increases related to current year's tax positions	438	411	301
Balance at end of the year	$ 3,024	$ 2,629	$ 2,944

Marketable Securities (Tables)

12 Months Ended

Dec. 31, 2024

Investments, Debt and Equity Securities [Abstract]

Schedule of Marketable Securities

The table below summarizes the marketable securities:


	December 31, 2024
	Amortized Cost		Unrealized Gains		Unrealized Losses		Aggregate Fair Value
	(in thousands)
Money market funds	$	27,326	$	—	$	—	$	27,326


Cash equivalents	27,326		—		—		27,326

U.S. treasury securities	112,649		91		(2)		112,738
U.S. agency bonds	2,355		1		—		2,356


Short-term investments	115,004		92		(2)		115,094



Total marketable securities	$	142,330	$	92	$	(2)	$	142,420


	December 31, 2023
	Amortized Cost		Unrealized Gains		Unrealized Losses		Aggregate Fair Value
	(in thousands)
Money market funds	$	23,331	$	—	$	—	$	23,331

Cash equivalents	23,331		—		—		23,331

U.S. treasury securities	129,695		67		—		129,762
U.S. agency bonds	2,988		—		(2)		2,986
Short-term investments	132,683		67		(2)		132,748



Total marketable securities	$	156,014	$	67	$	(2)	$	156,079

Warrants

12 Months Ended

Dec. 31, 2024

Other Liabilities Disclosure [Abstract]

Warrants

In 2023, a warrant holder exercised warrants, and the Company issued 22,603 net shares of common stock through a cashless exercise of the warrants in accordance with the conversion terms. The table below summarizes common stock warrants issued and outstanding as of December 31, 2024 and 2023:


Date		Outstanding Balance at December 31, 2023	Price per Share	Warrants Issued	Warrant Exercised	Warrant Expired	Outstanding Balance at December 31, 2024
Issuance	Expiration
3/1/2017	3/1/2027	1,388	$5.94	—	—	—	1,388
11/26/2014	11/26/2024	6,680	$16.47	—	—	(6,680)	—
10/20/2015	10/20/2025	41,650	$16.47	—	—	—	41,650
11/09/2015	11/09/2025	25,709	$16.47	—	—	—	25,709
12/22/2016	12/22/2026	9,712	$10.03	—	—	—	9,712
		85,139		—	—	(6,680)	78,459

Fair Value Measurement

12 Months Ended

Dec. 31, 2024

Fair Value Disclosures [Abstract]

Fair Value Measurement

Carrying amounts of certain of the Company’s financial instruments, including cash equivalents, accounts receivable, accounts payable and accrued liabilities, approximate fair value due to their relatively short maturities and market interest rates, if applicable. The carrying value of the Company’s long-term debt also approximates fair value based on management’s estimation that a current interest rate would not differ materially from the stated rate. There were no other financial assets and liabilities that requires fair value hierarchy measurements and disclosures for the periods presented.

The table below summarizes the fair value of the Company’s marketable securities measured at fair value on a recurring basis based on the three-tier fair value hierarchy:


	December 31, 2024
	Level 1		Level 2		Level 3		Total
	(in thousands)
Marketable securities
Money market funds	$	27,326	$	—	$	—	$	27,326
U.S. treasury securities	112,738		—		—		112,738
U.S. agency bonds	—		2,356		—		2,356


Total marketable securities	$	140,064	$	2,356	$	—	$	142,420

	December 31, 2023
	Level 1		Level 2		Level 3		Total
	(in thousands)
Marketable securities
Money market funds	$	23,331	$	—	$	—	$	23,331
U.S. treasury securities	129,762		—		—		129,762
U.S. agency bonds	—		2,986		—		2,986
Total marketable securities	$	153,093	$	2,986	$	—	$	156,079

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 107
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482078/820-10-55-107

Reference 2: http://www.xbrl.org/2003/role/exampleRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 100
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482078/820-10-55-100

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)(3)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6A
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-6A

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2E
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2E

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6A
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-6A

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6A
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-6A

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
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-Name Accounting Standards Codification
-Section 50
-Paragraph 6A
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-6A

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6A
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-6A

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 940
-SubTopic 820
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478119/940-820-50-1

+ Details

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Pay vs Performance Disclosure
Net loss	$ (30,913)	$ (43,336)	$ (61,256)

- Definition

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

+ References

+ Details

Stock-Based Compensation (Tables)

12 Months Ended

Dec. 31, 2024

Share-Based Payment Arrangement [Abstract]

Schedule of Stock Option Activity

The following table summarizes stock option activity for the years ended December 31, 2024 and 2023:


	Options Outstanding
	Number of Shares	Weighted-Average Exercise Price	Weighted-Average Contractual Remaining Life (Years)	Aggregate Intrinsic Value (in thousands)



Outstanding as of December 31, 2023	1,188,708	$10.14

Exercised	(143,685)	$3.96
Canceled and forfeited	(3,892)	$11.97
Outstanding as of December 31, 2024	1,041,131	$10.98	2.83	$	5,917
Options vested and exercisable as of December 31, 2024	1,041,131	$10.98	2.83	$	5,917
Options vested and expected to vest as of December 31, 2024	1,041,131	$10.98	2.83	$	5,917

Schedule of Options by Range of Exercise Price

Outstanding options and exercisable options information by range of exercise prices as of December 31, 2024 was as follows:


Exercise Price			Options Outstanding			Options Vested and Exercisable
			Number of Shares	Average Remaining Contractual Life (Years)	Weighted- Average Exercise Price	Number of Shares	Weighted- Average Exercise Price
$3.24	-	$4.41	246,331	1.45	$4.31	246,331	$4.31
$4.42	-	$5.31	287,641	2.31	$4.68	287,641	$4.68
$5.32	-	$18.10	194,938	3.42	$11.36	194,938	$11.36
$18.11	-	$20.51	16,627	4.09	$18.74	16,627	$18.74
$20.52	-	$22.00	295,594	4.04	$22.00	295,594	$22.00
			1,041,131	2.83	$10.98	1,041,131	$10.98

Schedule of Valuation Assumptions Related to Stock Option Awards

The table below summarizes the assumptions used to estimate the grant date fair value of the PSUs granted:


	Year Ended December 31,
						2024				2023				2022
Expected volatility of common stock				47.0%	to	59.0%		58.0%	to	73.0%		48.9%	to	58.7%
Expected volatility of peer companies						29.0%	to	97.0%		33.0%	to	141.0%		24.2%	to	152.5%
Correlation coefficient of peer companies				(0.01)	to	1.00		(0.15)	to	1.00		(0.13)	to	1.00
Risk-free interest rate						4.1%	to	4.7%		3.9%	to	5.0%		0.4%	to	1.2%
Dividend yield	0.6%	to	4.7%	—%	to	1.3%		—%	to	1.0%

Schedule of Restricted Stock Unit Activity

The following table summarizes RSU and PSU activity for the years ended December 31, 2024 and 2023:


	RSUs		PSUs
	Number of Shares	Weighted- Average Grant Date Fair Value	Number of Shares	Weighted- Average Grant Date Fair Value




Outstanding as of December 31, 2023	1,899,790	$19.93	385,122	$14.74
Granted	1,116,364	$18.11	319,858	$18.48
Vested	(978,267)	$20.95	(94,439)	$16.27
Canceled and forfeited	(153,247)	$18.07	—	—
Outstanding as of December 31, 2024	1,884,640	$18.47	610,541	$16.47

Schedule of Valuation Assumptions Related to ESPP Purchase Rights

The Company estimated the fair value of ESPP purchase rights during the offering period using a Black-Scholes option pricing model with the following assumptions:


	Year Ended December 31,
	2024			2023			2022
Expected term (years)	0.5			0.5			0.5
Expected volatility	41.9%	to	57.9%	41.9%	to	54.4%	49.5%	to	62.1%
Risk-free interest rate	4.44%	to	5.41%	5.26%	to	5.38%	0.07%	to	1.54%
Dividend yield	—%			—%			—%

Schedule of Stock-Based Compensation Expense

Stock-Based Compensation

The following table sets forth stock-based compensation expense recognized for the periods presented:


	Year Ended December 31,
	2024		2023		2022
	(in thousands)
Cost of goods sold	$	932	$	672	$	484
Sales and marketing	$	10,654	10,931		11,006
Research and development	$	3,270	2,933		2,637
General and administrative	$	11,013	9,521		8,934
	$	25,869	$	24,057	$	23,061

Stock-Based Compensation - Restricted Stock Unit Activity (Details)	12 Months Ended
	Dec. 31, 2024 $ / shares shares
Restricted Stock Units
Number of Shares
Beginning balance (in shares) \| shares	1,899,790
Granted (in shares) \| shares	1,116,364
Vested (in shares) \| shares	(978,267)
Canceled and forfeited (in shares) \| shares	(153,247)
Ending balance (in shares) \| shares	1,884,640
Weighted- Average Grant Date Fair Value
Beginning balance (in dollars per share) \| $ / shares	$ 19.93
Granted (in dollars per share) \| $ / shares	18.11
Vested (in dollars per share) \| $ / shares	20.95
Canceled and forfeited (in dollars per share) \| $ / shares	18.07
Ending balance (in dollars per share) \| $ / shares	$ 18.47
Performance Shares
Number of Shares
Beginning balance (in shares) \| shares	385,122
Granted (in shares) \| shares	319,858
Vested (in shares) \| shares	(94,439)
Canceled and forfeited (in shares) \| shares	0
Ending balance (in shares) \| shares	610,541
Weighted- Average Grant Date Fair Value
Beginning balance (in dollars per share) \| $ / shares	$ 14.74
Granted (in dollars per share) \| $ / shares	18.48
Vested (in dollars per share) \| $ / shares	16.27
Canceled and forfeited (in dollars per share) \| $ / shares	0
Ending balance (in dollars per share) \| $ / shares	$ 16.47

Borrowings - Summary of Borrowings (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Debt Disclosure [Abstract]
Principal Outstanding	$ 36,000	$ 36,000
Final payment fee	0	720
Total Principal outstanding and final payment fee	36,000	36,720
Less: Unamortized debt issuance costs and lender fees	(548)	(655)
Outstanding debt, net of debt issuance costs and unaccreted value of final fee	35,452	36,065
Long-term borrowings	$ 35,452	$ 36,065

- Definition

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

+ References + Details

Borrowings (Tables)

12 Months Ended

Dec. 31, 2024

Debt Disclosure [Abstract]

Schedule of Outstanding Borrowings

The following table summarizes the outstanding borrowings from the term loan as of the periods presented:


	December 31, 2024		December 31, 2023
	(in thousands)
Principal Outstanding	$	36,000	$	36,000
Final payment fee	—		720
Total Principal outstanding and final payment fee	36,000		36,720
Less: Unamortized debt issuance costs and lender fees	(548)		(655)

Outstanding debt, net of debt issuance costs and unaccreted value of final fee	$	35,452	$	36,065
Classified as:


Long-term borrowings	$	35,452	$	36,065

Schedule of Future Principal Payments

The table below summarizes the future principal payments under the Third Amendment Term Loan as of December 31, 2024:


Year ending December 31,	(in thousands)
2025	$	—
2026	—
2027	6,000
2028	18,000
2029	12,000
Total principal payments	$	36,000

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(22))
-SubTopic 10
-Topic 210
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480566/210-10-S99-1

Reference 2: http://www.xbrl.org/2003/role/exampleRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 69B
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481568/470-20-55-69B

Reference 3: http://www.xbrl.org/2003/role/exampleRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 69E
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481568/470-20-55-69E

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 3
-Subparagraph (SX 210.12-04(a))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-3

Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 835
-SubTopic 30
-Name Accounting Standards Codification
-Section 45
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482925/835-30-45-2

Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-3

Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Topic 942
-SubTopic 470
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477734/942-470-50-3

Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 8
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-8

Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-6

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 7
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-7

+ Details

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2024

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

Basis of Presentation and Principles of Consolidation

The accompanying consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“U.S. GAAP”). The consolidated financial statements include the Company's accounts, as well as those of the Company's wholly-owned international subsidiaries. All inter-company accounts and transactions have been eliminated.

Use of Estimates

Change in accounting estimate

Segments

administrative at the consolidated level. Other segment items within net loss include interest income, interest expense, and other income (expense), net.


	Year Ended December 31,
	2024		2023		2022
	(in thousands)
United States	$	158,416	$	130,621	$	98,751
International	8,762		8,265		7,658
	$	167,178	$	138,886	$	106,409

Foreign Currency

Concentration of Credit Risk

The Company’s revenue and accounts receivable are spread across a large number of customers, primarily in the United States, and no customer accounts for more than 10% of total revenue or gross accounts receivable in any period presented.

Fair Value of Financial Instruments

Level 1: Quoted prices (unadjusted) in active market that are accessible at measurement date for assets or liabilities. The fair value hierarchy gives the highest priority to Level 1 inputs.

Level 2: Observable prices that are based on inputs not quoted on active markets, but corroborated by market data.

Level 3: Unobservable inputs are used when little or no market data is available. The fair value hierarchy gives the lowest priority to Level 3 inputs.

Cash and Cash Equivalents

The Company considers all highly liquid investments with remaining maturities at the date of purchase of three months or less to be cash equivalents.

Marketable Securities

Accounts Receivable and Allowance for Credit Losses

Trade accounts receivable are recorded at the invoiced amount, net of allowances for credit losses for any potential uncollectible amounts. The allowance for credit losses is based on our assessment of the collectability of accounts. Management regularly reviews the adequacy of the allowance for credit losses on a collective basis by considering the age of each outstanding invoice, each customer’s expected ability to pay and collection history, current market conditions, and reasonable and supportable forecasts of future economic conditions to determine whether the allowance is appropriate. Accounts receivable are written-off and charged against an allowance for credit losses when the Company has exhausted collection efforts without success.

The movement in the allowance for credit losses was as follows:


	Year ended December 31,
	2024		2023		2022
	(in thousands)
Balance at beginning of year	$	1,118	$	400	$	264
Provision	470		761		150
Write-offs	(1,000)		(43)		(14)
Balance at end of year	$	588	$	1,118	$	400

Inventory

Property and Equipment


Computer and office equipment			3 – 5 years
Instrument trays			5 years
Machinery and equipment			3 – 5 years
Furniture and fixtures			7 years
Leasehold Improvement			Lesser of estimated useful life or remaining lease term

Impairment of Long-Lived Assets

Leases

Revenue Recognition

Shipping and Handling Costs

Shipping and handling costs are treated as fulfillment costs, which are expensed as incurred and are included in cost of goods sold.

Costs to Obtain Customer Contracts

year or less. The period of benefit is concurrent with when the Company recognizes its revenue and as such, the Company recognizes sales commissions as expense when incurred.

Warranty

Research and Development

Advertising Expenditures

The cost of advertising is expensed as incurred and is included under sales and marketing expense in the consolidated statements of operations. Advertising expenses were $0.5 million, $1.1 million and $1.6 million for the years ended December 31, 2024, 2023, and 2022 respectively.

Loss Contingency

Stock-Based Compensation

•Expected Volatility - The expected volatility is measured using the historical daily changes in the market price of the Company's

common stock over a period consistent with the expected term.

•Dividend Yield - The Company has not paid any dividends and has no current plans to pay dividends on its common stock. As such, the Company uses expected dividend yield of zero.

The fair value of the restricted stock unit (“RSU”) grant is based on the market price of the Company’s common stock on the date of grant.

Income Taxes

Net Loss per Share of Common Stock

Comprehensive Loss

Warrants

Recently Issued Accounting Standards Not Yet Adopted

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 588	$ 1,118
Preferred stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Preferred stock authorized (in shares)	5,000,000	5,000,000
Preferred stock issued (in shares)	0	0
Preferred stock outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.0001	$ 0.0001
Common stock authorized (in shares)	100,000,000	100,000,000
Common stock issued (in shares)	42,086,477	40,693,299
Common stock outstanding (in shares)	42,086,477	40,693,299

Summary of Significant Accounting Policies - Schedule of Accounts Receivable and Allowance for Credit Losses (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Accounts Receivable, Allowance for Credit Loss [Roll Forward]
Balance at beginning of year	$ 1,118	$ 400	$ 264
Provision	470	761	150
Write-offs	(1,000)	(43)	(14)
Balance at end of year	$ 588	$ 1,118	$ 400

Summary of Significant Accounting Policies - Narrative (Details)	12 Months Ended
	Dec. 31, 2024 USD ($) segment $ / shares	Dec. 31, 2023 USD ($) $ / shares	Dec. 31, 2022 USD ($) $ / shares	Jan. 01, 2024
Disaggregation of Revenue [Line Items]
Depreciation expense, decrease	$ (4,400,000)	$ (5,400,000)	$ (3,400,000)
Decrease in loss	$ (30,913,000)	$ (43,336,000)	$ (61,256,000)
Net loss per share, basic (in dollars per share) \| $ / shares	$ (0.75)	$ (1.13)	$ (1.79)
Net loss per share, diluted (in dollars per share) \| $ / shares	$ (0.75)	$ (1.13)	$ (1.79)
Number of reportable segments \| segment	1
Number of operating segments \| segment	1
Impairment losses on long-lived assets	$ 0	$ 0	$ 0
Warranty term	1 year
Sales credit reserve term	1 year
Advertising expenses	$ 500,000	$ 1,100,000	$ 1,600,000
Minimum
Disaggregation of Revenue [Line Items]
Standard payment terms per agreements	30 days
Maximum
Disaggregation of Revenue [Line Items]
Standard payment terms per agreements	90 days
Instrument trays
Disaggregation of Revenue [Line Items]
Estimated useful life	5 years	3 years		5 years
Service Life
Disaggregation of Revenue [Line Items]
Depreciation expense, decrease	$ 1,900,000
Decrease in loss	$ 1,900,000
Net loss per share, basic (in dollars per share) \| $ / shares	$ 0.04
Net loss per share, diluted (in dollars per share) \| $ / shares	$ 0.04

Commitments and Contingencies - Narrative (Details) - USD ($)	12 Months Ended
	Dec. 31, 2024	Jul. 18, 2024	Dec. 31, 2023
Operating Leased Assets [Line Items]
Operating lease, extended term		14 months
Operating lease liability not commenced	$ 0
Purchase commitments related to inventory management and training materials	400,000		$ 400,000
Indemnification Agreement
Operating Leased Assets [Line Items]
Costs to defend lawsuits or settle claims	0
Liability associated with indemnifications	$ 0

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2024

Income Tax Disclosure [Abstract]

Schedule of Components of Loss Before Income Taxes

The components of the Company’s loss before income taxes are as follows:


	Year Ended December 31,
	2024		2023		2022
	(in thousands)
Domestic	$	(31,082)	$	(43,491)	$	(61,396)
Foreign	169		155		140
Loss before income taxes	$	(30,913)	$	(43,336)	$	(61,256)

Schedule of Components of Income Tax Expense

The components of deferred income taxes are as follows:


	Year Ended December 31,
	2024		2023
	(in thousands)
Federal	$	(5,080)	$	(10,606)
State	(1,002)		(1,856)
Foreign	70		28
Total deferred income taxes	(6,012)		(12,434)
Change in deferred tax valuation allowance	6,012		12,434
Net deferred income tax	$	—	$	—

Schedule of Effective Income Tax Rate Reconciliation

Income tax expense differs from the amount computed by applying the statutory federal income tax rate due to the following:


	Year Ended December 31,
	2024		2023		2022
Tax at statutory federal rate	(21.0)	%	(21.0)	%	(21.0)	%
State tax, net of federal benefit	(3.3)	%	(4.3)	%	(4.9)	%
Tax credits	(2.0)	%	(1.3)	%	(0.7)	%
Change in deferred tax valuation allowance	19.5	%	28.7	%	26.1	%
Stock compensation	2.9	%	(3.0)	%	0.3	%
Foreign rate differences	0.2	%	(2.1)	%	0.1	%
Reversal of nontaxable or nondeductible items	1.3	%	2.1	%	0.1	%
Nondeductible executive compensation	1.3	%	0.3	%	—	%
Other	1.1	%	0.6	%	—	%
Total income tax expense	—	%	—	%	—	%

Schedule of Deferred Tax Assets

The tax effects of temporary differences and carryforwards that give rise to significant portions of the deferred tax assets are presented below:


	Year Ended December 31,
	2024		2023
	(in thousands)
Net operating loss carryforwards	$	89,592	$	85,173
Research and development credits	6,279		5,342
Accruals and reserves	4,506		3,698
Interest limitation	2,584		4,378
Depreciation and amortization	144		474
Stock compensation	3,693		3,474
Operating lease liabilities	511		735
Capitalized research and development	6,413		4,614
Total deferred tax assets	113,722		107,888
Operating lease right-of-use assets	(500)		(678)
Total deferred tax liabilities	(500)		(678)
Less: Valuation allowance	(113,222)		(107,210)
Total deferred tax asset, net of valuation allowance	$	—	$	—

Summary of Changes in Valuation Allowance

The following table summarizes changes in the valuation allowance for the years ended December 31, 2024, 2023, and 2022:


	Year Ended December 31,
	2024		2023		2022
	(in thousands)
Beginning balance	$	107,210	$	94,776	$	78,786
Net changes during the period	6,012		12,434		15,990
Ending balance	$	113,222	$	107,210	$	94,776

Schedule of Uncertain Income Tax Positions

The changes in the Company’s uncertain income tax positions for the years ended December 31, 2024, 2023 and 2022 consisted of the following:


	Year ended December 31,
	2024		2023		2022
	(in thousands)
Balance at beginning of the year	$	2,629	$	2,944	$	2,655
Increases related to tax positions taken prior to current year	(43)		$	(726)	$	(12)
Increases related to current year's tax positions	438		411		301
Balance at end of the year	$	3,024	$	2,629	$	2,944

The Company and Nature of Business (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended	12 Months Ended
	May 31, 2023	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Subsidiary, Sale of Stock [Line Items]
Net proceeds		$ 0	$ 83,671	$ 0
Additional shares purchased after exercise of option (in shares)		143,685
Common Stock
Subsidiary, Sale of Stock [Line Items]
Net proceeds	$ 83,700
Offering costs	$ 5,800
Issuance of common stock from public offerings, net of underwriting discounts, commissions and offering costs (in shares)	3,775,000		4,068,497
Additional shares purchased after exercise of option (in shares)	566,250	143,685	698,627	80,571
Public offering price (in dollars per share)	$ 22.00
Number of shares offered by a selling stockholder (in shares)	272,753

Borrowings - Narrative (Details) - USD ($) $ in Thousands			12 Months Ended
Borrowings - Narrative (Details) - USD ($) $ in Thousands	Nov. 08, 2024	Jan. 06, 2023	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Aug. 12, 2021
Debt Instrument [Line Items]
Final payment fee			$ 0	$ 720
Term loan
Debt Instrument [Line Items]
Effective interest rate during the period			9.10%	9.00%	7.80%
SVB Term Loan \| Term loan
Debt Instrument [Line Items]
Aggregate principal amount						$ 35,000
Proceeds from (repayments of) term loan		$ (35,000)
First-Citizens Term Loan \| Term loan
Debt Instrument [Line Items]
Aggregate principal amount		36,000
Proceeds from (repayments of) term loan		36,000
First-Citizens Term Loan \| Line of credit \| Revolving credit facility
Debt Instrument [Line Items]
Revolving credit facility, aggregate principal amount		$ 15,000
Final payment fee, percentage		2.00%
Third Amendment Term Loan \| Term loan
Debt Instrument [Line Items]
Aggregate principal amount	$ 36,000
Basis spread on variable rate	4.25%
Prime rate adjustment	0.50%
Prepayment fee, percentage of aggregate principal amount	1.50%
Prepayment fee, threshold period following closing	18 months
First Amendment Term Loan \| Term loan
Debt Instrument [Line Items]
Outstanding amount repurchased	$ 36,000
Final payment fee	$ 700