We improve lives by providing innovative spine surgery solutions through our relentless pursuit of superior outcomes.

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1 We improve lives by providing innovative spine surgery solutions through our relentless pursuit of superior outcomes September 2017

2 Forward Looking Statements & Guidance This presentation and our responses to your questions during the question and answer period will contain our estimated or anticipated future results. These forward-looking statements are typically identified by the words "anticipates," believes," "expects," "intends," "plans," "future," "strategy," or words of similar meaning. These statements reflect our current analysis of existing trends and information, and represent our judgment only as of today. Actual results could differ materially from those anticipated. As a result, you are cautioned not to rely on these forward-looking statements. You should refer to the "Risk Factors" and other information in the reports that we file from time to time with the Securities & Exchange Commission. References to the Company, ATEC, or Alphatec Spine include Alphatec Holdings, Inc., Alphatec Spine, Inc. and all its affiliates. In addition, any references to the Company s prior statements of financial guidance do not constitute any form of confirmation, guarantee, assurance or promise that the guidance will actually be achieved. Rather, such statements simply set forth our best estimate on the date that such statement was made, based on the Company s expectations at the time of such statement, and there can be no assurance that this represents the Company s current projections. All statements regarding guidance should be considered forwardlooking statements. The Company disclaims any intent or obligation to update any forwardlooking statements made here today. 2

3 Turnaround Positioned for Value Creation $7B+ U.S. Spine Market Nimble, top 10 public company in growing market New Leadership with Extensive Spine Experience Executing a vision to be the most respected, fastest-growing U.S. spine company Re-inventing the ATEC Brand Leveraging robust product portfolio, driving innovative pipeline focused on improving patient outcomes 3

4 Evolution The History Inception/ Development Poor Decisions/ Challenges : Founded as contract manufacturer of orthopedic devices 2000 s: - Focused on spine implants HPC acquired Alphatec Manufacturing - Rebranded as Alphatec Spine - Headquarters relocated to Carlsbad IPO Late 2000 s: - Broadened portfolio to expand revenues acquired Scient X Early 2010 s: - Levered business to expand globally - Orthotec lawsuit and negative settlement - Missed globalization expectations U.S. Revenue - Purchase for resale arrangements - Invested in technologies that never commercialized

5 Evolution Transformation to Growth Building the New ATEC to Drive Market Share Expansion Future Organizational: - Rebuilt leadership and added directors with spine experience - Overhauling processes with rightsized organization - Creating high-performance, focused culture and implementing HPMS - Rebranding to convey new direction and vision externally - Updating HQ to promote collaboration and innovation Sales/ Products: - Hired 3 new AVP s, improved sales management structure, transforming distribution channel - Expanding target market with new solutions and biologics relaunch - Capitalizing on broad spine portfolio and GPO/ IDN contractual strengths - Investing thoughtfully into highimpact pipeline opportunities Financial: - Divested international to GMED - Restructured balance sheet - Raised $18.9M - Improved expense profile - Optimizing supply chain - Positioning for profitable growth - Managing cash responsibly 5

6 Large and Growing Market $7B+ U.S. Market Opportunity* Expected to Grow 5%+ Through 2020^ Exceptionally strong patient demographics Tremendous opportunity for innovation Complex spine and minimally invasive surgery (MIS) fastest growing segments Hospital / GPO access increasingly important ATEC #8 U.S. public company in hardware * Biomed GPS (SmartTraks), idata, SpineMarket, Management Estimates; ^Technavio Global Spinal Implants

7 Our Comprehensive Portfolio Biologics Degenerative Lumbar Deformity/ Complex Spine Anterior Cervical Interbody Cervical Biologics & Plating SystemsMIS - Arsenal - Zodiac - Aspida - Battalion PLIF/TLIF Posterior Thoracolumbar MIS & Fixation Systems - Novel Tapered TL, SD PLIF/TLIF - Novel AIS - Solus ALIF - Zodiac - Arsenal - Osteotomy - Trestle Luxe - Solanas - Avalon - Novel CIS, XS Cervical - Neocore - 3D Profuse - Amnioshield - Cervical Allograft - AlphaGRAFT - Allograft Chips relaunched *Source: Biomed GPS (SmartTraks), idata, Spine Market, Management Estimates New Products Address Fastest-Growing Segments in Spine - Illico - Bridgepoint Lateral Access & Interbody Systems 7

8 Our New Spine Leadership Executive Terry Rich CEO, BOD Jeff Black EVP, CFO Craig Hunsaker EVP, People and Culture, GC Brian Snider EVP, Strategic Marketing and Product Dev Jon Allen EVP, Commercial Operations Sales Board of Directors Chris Ryan AVP, Central Greg Rhinehart AVP, East Jim Duffy AVP, South Amy Ables, PhD. VP, Corp Education and Performance Jeff Rydin Dave Mowry 8

9 First Spine Experienced Leadership at ATEC 100+ Years Combined Spine Experience Deep relationships with spine thought leaders Robust distributor ties to revamp sales channel Deep relationships executing with spine thought leaders Robust distributor the ties new to revamp sales channel Change agents driving cultural renovation Track record turnarounds and growth strategies Engineering, innovation, and commercial expertise Financial restructuring experience Financial restructuring and capital markets experience 9

10 1H 2017 Strategic Accomplishments Completed spine-experienced executive team, sales leadership, BOD Implemented High Performance Management System (HPMS) to Do the Right Things Right Defined new Vision, Mission, Values Closed $18.9M private placement with 100% management participation Hired key sales, marketing, and product development talent Increased sales from dedicated agents Eliminated purchase-for-resale arrangements Launched 2 new products and relaunched biologics Awarded 20 new patents 10

11 Financial Highlights Operating Expense Reduction Steady Gross Margin Improvement Rationalizing costs across all areas Operating Expenses ($M) $21.7 $20.2 $16.5 Q Q Q Increase in Adjusted EBITDA Positioning for profitable growth Adjusted EBITDA ($M) $0.5 $1.2 $(2.2) Q Q Q NOTE: To supplement the Company s financial statements presented in accordance with U.S. generally accepted accounting principles (GAAP), the Company reports certain non-gaap financial measures such as Adjusted EBITDA. Please refer to the Company s filings with the SEC for complete financial information 11

12 Financial Highlights 62.2% Gross Margin (%) 69.4% 70.9% Gross Margin Improvement Q Q Q Optimizing supply chain Cash Used ($M) $11.0 $11.5 $6.4 Q Q Q Laser-focused on managing cash resources Improved Cash Use NOTE: To supplement the Company s financial statements presented in accordance with U.S. generally accepted accounting principles (GAAP), the Company reports certain non-gaap financial measures such as Adjusted EBITDA. Please refer to the Company s filings with the SEC for complete financial information 12

13 Strategic Portfolio Expansion Launching Solutions to Expand Market Opportunity Biologics Arsenal Deformity Squadron Lateral Scoli, Tumor/ Trauma MIS, DDD, Adult Scoli 13

14 Strategic Portfolio Expansion - Biologics Re-Introducing to Capture Cross-Selling Opportunities Incremental procedural revenue opportunity in ATEC fixation cases Allograft offerings to complement synthetic business: - 3D Profuse Bioscaffold that maximizes endplate to endplate contact - Cervical Allograft Cortical ring, pure cortical, cortical cancellous - AlphaGRAFT Demineralized Bone Matrix in gel (syringe) and putty - Allograft Chips Ideal for posterolateral and interbody fusions 14

15 Strategic Portfolio Expansion Arsenal Deformity Launched Commercially Q Patented uniplanar and monoaxial screws designed to: - Reduce surgeon fatigue - Optimize height to improve outcomes - Minimize screw-head profile Differentiated ergonomic and light-weight instrumentation Unique instruments designed to provide mechanical advantage 15

16 Strategic Portfolio Expansion Squadron Lateral Launching NASS 2017 Numerous proprietary features designed to minimize psoas retraction times, decreasing post-op complications - Independent cranial/caudal blades - Patented level toeing to reduce tissue creep - Patented in situ blade DepthControl and replacement DepthControl Articulation Points Trigger Locks LevelToe Articulation Points StealthCoat Anti-glare, Anti-scratch, Synthetic Diamond Coating A/P Dial: Controls Anterior/Posterio r Blade Position Detachable Handles 4 th Blade Eyelets Blade Release Levers Single-step Thumb Release Proprietary and/or competitive features 16

17 Revolutionizing to Drive Shareholder Value The Vital Few Initiatives Dedicated Sales Force New Product Innovation Return to Growth Partner with current and new dedicated distribution partners to deliver sustainable revenue Drive new product development to improve patient outcomes Execute cultural changes to propel ATEC into the fastest growing company in spine 17

18 Dedicated Sales Force 3 new AVPs added, each with ~20 years of spine sales leadership Moving to geography-based representation Extensive spine relationships attracting high-caliber distributors and surgeons Existing distributors eager to transition to dedicated Significant opportunity in under-represented markets Well-established hospital access % of Sales from Dedicated Agents and Distributors <5% <15% >2x Target Increase ~18% >40% Q Q Q Q4 2017E 18

19 Innovating to Improve Patient Outcomes Protecting Investment in Engineering and Development >150 patents issued; 20 patents in 1H 2017; 75 pending Recent patent awards protect differentiating features of new lateral and deformity solutions: - Proprietary features of Squadron Lateral Retractor - Novel uniplanar and monoaxial screws, currently marketed under the Arsenal Deformity product line 19

20 Innovating to Improve Patient Outcomes Vast Unmet Clinical Needs Provide Pipeline Opportunities Sagittal balance PJK/ Osteoporosis Pipeline Focus on ASC/ HOPD Select High-Impact Soft Opportunities tissue management/ muscle disruption Biologics value Improve Patient Outcomes Disruptive technology Engage With The Customer Improved Outcomes 20

21 Return to Growth Revolutionizing the Organization to Build the New ATEC Re-built 90% of executive team, added spineexperienced BOD members Driving focus on field reputation with 5 leaders customer-facing vs.1 formerly We do the right thing Implemented proven High Performance Management System to propel growth We make it personal We deliver results Overhauling every process Creating a culture of fiscal responsibility, performance, urgency, and results We are unified and supportive Core Values We are honest and transparent 21

22 Return to Growth Rebranding to Convey New Direction and Vision World-Class Service and Superior Outcomes Officially launching NASS 2017 (October) Expression of change in direction for customer-facing interactions: marketing literature, website, business cards, addresses Modernized logo with deep navy blue to convey loyalty to core values, vibrant green to communicate excitement for the future Updated HQ with innovation areas to promote collaboration Surgeon innovation room professionalized and simplified to promote idea generation 22

23 Why Invest in ATEC? Large and growing, $7B+ U.S. Spine market Well-established player with huge opportunity to expand share New leadership team and directors with vast experience in spine Executing initiatives to position the new ATEC for sustained growth Turnaround is in progress Improved financial performance Distribution channel transition Sales stabilization Exciting new product launches Organizational and cultural transformation 23

24 A Powerful Value Creation Opportunity OUR VISION: To be the most respected, fastest-growing U.S. spine company September