L.O.T.W. #128 - Carlsmed, Inc. obtains custom credit facility to support continued advances in precision spine care
S-1 sheds light on Carlsmed's $12.5 million structured term loan from Customer's Bank (f/k/a Signature Bank)
Carlsmed entered into a $12.5 million non-dilutive senior secured term loan facility with Signature Bank (now Customer’s Bank), with $6.25 million funded upfront and the remaining amounts available based on performance to monthly revenue milestones. Debt capital will be used to support the refinance of a pre-existing credit facility and for general corporate purposes.
👓At a Glance
Borrower: Carlsmed, Inc.
Lender: Signature Bank (now Customer’s Bank)
Deal Size: $12.5 million
Structure: Senior secured, multi-tranche term loan
Rate: Variable - Prime Rate -1.00% with a floor of 5.25%
Term: ~ 48 months
Use of Proceeds: Refinance existing debt with SVB and provide additional cash runway
Source: SEC S-1
📷Borrower Snapshot
Sector: Health Care
Subsector: Healthcare Equipment and Supplies
Ownership: Private (S-1 on file)
Commercial Stage: Revenue generating; EBITDA (-) LTM
Business Overview: Carlsmed, Inc. is a medical technology company based in Carlsbad, California, focused on developing personalized, data-driven solutions for spinal surgery. Its flagship platform, aprevo®, uses AI-enabled surgical planning and patient-specific 3D-printed implants to improve outcomes in complex spine deformity procedures, particularly adult scoliosis. The company integrates advanced imaging, machine learning, and manufacturing to streamline preoperative planning and reduce operative time and complications. Backed by investors including U.S. Venture Partners and B Capital Group, Carlsmed is positioned at the intersection of medtech innovation and personalized care. Its FDA-cleared technology is currently in commercialization, targeting both clinical efficacy and value-based care efficiency in orthopedic surgery.
⚙️Structure & Terms
Source: SEC S-1
Commitment: $12.5 million
Tranche 1 - $6.250 million funded at close
Tranche 2 - $3.125 million available contingent on achieving first monthly revenue milestone
Milestone is T6M revenue of $7.0 million prior to September 20, 2023
Tranche 3 - $3.125 million available contingent on achieving second monthly revenue milestone
Milestone is T6M revenue of $9.5 million prior to March 31, 2024
Interest-only Period: 18 months with ability to extend to 24 months upon completion of first and second monthly revenue milestones
Maturity: December 20, 2026
Rate: Variable - Prime Rate -1.00% with a floor of 5.25%
Facility Fee: $31.25k
Final Payment Fee: 4.21%
Prepayment Fee: None
Warrants: Yes - see SEC filings for additional details
Success Fee: Not-disclosed
Covenants:
No documented financial covenants
Board composition negative covenant - Carlsmed can’t suffer change of Board which results in failure of at least one partner of B Capital or U.S. Venture Partners to serve as a voting member without prior written consent of the Lender