Centinel Spine is going public. The West Chester, Pennsylvania, company behind the prodisc total disc replacement platform filed its S-1 with the Securities and Exchange Commission on October 7, 2026.
Centinel Spine Files to Go Public on the NYSE
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The plan is to list Class A common stock on the New York Stock Exchange under the ticker “CNTL.” Morgan Stanley, Goldman Sachs and Piper Sandler are the lead underwriters, with Canaccord Genuity and BTIG also on the deal. We don’t yet know how many shares or at what price range. Neither has been disclosed.
The Numbers
Centinel did $132.2 million in net revenue in 2025. That is up 39% from $95.1 million in 2024. And the growth hasn’t slowed down. Revenue for the first six months of 2026 came in at $85.2 million, a 42% increase over the same period a year earlier.
Operating income was $15.7 million in 2025, compared with $1.8 million in 2024, and $13.0 million in the first half of 2026. The company reported net income of $10.2 million for the first half of 2026. That follows a net loss of $4.3 million for full-year 2025.
2024 | 2025 | 1H 2025 | 1H 2026 | |
|---|---|---|---|---|
Net revenue | $95.1M | $132.2M | $60.1M | $85.2M |
Gross margin | 77% | 80% | 80% | 82% |
Operating income | $1.8M | $15.7M | $4.5M | $13.0M |
Net income (loss) | ($12.1M) | ($4.3M) | ($0.5M) | $10.2M |
Adjusted EBITDA | $5.9M | $20.2M | $6.6M | $15.5M |
Where does the money go? Selling and marketing expense was $67.5 million in 2025. General and administrative was $19.2 million. Research and development was $3.7 million.
As of June 30, 2026, Centinel had $25.1 million in cash and $168.9 million in total liabilities. That includes $62.1 million in convertible notes and $12.5 million in term notes. Interest expense was $11.1 million in 2025, and the accumulated deficit was $188.4 million.
The Business
Centinel calls itself a company “exclusively focused on Total Disc Replacement.” Its belief, as stated in the filing, is that spine surgery is following the same adoption pattern we saw in hips, knees and shoulders, where motion-preserving procedures became the standard of care.
According to the filing, about 750,000 instrumented cervical and lumbar fusions were performed in the U.S. in 2025. Centinel estimates roughly 275,000 of those could be addressed with a disc replacement. About 58,000 TDR procedures were actually performed in the U.S. in 2025.
Using an average selling price of about $5,500 per implant, the company puts its U.S. market opportunity at approximately $2.5 billion, about two-thirds cervical and one-third lumbar. The filing also cites third-party data showing the TDR market grew at about 7.7% annually from 2022 to 2025. Fusion grew at 0.6%.
The filing states that the prodisc platform has been developed over more than 35 years, with more than 300,000 implantations worldwide and over 590 peer-reviewed papers. The portfolio is four cervical systems and one lumbar system, all Class III devices approved through the PMA pathway. Centinel says prodisc is the only TDR platform with FDA approval for both one-level and two-level procedures in both the cervical and lumbar spine.
The timeline: the company began selling two-level prodisc L in 2020. It launched prodisc C Vivo, C SK and C Nova for single-level use in 2022, then added two-level indications for C Vivo and C SK in 2025.
More than 1,500 U.S. surgeons performed a prodisc procedure in 2025. The U.S. commercial organization includes 48 sales management and clinical support professionals and more than 400 distributors. Outside the U.S., the company operates in 35 countries.
The Structure
The offering uses an Up-C structure. Public investors will hold Class A shares in a new holding company, Centinel Spine Holdco. Existing owners keep their economic interests in the operating LLC and receive voting-only Class B shares.
The company will also enter into a tax receivable agreement that requires it to pay existing owners 85% of certain tax benefits it realizes. The filing states that these payments are expected to be substantial and could materially affect liquidity.
What will Centinel do with the proceeds? Repay its 2023 credit agreement and pay down two other credit facilities. Fund sales and marketing, medical education and patient awareness programs. Fund research and development, including clinical trials. And add instrument sets and implant inventory.
On the notes: the $10 million 6% convertible note will convert to equity as part of the reorganization. Holders of $46 million in 4.42% convertible notes may convert at a set price beforehand. Any that do not will convert automatically into Class A shares at a 30% discount to the IPO price.
Risk Factors and Next Steps
Among the risk factors listed in the filing: the company depends entirely on prodisc sales for its revenue. It relies on third-party contract manufacturers, some of which are single source. And its business depends on coverage and reimbursement from third-party payors.
The offering size, price range and preliminary third-quarter 2026 results are left blank in this version of the filing. For reference, third-quarter 2025 revenue was $31.9 million.
Steven Murray is chief executive officer of Centinel Spine.
Author
TH
TJ Halvorson
The De Angelis Group | Orthopedics This Week | MSK Innovations
Why This Matters
Two Perspectives
MBA Lens: Economic and industry impact
Centinel Spine is pursuing an IPO on the NYSE, leveraging its exclusive focus on the growing total disc replacement (TDR) market. The company reported significant revenue growth and improved profitability, aiming to capitalize on the shift towards motion-preserving spine procedures. Proceeds will fund sales, marketing, R&D, and debt repayment, enhancing its market position and operational capabilities.
- The U.S. TDR market opportunity is estimated at $2.5 billion, with Centinel's pro d isc platform positioned to capture a larger share given its comprehensive FDA approvals.
- Strategic use of IPO proceeds targets increased market penetration through enhanced commercial efforts, R&D investments, and strengthening its financial structure.
PhD Lens: Clinical and outcomes impact
Centinel Spine's pro d isc platform, developed over 35 years with extensive clinical evidence, is a Class III total disc replacement system approved via the PMA pathway. It uniquely holds FDA approval for both one-level and two-level procedures in both cervical and lumbar spine, reflecting its robust safety and efficacy profile for motion preservation.
- The pro d isc portfolio includes four cervical and one lumbar system, with over 300,000 implantations worldwide and 590+ peer-reviewed papers supporting its clinical use.
- The company's R&D efforts, funded by IPO proceeds, will continue to expand the platform, building on its established timeline of launching new indications and systems.
React:
Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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