The following table presents adjusted EBITDA, the primary metric used in managing the Company, by reporting segment:


	Year Ended December 31, 2024
(U.S. Dollars, in thousands)	Global Spine			Global Orthopedics			Total
Segment revenues	$	675,314		$	124,177		$	799,491
Less:
Non-GAAP Cost of sales		183,064			48,638			231,702
Non-GAAP Sales, general, and administrative		368,817			70,185			439,002
Non-GAAP Research and development		58,262			13,154			71,416
Other segment benefits		(22	)		(54	)		(76	)
Add:
Non-GAAP Depreciation, amortization, and share-based compensation expense		42,193			12,367			54,560
Segment Adjusted EBITDA	$	107,386		$	4,621		$	112,007

Reconciling items:
Corporate operating expenses							$	44,591
Interest expense, net								29,631
Depreciation and amortization								60,061
Share-based compensation expense								32,455
Foreign exchange impact								4,395
SeaSpine merger-related costs								14,485
Strategic investments								910
Acquisition-related fair value adjustments								19,088
Interest and loss on investments								5,120
Litigation and investigation costs								15,770
Succession charges								9,376
Medical device regulation								—
Business interruption - COVID-19								—
Loss before income taxes							$	(123,875	)


	Year Ended December 31, 2023
(U.S. Dollars, in thousands)	Global Spine		Global Orthopedics			Total
Segment Revenues	$	631,319	$	115,322		$	746,641
Less:
Non-GAAP Cost of sales		166,885		47,928			214,813
Non-GAAP Sales, general, and administrative		355,827		67,815			423,642
Non-GAAP Research and development		56,512		10,726			67,238
Other segment expenses (benefits)		45		(82	)		(37	)
Add:
Non-GAAP Depreciation, amortization, and share-based compensation expense		39,065		11,507			50,572
Segment Adjusted EBITDA	$	91,115	$	442		$	91,557

Reconciling items:
Corporate operating expenses						$	45,272
Interest expense, net							8,631
Depreciation and amortization							53,063
Share-based compensation expense							35,707
Foreign exchange impact							(1,581	)
SeaSpine merger-related costs							36,577
Strategic investments							2,272
Acquisition-related fair value adjustments							33,393
Interest and loss on investments							1,781
Litigation and investigation costs							14,453
Succession charges							1,176
Medical device regulation							9,492
Business interruption - COVID-19							—
Loss before income taxes						$	(148,679	)


	Year Ended December 31, 2022
(U.S. Dollars, in thousands)	Global Spine			Global Orthopedics			Total
Segment Revenues	$	353,174		$	107,539		$	460,713
Less:
Non-GAAP Cost of sales		74,573			44,784			119,357
Non-GAAP Sales, general, and administrative		204,840			56,760			261,600
Non-GAAP Research and development		29,220			8,364			37,584
Other segment benefits		(183	)		(49	)		(232	)
Add:
Non-GAAP Depreciation, amortization, and share-based compensation expense		17,969			7,587			25,556
Segment Adjusted EBITDA	$	62,693		$	5,267		$	67,960

Reconciling items:
Corporate operating expenses							$	19,406
Interest expense, net								1,288
Depreciation and amortization								29,019
Share-based compensation expense								18,443
Foreign exchange impact								3,291
SeaSpine merger-related costs								11,902
Strategic investments								4,018
Acquisition-related fair value adjustments								(15,595	)
Interest and loss on investments								187
Litigation and investigation costs								803
Succession charges								147
Medical device regulation								10,370
Business interruption - COVID-19								2,387
Loss before income taxes							$	(17,706	)

The table below presents net sales by geographic destination for each reporting segment and for the consolidated Company:

The following data includes net sales by geographic destination: