Orthofix returns to positive cash flow as spine fixation sales hit double digits

Orthofix Medical (NASDAQ:OFIX) delivered a pivotal fourth quarter to close out fiscal 2025, reaching a long-sought milestone of positive annual free cash flow while reporting a 10% jump in its global spine fixation business.

The company posted fourth-quarter net sales of $219.9 million, a 2% increase on a reported basis.

Stripping out the impact of its M6 artificial disc line, non-GAAP pro forma sales grew 3% in constant currency.

The results were anchored by the Global Spine Fixation segment, which maintained double-digit growth throughout the year, and U.S. Limb Reconstruction, which surged 16% for the full year 2025.

Orthofix demonstrated significant operational progress, with its non-GAAP pro forma adjusted EBITDA margin expanding by approximately 230 basis points compared to the fourth quarter of 2024.

This efficiency drive culminated in $16.8 million of free cash flow in the fourth quarter alone, bringing the full-year total to a positive $3.1 million (excluding M6-related restructuring charges).

The company’s Bone Growth Therapies (BGT) also showed steady momentum, with fourth-quarter sales rising 7%.

Management attributed the performance to the successful rollout of the AccelStim bone healing system and continued leadership in the spinal fusion stimulation market.