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We improve lives by providing

innovative spine surgery solutions


through our relentless pursuit of
superior outcomes.
July 2017

CONFIDENTIAL - For Internal


CONFIDENTIAL
Use Only -| 7/20/2017 | 1
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 or Alphatec Spine including Alphatec
Holdings, Inc., Alphatec Spine, Inc. and all its global affiliates. In addition, any
references to the Companys 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 Companys expectations at the
time of such statement, and there can be no assurance that this represents the
Companys current projections. All statements regarding guidance should be
considered forward-looking statements. The Company disclaims any intent or
obligation to update any forward-looking statements made here today.

CONFIDENTIAL - 7/20/2017 | 2
Overview
Improving lives by delivering advancements in spinal fusion technologies

Well-established, nimble player in the large and growing


$7B US Spine Market

Comprehensive spine fusion solutions to


treat most spine pathologies

New leadership with spine


market expertise
104 patents; 100 patents
pending

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Evolution
Market Share
Inception/ Development Transformation Expansion

1990 - 2015 2016 - 2017 Future

- 1990: Founded as contract Organizational: Organizational:


manufacturer of orthopedic - Renovated leadership with - Fostering high-performance
devices spine-experienced execs, BOD spine culture
- 2000s: Focused business - Streamlined product portfolio
on spine implants - Galvanizing high-performance Sales:
- Late 2000s: Broadened spine culture - Capitalizing on broad spine
portfolio to drive revenue portfolio & GPO/ IDN
expansion Sales: contractual access
- Early 2010s: Levered - Reconfigured sales - Expanding target market
business to expand globally; management, structure with 3 new solutions,
Missed globalization strategy - Re-introducing surgeons to biologics re-launch
expectations ATEC - Continuing to transform
distribution channel
Financial:
- Balance sheet restructured; Financial:
divested international to GMED - Reduced burn
- Right-sized organization

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Vision and Strategy
Future
Our Vision

We will be the most respected, fastest growing US spine company.

Our Vital Few Initiatives

Strengthen our distribution channel by partnering with a


consolidated network of current and new dedicated
distribution partners

Drive new product innovation to advance our focus on


improving outcomes

Return Alphatec to a growth organization

CONFIDENTIAL - 7/20/2017 | 5
Recent Highlights and Developments

Q1 Financials
Revenues of $28.0 million; U.S. revenues of $23.4 million
U.S. commercial gross margin of 68%
Gross proceeds of $18.9 million from private placement
Cash balance of $25.5 million at March 31, 2017

Organizational and Product


Completed seven-person senior leadership team
Initiated transition of sales organization from non-exclusive to dedicated.
Added three new Area Vice Presidents with a history of building strong,
dedicated distribution channels in spine.
Reduced headcount and implemented cost-control measures
Completed a limited user release of Arsenal Deformity Adolescent
Idiopathic Scoliosis (AIS) System, and introduced a limited user release
of Battalion Lateral System

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Agenda

New Leadership with Track Record of Spine Market Share Expansion

Large, Growing Market with Huge Opportunity to Take Share

Capitalizing on Established Spine Portfolio

Transforming Distribution Channel for Growth

Expanding Target Market with 3 Advanced Platforms, Biologics

CONFIDENTIAL - For Internal


CONFIDENTIAL
Use Only -| 7/20/2017 | 7
Agenda

New Leadership with Track Record of Spine Market Share Expansion

Large, Growing Market with Huge Opportunity to Take Share

Capitalizing on Established Spine Portfolio

Transforming Distribution Channel for Growth

Expanding Target Market with 3 Advanced Platforms, Biologics

CONFIDENTIAL - For Internal


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New Leadership with Spine Market Expertise
Terry Rich
CEO, BOD

Mike Plunkett
President and COO
Craig Hunsaker
EVP, People and Culture, General Counsel
Jon Allen
EVP, Commercial Operations

Amy Ables, PhD.


VP, Corporate Education and Performance

Jeff Black
CFO, EVP and Treasurer

Brian Snider
EVP, Strategic Marketing and Product Development

Jeff Rydin
Special Advisor to BOD

Dave Mowry
BOD

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New Leadership with Track Record of
Executing a Spine Market Share Expansion Strategy
Organizational Product Launch Expertise
Transformation
- Launch strategy development
- History of meeting and execution
expectations in
- Creation of successful sales
execution-focused
training, medical education
turnaround strategies
CORE programs
- High-performance
culture development Spine/ Ortho Expertise
and maintenance - Executive/ senior leadership of
- Balance sheet ortho and spine organizations
improvement - Deep understanding of spine
market and landscape
Sales and
- Corporate account navigation,
Distribution
group-purchasing organization/
integrated delivery network Transformation
knowledge - Long tenure of sales
- Reimbursement know-how leadership
- Transition to
exclusive non-
competitive sales
channel

CONFIDENTIAL - 7/20/2017 | 10
Agenda

New Leadership with Track Record of Spine Market Share Expansion

Large, Growing Market with Huge Opportunity to Take Share

Capitalizing on Established Spine Portfolio

Transforming Distribution Channel for Growth

Expanding Target Market with 3 Advanced Platforms, Biologics

CONFIDENTIAL - For Internal


CONFIDENTIAL
Use Only -| 7/20/2017 | 11
Large and Growing Spine Market
Exceptionally strong patient demographics*
Degenerative disc disease (DDD) affects
~90% of adults > age 50
Longer US population lifespans
Increasing rates of obesity
~6-9M Americans have scoliosis/ deformity;
~50% require spine surgery
Ample room for unmet clinical needs:
- Strong growth of minimally invasive
surgery (MIS), surgeon adoption rate
expected to approach 70% by 2025
- Complex spine: Not commoditized,
highest revenue/ procedure
Evolving ortho payment models driving
opportunities for new products and solutions

* Sources: Biomed GPS (SmartTraks), iData, SpineMarket


CONFIDENTIAL - 7/20/2017 | 12
Large and Growing Market
$7B U.S. Market Opportunity* Expected to Grow 5%+ Through 2020^
817K Fusion procedures in 2017, expected to grow ~22% to 1M+ by 2020

MIS & Complex Vertebral


Spine ~31% compression
Other fracture (VCF),
9% Motion
preservation

Biologics
20%
Core Fusion 40%

Sources: * Biomed GPS (SmartTraks), iData, SpineMarket; ^Technavio Global Spinal Implants 2016-2020
CONFIDENTIAL - 7/20/2017 | 13
Agenda

New Leadership with Track Record of Spine Market Share Expansion

Large, Growing Market with Huge Opportunity to Take Share

Capitalizing on Established Spine Portfolio

Transforming Distribution Channel for Growth

Expanding Target Market with 3 Advanced Platforms, Biologics

CONFIDENTIAL - For Internal


CONFIDENTIAL
Use Only -| 7/20/2017 | 14
Comprehensive Spine Fusion Portfolio
Degenerative Deformity Cervical Biologics MIS/ Lateral
Lumbar

Market Size* $2.1B $650M $1.5B $1.5B $1.5B


- Arsenal - Arsenal Adult - Trestle Luxe - Neocore - Illico

- Zodiac - Arsenal AIS - Solanas - 3D Profuse - Bridgepoint

- Aspida - Avalon - Cervical - Battalion


Allografts Lateral
- Battalion - Novel CIS,
PLIF/TLIF XS Cervical - AlphaGRAFT - Squadron
DBM Retractor
- Novel Tapered
TL, SD - Amnioshield - XYCor
PLIF/TLIF Expandable
Interbody
- Novel AIS

- Solus ALIF

*Sources: Biomed GPS (SmartTraks), iData, Spine Market, Management Estimates


CONFIDENTIAL - 7/20/2017 | 15
Agenda

New Leadership with Track Record of Spine Market Share Expansion

Large, Growing Market with Huge Opportunity to Take Share

Capitalizing on Established Spine Portfolio

Transforming Distribution Channel for Growth

Expanding Target Market with 3 Advanced Platforms, Biologics

CONFIDENTIAL - For Internal


CONFIDENTIAL
Use Only -| 7/20/2017 | 16
Transforming Distribution Channel for Growth
Exclusive, Dedicated Distribution Strategy
Moving from non-exclusive doctor assignments to exclusive geographic
assignments; eliminating non-performers
Exploiting managements extensive spine backgrounds and relationships to
attract high caliber distributors (just added 3 experienced AVPs)
- Each addition of a dedicated distributor can accelerate sales growth
Timing is advantageous
- Recent industry consolidation
- Established ATEC portfolio plus new
innovation attracting distributor interest

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Transforming Distribution Channel for Growth
ATEC is an Attractive Partner for Distributors GPO/IDN # of Hospitals
Relationships Represented
Portfolio breadth enables comprehensive
1740
treatment of most spine pathologies
New products driving interest and 169
excitement in the field
Established access to hospitals through 157
group-purchasing organization (GPO) and
integrated delivery network (IDN) contracts 131
is increasingly a competitive advantage
70

53

46

28

13

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Agenda

New Leadership with Track Record of Spine Market Share Expansion

Large, Growing Market with Huge Opportunity to Take Share

Capitalizing on Established Spine Portfolio

Transforming Distribution Channel for Growth

Expanding Target Market with 3 Advanced Platforms, Biologics

CONFIDENTIAL - For Internal


CONFIDENTIAL
Use Only -| 7/20/2017 | 19
Expanding Target Market with
3 Advanced Platforms
MIS and Complex Spine Solutions to Address a $1.3B Opportunity

XYcor
Arsenal Deformity Battalion Lateral Expandable
Interbody
360

76

Scoliosis, Tumor/ Trauma MIS, DDD, adult scoliosis MIS, DDD

Market Size $650M* $500M* $100M^

Sources: Biomed GPS, iData; ^Management estimates for 2016


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Expanding Target Market with
3 Advanced Platforms

Comprehensive system for


complex degenerative
Arsenal pathologies and deformity
Differentiated uniplanar and
Deformity monoaxial implants
AIS Optimized placement of
screws and rods

The entire Arsenal Deformity AIS set is


fantastic, but the shining star is the ability
to spin the uniplanar bodies independent
of the screw shank, which allows surgeons
to achieve optimal fixation and placement
of the pedicle screws.

12 year old female: double major curve Sheldon St. Clair, M.D.
79 Thoracic/ 83 Lumbar T2-L3 Childrens Hospital of Kings Daughters

CONFIDENTIAL - 7/20/2017 | 21
Expanding Target Market with
3 Advanced Platforms

Arsenal
Arsenal
Deformity
Deformity
AIS
AIS

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Expanding Target Market with
3 Advanced Platforms

Longer Retraction Times Increase Likelihood of Post-Op


Complications
Battalion
Retraction time was significantly longer in
Lateral patients with symptomatic neuropraxia
System vs. those without (p = 0.031).*

Greatest contributors to extended retraction


times:
- Repositioning retractor
- Osteophytes
- Unclear anatomy with intra-op
fluoroscopy
- Accessing disc space adjacent to crest
or ribs
- Soft tissue creep underneath the
retractor

* Source: Uribe, Youssef, Khajavi, Baizer, Kanter, Kuelling, Peterson, SOLAS Degenerative Study Group. Can triggered electromyography monitoring throughout retraction predict postoperative
symptomatic neuropraxia after XLIF? Results from a prospective multicenter trial. Eur Spine. 2015 Apr 24.
CONFIDENTIAL - 7/20/2017 | 23
Expanding Target Market with
3 Advanced Platforms

Best in class lateral access


retractor designed to improve
Battalion clinical outcomes by
preventing tissue creep and DepthControl 4th Blade
Lateral minimizing retraction time Articulation Points Eyelets

System Numerous proprietary features Blade


LevelToe Release
- Independent cranial/caudal Articulation Levers
blades and DepthControl Points

technology for patient-


StealthCoat Single-step
specific access throughout Anti-glare, Anti- Thumb
procedure scratch, Release
Synthetic
- In situ blade height Diamond
Coating
adjustment and A/P Dial:
replacement Controls
Anterior/Posterior
Trigger Locks Blade Position

Detachable Handles

Proprietary and/or competitive features

Minimizing retraction time to improve outcomes


CONFIDENTIAL - 7/20/2017 | 24
Expanding Target Market with
3 Advanced Platforms

Battalion
Lateral
System

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Expanding Target Market with
3 Advanced Platforms

First truly minimally


invasive TLIF approach
XYcor with footprint of an ALIF
through posterior approach
Expandable
ALIF superior:
Interbody
- Graft volume
- Surface area
- Loading characteristics

Prevents subsidence to maintain saggital balance


CONFIDENTIAL - 7/20/2017 | 26
Expanding Target Market with
3 Advanced Platforms

XYcor
Expandable
Interbody

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Re-Entering Biologics to Drive Growth

Significant cross-selling
opportunity into existing and
new accounts
Biologics
Benchmarked peers have 3x
Portfolio Alphatecs current biologics
procedural penetration
Comprehensive bone graft
substitutes (BGS) to meet
surgeon preferences: tissue
and synthetic offerings; cervical
allograft offering
Published animal data
demonstrating Neocores
superior bone remodeling to
Vitoss (industry leader)

CONFIDENTIAL - 7/20/2017 | 28
Why Invest in ATEC?
Market Share-Driven Revenue Growth

Transformation of distribution
channel for growth

New leadership with solid track record


of spine market expansion

Expanding target market with 3 advanced


platforms and biologics

Capitalizing on established portfolio


that generated $100M+ U.S.
commercial revenue in 2016

CONFIDENTIAL - 7/20/2017 | 29
Financing for Growth and Value Creation

Advance next generation platform development


Investment in Lateral and Deformity sets to meet demand
and fuel growth
Expand clinical expert team and surgeon education
program in complex spine and MIS to grow surgeon
adoption
Build clinical support to strengthen brand and hospital
access
Expand distribution network

CONFIDENTIAL - 7/20/2017 | 30
A Powerful Value Creation Opportunity

New leadership
Building on an attractive market landscape
And a strong product portfolio
With exciting new products,
Renovated financials,
Significant distribution upgrades,
And a market-share taking vision

July 2017

CONFIDENTIAL - For Internal


CONFIDENTIAL
Use Only -| 7/20/2017 | 31

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