Carlsmed is a medical technology company that makes and sells AI-powered, personalized spine implants and surgical planning software for spine fusion surgery. Its core product, the aprevo Technology Platform, addresses a key limitation of traditional spine surgery: stock implants come in fixed sizes and are selected visually during surgery, leading to poor spinal alignment and high complication and revision rates. Carlsmed uses standard CT scan imaging and AI algorithms to build a 3D model of each patient's spine, generate a personalized surgical plan, and manufacture a custom titanium interbody implant to match that patient's bone structure. The sterile implant kit is delivered directly to the operating room within six business days of surgical plan approval. Carlsmed sells implants directly to hospitals and ambulatory surgical centers on a per-procedure basis, with revenue driven by the number of trained surgeons and the volume of procedures each performs. The business is inventory-light, as implants are made-to-order by contract manufacturers. A key adoption driver is CMS reimbursement: hospitals receive incremental reimbursement for using custom interbody devices versus stock implants, creating a direct financial incentive for hospital purchasing decisions. Carlsmed's primary commercial focus has been lumbar spine fusion since 2021, and the company launched a cervical spine fusion product in late 2025. As of year-end 2025, 253 surgeons had performed at least one aprevo procedure, out of an estimated 4,000 potential spine surgeons nationwide.