NuVasive Annual Report 2014

Plain-text annual report

UNITED STATESSECURITIES AND EXCHANGE COMMISSIONWashington, D.C. 20549 Form 10-K (Mark One)xANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934For the fiscal year ended December 31, 2014OR¨TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934For the transition period from to Commission file number: 000-50744 NUVASIVE, INC.(Exact name of registrant as specified in its charter) Delaware 33-0768598(State or other jurisdiction ofincorporation or organization) (I.R.S. EmployerIdentification No.) 7475 Lusk Boulevard, 92121San Diego, California(Address of principal executive offices) (Zip Code)(858) 909-1800(Registrant’s telephone number, including area code)Securities registered pursuant to Section 12(b) of the Act Title of Class: Name of Exchange on which Registered: Common Stock, par value $0.001 per share The NASDAQ Stock Market LLC(NASDAQ Global Select Market)Securities registered pursuant to Section 12(g) of the Act: None Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act of 1933, as amended. YES þ NO ¨Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Securities Exchange Act of 1934, asamended. YES ¨ NO þIndicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding12 months (or for such shorter period than the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past90 days. YES þ NO ¨Indicate by check mark whether the registrant has submitted electronically and posted on its corporate website, if any, every Interactive Data File required to be submitted andposted pursuant to Rule 405 of Regulation S-T (Section 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submitand post such files). YES þ NO ¨Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K (Section 229.405 of this chapter) is not contained herein, and will not becontained, to the best of registrant’s knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any amendment to thisForm 10-K. ¨Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of“large accelerated filer,” “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act. (Check one): Large accelerated filer þ Accelerated filer ¨ Non-accelerated filer ¨ (Do not check if a smaller reporting company) Smaller reporting company ¨Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). YES ¨ NO þThe aggregate market value of the voting and non-voting common equity held by non-affiliates of the registrant was approximately $1.6 billion as of the last business day ofthe registrant’s most recently completed second fiscal quarter (June 30, 2014), based upon the closing sale price for the registrant’s common stock on that day as reported by theNASDAQ Global Select Market. Shares of common stock held by each officer and director on June 30, 2014 have been excluded in that such persons may be deemed to be affiliates.As of February 23, 2015, there were 48,147,397 shares of the registrant’s common stock issued and outstanding.DOCUMENTS INCORPORATED BY REFERENCEPart III of this Form 10-K incorporates information by reference to portions of the registrant’s definitive Proxy Statement for the Annual Meeting of Stockholders to be heldon May 22, 2015 (the “Proxy Statement”). The Proxy Statement will be filed with the U.S. Securities and Exchange Commission not later than 120 days after December 31, 2014. NuVasive, Inc.Annual Report on Form 10-K for the Fiscal Year ended December 31, 2014Table of Contents PART IItem 1. Business 2Item 1A. Risk Factors 14Item 1B. Unresolved Staff Comments 32Item 2. Properties 33Item 3. Legal Proceedings 33Item 4. Mine Safety Disclosures 35 PART IIItem 5. Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities 36Item 6. Selected Financial Data 39Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations 40Item 7A. Quantitative and Qualitative Disclosures About Market Risk 54Item 8. Financial Statements and Supplementary Data 54Item 9. Changes in and Disagreements With Accountants on Accounting and Financial Disclosure 55Item 9A. Controls and Procedures 55Item 9B. Other Information 57 PART IIIItem 10. Directors, Executive Officers and Corporate Governance 57Item 11. Executive Compensation 57Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters 57Item 13. Certain Relationships and Related Transactions, and Director Independence 57Item 14. Principal Accountant Fees and Services 57 PART IVItem 15. Exhibits, Financial Statement Schedules 57SIGNATURES 62Index to Consolidated Financial Statements 64 1Table of ContentsPART IThis Annual Report on Form 10-K (“Annual Report”) contains forward-looking statements that involve risks, uncertainties, assumptions and otherfactors which, if they do not materialize or prove correct, could cause our results to differ from historical results or those expressed or implied by suchforward-looking statements. Many of the forward-looking statements are located in Part I, Item 1 under the heading “Business” and Part II, Item 7 under theheading “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in this Annual Report and the documentsincorporated by reference to this Annual Report. In some cases, you can identify these forward-looking statements by words like “may”, “will”, “should”,“could”, “expect”, “plan”, “anticipate”, “believes”, “estimates”, “predicts”, “potential”, “intends”, or “continues” (or other tenses or the negative ofthose words and other comparable words). Forward-looking statements include, but are not limited to, statements about:·our intentions, beliefs and expectations regarding our expenses, sales, operations and future financial performance;·our operating results;·our plans for future products and enhancements of existing products;·anticipated growth and trends in our business;·the timing of and our ability to maintain and obtain regulatory clearances or approvals;·our belief that our cash and cash equivalents and investments will be sufficient to satisfy our anticipated cash requirements;·our expectations regarding our revenues, customers and distributors;·our beliefs and expectations regarding our market penetration and expansion efforts;·our expectations regarding the benefits and integration of recently-acquired businesses and our ability to make future acquisitions andsuccessfully integrate any such future-acquired businesses;·our anticipated trends and challenges in the markets in which we operate; and·our expectations and beliefs regarding and the impact of investigations, claims and litigation.These statements are not guarantees of future performance or events. Our actual results may differ materially from those discussed in this AnnualReport and the documents incorporated by reference to this Annual Report. The potential risks and uncertainties that could cause actual results to differmaterially include, but are not limited to, those set forth in Part I, Item 1(A) under the heading “Risk Factors”, Part II, Item 7 “Management’s Discussionand Analysis of Financial Condition and Results of Operations” and elsewhere throughout this Annual Report and in any other documents incorporated byreference to this Annual Report. Accordingly, readers are cautioned not to place undue reliance on such forward-looking statements. We assume noobligation to update any forward-looking statements to reflect new information, future events or circumstances or otherwise, except as required by law. This Annual Report on Form 10-K refers to trademarks, such as Absolute Responsiveness, Acuity, Affix, Armada, Attrax, Back Pact, Bendini, BetterBack Alliance, Better Insight. Better Decisions. Better Medicine, Brigade, CerPass, CoRoent, Creative Spine Technology, DBR, Embody, Embrace,ExtenSure, FormaGraft, Gradient Plus, Halo, ILIF, InStim, JJB, Leverage, M5, Magnitude, MAS, MaXcess, NeoDisc, Nerve Avoidance Leader, NuVasive,NVJJB, NVM5, Osteocel, Precept, Radian, SOLAS, Speed of Innovation, SpheRx, The Better Way Back, Traverse, Triad, VuePoint, X-Core, XL-TDR, XLIF andXLP, which are protected under applicable intellectual property laws and are our property or the property of our subsidiaries. Solely for convenience, ourtrademarks and tradenames referred to in this Form 10-K may appear without the ® or ™ symbols, but such references are not intended to indicate in anyway that we will not assert, to the fullest extent under applicable law, our rights to these trademarks and tradenames. 2Table of Contents Item 1.BusinessOverviewWe are the third largest global medical device company in the global spine market, focused on developing minimally-disruptive surgical products andprocedurally-integrated solutions for the spine. Our currently-marketed product portfolio is focused on applications for spine fusion surgery (includingbiologics), a combined market estimated to be approximately $9.0 billion globally in 2015. Our principal product offering includes a minimally-disruptivesurgical platform called Maximum Access Surgery, or MAS®. The MAS platform combines three categories of solutions that collectively minimize soft tissuedisruption during spine fusion surgery, provide maximum visualization and are designed to enable safe and reproducible outcomes for the surgeon and thepatient. The platform includes our proprietary software-driven nerve detection and avoidance systems, NVM5 and NVJJB, and Intra-Operative Monitoring(IOM) services and support; MaXcess®, an integrated split-blade retractor system; and a wide variety of specialized implants and biologics. Many of ourproducts, including the individual components of our MAS platform can also be used in open or traditional spine surgery. Our spine surgery product lineofferings, which include products for the thoracolumbar and the cervical spine, are primarily used to enable surgeons access to the spine to performrestorative and fusion procedures in a minimally-disruptive fashion. Our biologic product line offerings used to aid the spinal fusion process or bone healingprocess include Osteocel Plus® and Osteocel Pro® allograft (donated human tissue) which are cellular matrix products containing viable mesenchymal stemcells (or MSCs), as well as other allograft offerings, FormaGraft® - a collagen synthetic product, and AttraX® - a synthetic bone graft material that is currentlyavailable commercially only in select markets outside of the United States. We also offer IOM services for insight into the nervous system during non-spine(in addition to the offerings noted above). We continue to focus significant research and development efforts to expand our MAS product platform andadvance the applications of our unique technology into procedurally-integrated surgical solutions. We have dedicated and continue to dedicate significantresources toward training spine surgeons around the world; both those who are new to our MAS product platform as well as previously MAS-trained surgeonsattending advanced courses.We believe our MAS platform and its related offerings provide(s) a unique and comprehensive solution for the safe and reproducible minimally-disruptive surgical treatment of spine disorders by enabling surgeons to access the spine in a manner that affords both direct visualization and detection andavoidance of critical nerves. The fundamental difference between our MAS platform and is sometimes referred to in the industry as “minimally invasivesurgery” or “MIS” is the ability to customize safe and reproducible access to the spine while allowing surgeons to continue to use instruments that arefamiliar to them and effective during surgery. Accordingly, the MAS platform does not force surgeons to reinvent or learn new approaches that addcomplexity and undermine safety, ease of use and/or efficacy. An important ongoing objective of ours has been to maintain a leading position in access andnerve avoidance, as well as to pioneer and remain the ongoing leader in minimally invasive spine surgery. Our MAS platform, with the unique advantagesprovided by our nerve monitoring systems, enables an innovative lateral procedure known as eXtreme Lateral Interbody Fusion, or XLIF, in which surgeonsaccess the spine for a fusion procedure from the side of the patient’s body, rather than from the front or back. Our MaXcess instruments provide access to thespine in a manner that affords direct visualization and our nerve monitoring systems assist surgeons in the detection and navigation of critical nerves. It hasbeen demonstrated clinically that the procedures facilitated by our MAS platform decrease trauma and blood loss, and lead to faster overall patient recoverytimes compared to open spine surgery.We also have robust product offerings that we continue to expand for procedures in the cervical spine. Our cervical product offering provides a full setof solutions for cervical fusion surgery, including both allograft and CoRoent® implants, as well as cervical plating and posterior fixation products.Our corporate headquarters is located in San Diego, California. We lease approximately 208,000 square feet in San Diego. Our headquarters has a six-suite state-of-the-art cadaver operating theatre designed to accommodate the training of spine surgeons. During 2014, we committed to a plan to consolidateits offices located in San Diego, California into one corporate headquarters for efficiency purposes. This project is expected to be completed by March 31,2015. Our location in Amsterdam, the Netherlands was established in 2014 and now serves as our International Headquarters. We have historicallymaintained a secondary training facility in Paramus, New Jersey, which we expect to depart in 2015. We are now in the process of committing or re-purposingresources to develop regional training facilities and centers for excellence in strategic locations around the globe. Impulse Monitoring, Inc. (ImpulseMonitoring), our IOM services and support arm, is located in Columbia, Maryland. Our primary distribution and warehousing operations are located in ourfacility in Memphis, Tennessee. Our business is facilitated by rapid delivery of products and surgical instruments for surgeries involving our products.Because of its location and proximity to overnight third-party transporters, our Memphis facility enhances our ability to meet demanding delivery schedulesand provide a greater level of customer service. Additionally, we have a manufacturing facility located in Dayton, Ohio that produces spinal implants. 3Table of ContentsOur StrategyWe are a leading provider of innovative medical products that provide comprehensive solutions for the surgical treatment of spine disorders. Wecontinue to pursue the following business strategies in order to improve our competitive position:●Establish our MAS Platform as the Standard of Care. We believe our MAS platform has the potential to become the standard of care for spinesurgery as hospitals, providers and spine surgeons alike continue to recognize its many benefits and adopt our products and procedures. We alsobelieve that our MAS platform has the potential to dramatically improve the clinical results of spine surgery. Because of this belief, we dedicatesignificant resources to researching clinical outcomes data as well as educating spine surgeons, hospitals, and other providers and their patients onthe clinical and financial benefits of our products, and we intend to capitalize on the growing demand for minimally-disruptive surgicalprocedures.●Continue to Develop and Introduce Procedurally-Integrated Solutions and New Innovative Products. One of our core competencies is our abilityto rapidly develop and commercialize innovative spine surgery products and procedures. In the past several years, we have introduced a continualflow of new products and product enhancements. We have additional products and procedural offerings currently under development that shouldexpand our presence in fusion surgery. We intend to accomplish our continued product expansion with an unwavering commitment to our MASplatform and extending our core technology. We believe that these additional products will allow us to increase our market share while at the sametime improving patient care. Protecting and defending the intellectual property related to our innovative products is also a core component to thisstrategy.●Expand the Reach of Our Exclusive Sales Force. We believe that having a sales force dedicated to selling only our products is critical to achievingcontinued growth across our various product lines, driving greater market penetration and increasing our revenues. In the United States, we have anexclusive sales force consisting of a mix of directly-employed sales shareowners (our employees) and exclusive sales agents that are responsible forparticular geographic regions of the country. Outside of the United States, our sales force consists of directly-employed sales shareowners,independent sales agents and territory-based distributors. We believe that continuing to expand the range of such teams will allow us to increaseour market share while and drive adoption of our products and procedures.●Provide Tailored Solutions in Response to Surgeon Needs. Responding quickly to the needs of spine surgeons, which we refer to as “AbsoluteResponsiveness®”, is central to our corporate culture, critical to our success, and we believe differentiates us from our competition. We solicitinformation and feedback from our surgeon customers and clinical advisors regarding the utility of, and potential improvements to, our products.For example, we have an on-site machine shop to allow us to rapidly manufacture product prototypes and a state-of-the-art cadaver operatingtheatre in San Diego, California to provide clinical training and validate new ideas through prototype testing. We also have historicallymaintained a training facility in Paramus, New Jersey which we expect to depart in 2015. We are in the process of committing or re-purposingresources to develop regional training facilities and centers for excellence in strategic locations around the globe. Absolute Responsiveness goesbeyond product development to include active support in all areas, including clinical research and payer relations. We believe that continuing toremain connected and responsive to the collective voices of the surgeon community will allow us to increase our market share while and driveadoption of our products and procedures.●Selectively License or Acquire Complementary Spine Products and Technologies and Drive our OUS Presence. In addition to building ourcompany through internal product development efforts, we intend to selectively license or acquire complementary products and technologies thatwe believe will keep us on the forefront of innovation and to pursue opportunities that allow us to expand our presence in emerging geographicalopportunities. By acquiring complementary products and executing on international footprint opportunities, we believe we can leverage ourexpertise at bringing new products to market that are intended to improve patient outcomes, simplify or better integrate techniques, reducehospitalization and rehabilitation times across the globe, and, as a result, reduce overall costs to the healthcare system and continue to grow ourglobal presence.●Provide Intra-Operative Monitoring Capabilities. Monitoring the health of the nervous system during spinal surgery has been a key component ofour strategy of product differentiation since early in our development. Over time, surgeon and hospital demand for nerve monitoring has increasedalong with the advancement of technologies and techniques used in IOM. We believe that our proprietary NVJJB and NVM5 platforms aredifferentiators in the market and are unique in their ability to provide information about the directionality and proximity of nerves. We intend tocontinue to advance the utility and adoption of such platforms and, accordingly, further our value to our customer base. 4Table of ContentsIndustry Background and MarketThe spine is the core of the human skeleton, and provides a crucial balance between structural support and flexibility. It consists of 33 separate bonescalled vertebrae that are connected together by connective tissue (defined as bone, muscle, or ligament) to form a column and to permit a normal range ofmotion. The spinal cord, the body’s central nerve system, is enclosed within the spinal column. Vertebrae are paired into what are called motion segmentsthat move by means of three joints: two facet joints and one spine disc. The four major categories of spine disorders are degenerative conditions, deformities,trauma and tumors. The largest market and the focus of our business historically are degenerative conditions of the facet joints and the intervertebral discspace. These two conditions can result in instability and pressure on the nerve roots as they exit the spinal column, causing back or neck pain or radiatingpain in the arms or legs.Hundreds of millions of people around the world suffer from some type of back or neck pain. The prescribed treatment depends on the severity andduration of the disorder. Initially, physicians will prescribe non-operative, conservative procedures including bed rest, medication, lifestyle modification,exercise, physical therapy, chiropractic care and steroid injections. In many cases, non-operative treatment options are effective; however, some patientseventually require spine fusion surgery. The vast majority of spine fusion surgeries are done using traditional open surgical techniques from either the frontor back of the patient. These traditional open surgical approaches generally require a large incision in the patient’s abdomen or back in order to enable thesurgeon to access and see the spine and surrounding area. These open procedures are invasive, lengthy and complex, and typically result in significant bloodloss, extensive tissue damage and lengthy patient hospitalization and rehabilitation.We believe that the market for spine surgery procedures will continue to grow over the long term, and we also believe that our market share willincrease, because of the following market dynamics:●Demand for Surgical Alternatives with Less Tissue Disruption. As has been proven in other surgical markets, we anticipate that the broaderacceptance of surgical treatments with less tissue disruption and patient trauma will result in increased demand.●Favorable Domestic Demographics. The population segment most likely to experience back pain is expected to increase as a result of aging “babyboomers” (people born between 1946 and 1965). We believe this large population segment will increasingly demand a quicker return to activitiesof daily living following surgery than prior generations.●Access to Care in Emerging Markets. Health care reforms in many emerging markets are expanding access to treatments to a greater proportion oftheir populations, which we believe will continue to drive strong increases in demand for healthcare-related product volumes. Increasing economicaffluence in key developing regions will further drive demand for health care treatments.Although we believe that the market for spine surgery procedures will continue to grow over the long term, economic, political and regulatoryinfluences are subjecting our industry to significant changes that may slow the spine market’s growth rate. These changes include pricing pressure from thecontinued consolidation of our hospital customers and the expansion of group purchasing organizations, unfavorable third-party payer coverage andreimbursement policies, and new and proposed legislation and regulations designed to contain or reduce the cost of healthcare.Surgical Alternatives with Less Tissue DisruptionThe benefits of minimally invasive surgery procedures in other areas of orthopedics have significantly contributed to the strong and growing demandfor surgical alternatives with less tissue disruption of the spine. Surgeons and hospitals seek spine procedures that result in fewer operative complications anddecreased patient hospitalization periods. At the same time, patients seek procedures that cause less trauma, allow for faster recovery times and result in morefavorable clinical outcomes. Despite the patient and doctor demands, the rate of adoption of surgical alternatives with less tissue disruption procedures hasbeen relatively slow with respect to the spine. Currently, the majority of spine surgery patients are treated with open and invasive techniques.We believe the principal factor contributing to spine surgeons’ slow adoption of traditional “minimally invasive” spine alternatives has beeninconsistent outcomes driven by two main reasons: (i) the limited or lack of direct access to and visibility of the surgical anatomy; and (ii) the associatedcomplex instruments that have been required to perform these procedures. Most traditional “minimally invasive” spine systems do not allow the surgeon todirectly view the spine and the relevant pathology point and, as such, provide only restrictive visualization through a camera system or endoscope, whilealso requiring the use of complex surgical techniques. In addition, most traditional “minimally invasive” spine systems use complex or highly customizedsurgical instruments that require special training and the completion of a large number of trial cases before the surgeon becomes proficient using the system,which is an impediment and/or deterrent to their adoption. 5Table of ContentsThe NuVasive Solution — Maximum Access Surgery with minimal tissue disruptionOur MAS platform allows surgeons to perform a wide range of minimally-disruptive spine procedures in all regions of the spine and from varioussurgical approaches, while overcoming the shortcomings of traditional “minimally invasive” spine surgical techniques. The platform is designed to treat awide range of spinal pathologies while accommodating a surgeon’s preferred surgical technique. We believe our products improve clinical results and shouldcontinue to drive an expanded number of minimally-disruptive procedures performed, lead the market movement away from open surgery and make lessinvasive techniques the standard of care in spine fusion and non-fusion surgery.Our MAS platform combines three product categories: our MaXcess retractors, our specialized implants, and our nerve monitoring systems and serviceofferings that collectively enable surgeons to detect and navigate around nerves while directing customized access to the spine for implant delivery. Each ofthese offerings is summarized in a bit more detail below. MaXcess also allows surgeons to use well-established traditional instruments in a minimally-disruptive and less traumatic manner while our biologics offerings complement our MAS\ platform by facilitating bone growth and fusion. We also offer avariety of specialized implants that enable the maximization of disc height restoration and sufficient structural support while conforming to the anatomicalrequirements of the patient.Our products facilitate minimally-disruptive applications of the following spine surgery procedures, among others:·Lumbar and thoracic fusion procedures in which the surgeon approaches the spine through the patient’s back, side or abdomen;·Cervical fusion procedures for either the posterior occipito-cervico-thoracic region or the anterior cervical region; and·Decompression, which is removal of a portion of bone or disc from over or under the nerve root to relieve pinching of the nerve.MAS — Nerve MonitoringOur nerve monitoring systems utilize electromyography (EMG), proprietary software hunting algorithms and graphical user interfaces to providesurgeons with an enhanced and intuitive nerve avoidance system. Our systems function by monitoring changes in electrical signals across muscle groups,which allows us to detect underlying changes in nerve activity. Through the NVM5 and NVJJB platforms, we give surgeons the option to connect theirinstruments to a computer system that provides discrete, real-time, surgeon directed and surgeon controlled feedback about the directionality and relativeproximity of nerves during surgery. Our systems analyze and then translate complex neurophysiologic data into simple, useful information to assist thesurgeon’s clinical decision-making process. For example, during a pedicle screw test, in which the integrity of the bone is tested where the implant is placed,if the insertion of a screw results in a breach of the bone, the system is designed so that a red light and corresponding numeric value will be displayed to alertthe surgeon that the screw may need to be repositioned to avoid potential nerve impingement or irritation. If no breach of the bone occurs, the system isdesigned so that a green light and corresponding numeric value will result. The health and integrity of the spinal cord and related nerves can also be assessedusing motor evoked potentials (MEPs) and somatosensory evoked potentials (SSEPs). Both of these methods of IOM involve applying stimulation andrecording the response that must travel along the motor or sensory paths of the spinal cord.Surgeons can connect certain instruments to our nerve monitoring systems, thus creating an interactive set of instruments that better enable the safenavigation through the body’s nerve anatomy during surgery. The connection is accomplished using a clip that is attached to the instrument, effectivelyproviding the benefits of our nerve monitoring systems through an instrument already familiar to the surgeon. The systems’ proprietary software and easy touse graphical user interface enables the surgeon to make critical decisions in real time resulting in safer, faster, and more reproducible procedures with thedesign for improved patient outcomes.Through our IOM subsidiary, Impulse Monitoring, the data from the various nerve monitoring systems, including our own, can be analyzed in realtime by healthcare professionals for additional interpretation of intra-operative information. Adding the value of real time healthcare professional oversightfurther improves the safety and reproducibility of the vast array of our spine procedures. 6Table of ContentsMAS — MaXcessOur MaXcess system integrates nerve monitoring and specialized implants that provide maximum access to the spine with minimal soft tissuedisruption. MaXcess has a split-blade design consisting of three blades that can be positioned to customize the surgical exposure in the shape and sizespecific to the surgical requirements rather than the more traditional fixed tube or two blade designs of traditional off-the-shelf “minimally invasive” spinesurgical systems. MaXcess’ split-blade design also provides customizable access to the spine, which allows surgeons to perform surgical procedures usinginstruments that are similar to those used in open procedures but with a smaller incision and less tissue disruption. The ability to use familiar instrumentsreduces the learning curve for our procedures and facilitates the adoption of our products. Our system’s illumination of the operative corridor aids inproviding surgeons with better direct visualization of the patient’s anatomy, without the need for additional technology or other special equipment such asendoscopes.Over the years, several improvements to our MaXcess systems have been made, including incorporating integrated neuromonitoring technology andimproving the blade systems, and the MAS approach has broadened from the lumbar to the thoracic region. Our MaXcess products are used in the cervicalspine for posterior application and anterior retraction, the lumbar spine for decompressions, transforaminal lumbar interbody fusions (TLIFs) and posteriorlumbar interbody fusions (PLIFs), the thoracolumbar spine for eXtreme Lateral Interbody Fusion (XLIFs), and the thoracic region for tumors and trauma, aswell as in adult degenerative scoliosis procedures.MAS — Specialized Implants and Fixation SystemsWe have many implants and fixation devices designed to be used with our MAS platform. These implants are used for interbody disc heightrestoration for fusion and stabilization of the spine. Our implants are available in a variety of shapes and sizes to accommodate specific approach, pathologyand anatomical requirements of the patient and the particular fusion procedure. Our implants are designed for insertion into the smallest possible space whilemaximizing surface area contact for fusion. Our fixation systems have been uniquely designed and include a highly differentiated percutaneous minimallyinvasive solution with advanced guide technology, superior rod insertion options, and multiple reduction capabilities to be delivered through our MaXcesssystem to provide stabilization of the spine. These systems enable minimally-disruptive placement of implants and are intended to reduce patient morbidity,at times through a single approach.The following products and services complement our MAS platform:BiologicsThe global biologics market in spine surgery consists of autograft (autologous human tissue), allograft (donated human tissue), a varied offering ofsynthetic products, stem cell-based products, and growth factors. We currently offer FormaGraft, a collagen-based synthetic bone substitute, and OsteocelPlus and Osteocel Pro, an allograft cellular matrix designed to mimic the biologic profile of autograft that includes endogenous MSCs and osteoprogenitorsto aid in fusion. Additionally, we have developed biologics products such as AttraX, a synthetic bone graft material delivered in putty form, to meet thedifferent needs of these international markets. We have successfully commercialized AttraX in several international countries.Intra-Operative Monitoring ServiceMonitoring the health of the nervous system during spinal surgery has been a key component of our strategy of product differentiation since early inour development. Over time, surgeon and hospital demand for nerve monitoring has increased along with the advancement of technologies and techniquesused in IOM. We believe that our proprietary NVJJB and NVM5 platforms are differentiators in the market and are unique in their ability to provideinformation about the directionality and proximity of nerves.Development Projects We continue development on a wide variety of projects intended to broaden surgical applications for greater procedural integration of our MAStechniques. Such applications include tumor, trauma, and deformity, and increased fixation options, including motion preservation and sagittal alignmentproducts. We also continue expanding our cervical product portfolio to provide for a comprehensive cervical offering that will include further segmentationof both the fixation and motion preservation segments. In biologics, we continue to pursue advancements in our existing product lines as well as new andinnovative biologics offerings. Additionally, we intend to focus on integrated product offerings that focus on sagittal alignment.Research and DevelopmentOur research and development efforts are primarily focused on developing further enhancements to our existing products and improving and furtherintegrating our procedural solutions. Our research and development group has extensive experience in developing products to treat spine pathologies andthis group continues to work closely with our clinical advisors and spine surgeon customers to design products and procedural solutions designed to improvepatient outcomes, simplify techniques, and reduce patient trauma and the subsequent hospitalization and rehabilitation times, and - as a result - reduceoverall costs to patients and the healthcare system. 7Table of ContentsInternationalWe believe a spine market shift towards minimally invasive surgery and increases in international access to healthcare will provide us with anopportunity for accelerated growth outside the United States. Because our products and technologies treat similar pathologies around the world, we arefocused on expanding our operations in select developed and emerging international markets. We are investing to tailor our products and technologies tomeet varying international patient, surgeon and market requirements. We are also investing in expanding our global infrastructure to adapt to alternativedistribution channels, to support differing language and customer service requirements, and to provide training and surgeon education in our MAS surgicaltechniques, our complementary instruments and our implants to our international customers. During 2014, we opened many offices across the world as part ofour focus on increasing our commercial footprint in the regions. Among them was the opening of a new office in Amsterdam, the Netherlands, which nowserves as our International Headquarters and is a continued investment in its strategic expansion throughout the European market and also European center ofexcellence for customer services. Additionally, we have continued to expand our available product offerings internationally. Our geographic expansionefforts will enable us to accelerate our global market share position and change patient’s lives, not just in the United States, but around the world. Ourinternational revenue, which excludes Puerto Rico, was $94.6 million or 12% of total revenue for the year ended December 31, 2014.Sales and MarketingIn the United States, we currently sell our products through a combination of exclusive independent sales agencies and directly-employed salesshareowners. Each member of our United States sales force is responsible for a defined territory, with our independent sales agents acting as our solerepresentative in their respective territories. The determination of whether to engage a directly-employed sales shareowner or an independent sales agency ismade on a territory–by-territory basis, with a focus on aligning the sales team with the best skills and experience with local surgeons’ needs. Ourinternational sales force is comprised of directly-employed sales shareowners as well as exclusive distributors and independent sales agents. The splitbetween directly-employed sales shareowners and independent sales agents and distributors in our sales force is approximately equal. There are many reasonsthat we believe strongly in an exclusive sales force, none more important than having a sales force that is properly educated, trained and incentivized to selland represent only our portfolio of products.Surgeon Training and EducationWe devote significant resources to training and educating surgeons regarding the safety and reproducibility of our MAS surgical techniques and ourcomplementary instruments and implants. We maintain state-of-the-art cadaver operating rooms and training facilities to help educate surgeons regarding ourproducts at our corporate headquarters in San Diego, California and historically our facility in Paramus, New Jersey, which we expect to depart in 2015. Weare in the process of committing or re-purposing resources to develop regional training facilities and centers for excellence in strategic locations around theglobe. We continue to train surgeons on the XLIF technique and our other MAS platform products including: our proprietary nerve monitoring systems,MaXcess, biologics, and specialized implants. The number of surgeons trained annually includes first-time surgeons new to our MAS product platform aswell as surgeons previously trained on our MAS product platform who are attending advanced training programs. The Society of Lateral Access Surgery(SOLAS), Surgeon Education Committee helps direct the continued evolution of our many procedure-related training classes and materials.Manufacturing and SupplyWe rely on third parties for the manufacture of a majority of our products, their components and servicing, and we maintain alternative manufacturingsources for a majority of our finished goods products. We also manufacture certain implants internally at our facility in Dayton, Ohio. We have identified orare in the process of identifying and qualifying additional suppliers, on a per product basis, for our highest volume products to best enable us to be able tomaintain consistent supply to our customers. Our outsourcing strategy is targeted at companies that meet FDA, International Organization for Standardization(ISO), and quality standards supported by internal policies and procedures. Supplier performance is maintained and managed through a supplierqualification, performance management and corrective action program intended to ensure that all of our product requirements are met or exceeded. Webelieve that, at our current scale, these types of manufacturing relationships balance our capital investment, help control costs and provide manufacturingcapacity necessary to compete with larger volume manufacturers of spine surgery products. As our business continues to scale, we will continue to evaluatethis strategy for selective product lines to drive improving profitability and shareholder returns. We anticipate that we will ultimately internally manufacturegreater portions of our products and product components as such opportunities arise and when a transition to such capability would be and efficient andappropriate use of capital that aligns with our overall strategy.Our products are inspected, packaged and labeled, as needed, at either our San Diego headquarters or our Memphis distribution facility. Under ourexisting contracts with third-party manufacturers, we reserve the exclusive right to inspect and assure conformance of each product and product component toour specifications. 8Table of ContentsWe currently rely on several tissue banks as our suppliers of allograft tissue implants, including two for our Osteocel Plus and Osteocel Pro productlines. Like our relationships with our device manufacturing suppliers, we subject our tissue processing suppliers to the same quality criteria in terms ofselection, qualification, and verification of processed tissue quality upon receipt of goods, as well as hold them accountable to compliance with FDAregulations, state requirements, and as-voluntary industry standards (such as those put forward by the American Association of Tissue Banks (AATB)).We rely on one, exclusive supplier of polyetheretherketone (PEEK), which comprises our CoRoent PEEK partial vertebral body replacement andinterbody product lines. We also rely on one, exclusive supplier for our NVM5 and NVJJB neuromonitoring systems, and rely on one, exclusive supplier forour neuromonitoring equipment that is used outside of the NV platform.We, and our third-party manufacturers, are subject to the FDA’s quality system regulations, state regulations (such as the regulations promulgated bythe California Department of Health Services), and regulations promulgated by foreign regulatory bodies (such as in the European Union). For tissueproducts, we are FDA registered and licensed in the States of California, New York, Florida, Maryland and Oregon. For our device implants and instruments,we are FDA registered, California licensed, CE marked and ISO certified. CE is an abbreviation for “Conformité Européenne” or European Conformity, and isthe registration marking designating that a device can be commercially distributed throughout Europe. Our facilities and the facilities of our third-partymanufacturers are subject to periodic announced and unannounced inspections by regulatory authorities, and may undergo compliance inspectionsconducted by the FDA, state, and/or international regulatory agencies.Surgical Instrument and Implant SetsFor many of our customers, we provide surgical instrumentation sets, including both implants and instruments, as well as our nerve monitoringsystems in a manner tailored to fulfill our customer’s obligations to meet surgery schedules. We do not generally receive separate economic value specific tothe surgical instrument sets from the surgeons or hospitals that utilize them. In many cases, once the surgery is finished, the surgical instrument sets arereturned to us and we prepare them for shipment to meet future surgeries.We complement this implant and instrument shipment model with field-based instrument assets. This hybrid strategy is designed to improve customerservice, minimize backlogs, increase asset turns, optimize freight costs, and maximize cash flow. Our pool of surgical equipment that we loan to or place withhospitals continues to increase as we increase our product offering, expand our distribution channels and increase the market penetration of our products.These surgical instrumentation and implant sets are important to the growth of our business, and we anticipate additional investments in such assets goingforward.Intellectual PropertyWe rely on a combination of patent, trademark, copyright, trade secret and other intellectual property laws, nondisclosure agreements and othermeasures to protect our intellectual property rights. We believe that in order to have a competitive advantage, we must develop and maintain the proprietaryaspects of our technologies. We require our shareowners, consultants and advisors to execute confidentiality agreements in connection with theiremployment, consulting or advisory relationships with us. We also require our shareowners, consultants and advisors who we expect to work on our productsto agree to disclose and assign to us all inventions conceived using our property or which relate to our business. Despite any measures taken to protect ourintellectual property, unauthorized parties may attempt to copy aspects of our products or to obtain and use information that we regard as proprietary.PatentsAs of December 31, 2014, we had 258 issued U.S. patents, 119 foreign national patents, and 252 pending patent applications, including 188U.S. applications, 2 international (PCT) application and 62 foreign national applications. Our issued and pending patents cover, among other things:·MAS surgical access instrumentation and methodology, including our XLIF procedure and aspects thereof;·Neurophysiology enabled instrumentation and methodology, including pedicle screw test systems, software hunting algorithms, navigatedguidance, rod bending and surgical access systems;·Implants and related instrumentation and targeting systems;·Biologics, including Osteocel Plus and Osteocel Pro, Formagraft and AttraX; and·Motion preservation products.Our issued patents begin to expire in 2018. We do not believe that the expiration of any single patent is likely to significantly affect our intellectualproperty position. 9Table of ContentsThe medical device industry is characterized by the existence of a large number of patents and frequent litigation based on allegations of patentinfringement. Patent litigation can involve complex factual and legal questions and its outcome is uncertain. Our success will depend in part on our notinfringing patents issued to others, including our competitors and potential competitors. As the number of entrants into our market increases, the possibilityof future patent infringement claims against us grows. While we make extensive efforts to ensure that our products do not infringe other parties’ patents andproprietary rights, our products and methods may be covered by patents held by our competitors. There are numerous risks associated with our intellectualproperty. For a complete discussion of these risks, please see the “Risk Factors” section of this Annual Report.TrademarksAs of December 31, 2014, we had 213 trademark registrations in both domestic and foreign regions.CompetitionCompetition within the industry is primarily based on technology, innovation, quality, reputation and customer service. We believe that oursignificant competitors are Medtronic Sofamor Danek (Medtronic), DePuy/Synthes, a Johnson & Johnson company, Stryker Spine, Globus Medical, BiometSpine, and Zimmer Spine, which together represent a significant portion of the spine market. We also face competition from a significant number of smallercompanies with more limited product offerings and geographic reach than our larger competitors. These companies, who represent intense competition inspecific markets, include Orthofix International N.V. (Orthofix), Alphatec Spine (Alphatec), Landauer (LDR), K2M and others. We also face competition fromphysician owned distributorships (PODs), which are medical device distributors that are owned, directly or indirectly, by physicians. However, these PODshave recently come under scrutiny by the Office of Inspector General (OIG) as the associated physicians derive a portion of their revenue from selling orarranging for the sale of medical devices for use in procedures they perform on their own patients. The prevalence of these PODs may impact our ability togrow.The United States Government RegulationOur products are medical devices and tissue subject to extensive regulation by the FDA and other regulatory bodies both inside and outside of theUnited States. Each of these agencies requires us - to varying degrees - to comply with laws and regulations governing the development, testing,manufacturing, storage, labeling, marketing and distribution of our products.FDA’s Premarket Clearance and Approval RequirementsUnless an exemption applies, each medical device that we market and sell in the United States must first receive either premarket clearance (bysubmitting a 510(k) notification) or premarket approval (by filing a premarket approval application (PMA)) from the FDA. In addition, certain modificationsto marketed devices may require 510(k) clearance or approval of a PMA supplement. The FDA’s 510(k) clearance process usually takes between three andtwelve months from the date the application is completed, but may last longer. The process of obtaining PMA approval is much more costly, lengthy anduncertain than the 510(k) clearance process and generally takes between one and three years, or even longer, from the time the application is submitted to theFDA until any approval is obtained. In addition, a clinical trial is almost always required to support a PMA application and may be required for a 510(k)premarket notification. There are numerous risks associated with conducting clinical trials, including high costs and uncertain outcomes. For a completediscussion of these risks, please see the “Risk Factors” section of this Annual Report.Human Cell, Tissue, and Cellular and Tissue Based ProductsOur allograft products, including our Triad, H2 and ExtenSure, and our Osteocel Plus and Osteocel Pro products, are regulated by the FDA as HumanCell, Tissue, and Cellular and Tissue Based Products. FDA regulations do not currently require these minimally manipulated human tissue-based products tobe subjected to a premarket approval process before they are marketed. We are, however, required to register with the FDA as a provider of such products andto list these products with the FDA and comply with its Current Good Tissue Practices for Human Cell, Tissue, and Cellular- and Tissue-Based ProductEstablishments. The FDA periodically inspects tissue facilities to determine compliance with these requirements. Entities that provide us with allograft bonetissue are responsible for performing donor recovery, donor screening and donor testing and our compliance with those aspects of the Current Good TissuePractices regulations that regulate those functions are dependent upon the actions of these independent entities.The procurement and transplantation of allograft bone tissue is subject to United States federal law pursuant to the National Organ Transplant Act(NOTA), a criminal statute that prohibits the purchase and sale of human organs used in human transplantation - including bone and related tissue - for“valuable consideration” (as defined in the NOTA). The NOTA permits reasonable payments associated with the removal, transportation, processing,preservation, quality control, implantation and storage of human bone tissue. With the exception of removal and implantation, we provide services, directlyor indirectly, in all of these areas. We make payments to vendors in consideration for the services they provide in connection with the recovery and screeningof donors. Failure to comply with the requirements of NOTA could result in enforcement action against us.The procurement of human tissue is also subject to state anatomical gift acts and some states have statutes similar to NOTA. In addition, some statesrequire that tissue processors be licensed by that state. Failure to comply with state laws could also result in enforcement action against us. 10Table of ContentsContinuing FDA RegulationAfter a device is placed on the market, numerous regulatory requirements continue to apply. These regulatory requirements include, but are notlimited to, the following:·product listing and establishment registration;·adherence to the Quality System Regulation which requires stringent design, testing, control, documentation and other quality assuranceprocedures;·labeling requirements and FDA prohibitions against the promotion of off-label uses or indications;·adverse event reporting;·post-approval restrictions or conditions, including post-approval clinical trials or other required testing;·post-market surveillance requirements;·the FDA’s recall authority, whereby it can ask for, or require, the recall of products from the market; and·requirements relating to voluntary corrections or removals.Failure to comply with applicable regulatory requirements can result in fines and other enforcement actions by the FDA, which could adversely impactour business.We are also subject to unannounced device inspections by the FDA and the California Food and Drug Branch, as well as other regulatory agenciesoverseeing the implementation and adherence of applicable state and federal tissue licensing regulations. These inspections may include our manufacturingand subcontractors’ facilities.Pursuant to FDA regulations, we can only market our products for cleared or approved uses. Although surgeons are permitted to use medical devicesfor indications other than those cleared or approved by the FDA based on their medical judgment, we are prohibited from promoting products for such “off-label” uses.Healthcare Regulation and Commercial ComplianceThe healthcare industry is highly regulated and changes in laws and regulations can be significant. The federal government and all states in which wecurrently operate regulate various aspects of our business. Changes in the law or new interpretation of existing laws can have a material effect on ourpermissible activities, the relative costs associated with doing business and the amount of reimbursement by government and other third-party payers. Anti-kickback Statute: We are subject to the federal anti-kickback statute which, among other things, prohibits the knowing and willful solicitation,offer, payment or receipt of any remuneration, direct or indirect, in cash or in kind, in return for, or to induce the referral of patients for, items or servicescovered by Medicare, Medicaid and certain other governmental health programs. Under the Patient Protection and Affordable Care Act, as amended by theHealth Care and Education Reconciliation Act of 2010 (PPACA), neither knowledge of the anti-kickback statute nor the specific intent to violate the law is arequirement for being found in violation of such laws. Violation of the anti-kickback statute may result in civil or criminal penalties and exclusion fromMedicare, Medicaid and other federal healthcare programs, and - according to PPACA - now provides a basis for liability under the False Claims Act. Manystates have enacted similar statutes, which are not limited to items and services paid for under Medicare or a federally funded healthcare program. We believethat our operations materially comply with the anti-kickback statutes; however, because these provisions are interpreted broadly by regulatory authorities, wecannot be assured that law enforcement officials or others will not challenge our operations under these statutes.Federal False Claims Act: The Federal False Claims Act (in particular -its “qui tam” or “whistleblower” provisions) allow(s) private individuals tobring actions in the name of the United States government alleging that a defendant has made false claims for payment from federal funds. In addition,various states are considering enacting or have enacted laws modeled after the Federal False Claims Act, penalizing false claims against state funds. Duringthe second quarter of 2013, we received a federal administrative subpoena from the Office of the Inspector General of the U.S. Department of Health andHuman Services (OIG) in connection with an investigation into possible false or otherwise improper claims submitted to Medicare and Medicaid. Thesubpoena seeks discovery of documents for the period January 2007 through April 2013. We continue to work with the OIG to understand the scope of thesubpoena and to provide the requested documents. Responding to the subpoena requires the Company’s management team’s attention and results insignificant legal expense. Any adverse findings related to this investigation could result in material financial penalties against the Company. 11Table of ContentsHealth Insurance Portability and Accountability Act: Under the Health Insurance Portability and Accountability Act of 1996, as was amended in2005 and in 2009 (HIPAA), a Covered Entity, as further defined under HIPAA, is required to adhere to certain requirements regarding the use, disclosure andsecurity of protected health information (PHI). In the past, HIPAA has generally affected us indirectly, as NuVasive is generally neither a Covered Entity nor aBusiness Associate, as further defined under HIPAA, to Covered Entities, except that our provision of IOM services through various subsidiaries may create aBusiness Associate relationship and/or our Puerto Rico subsidiary may be a Covered Entity. Regardless of Covered Entity status under HIPAA, in those caseswhere patient data is received, NuVasive is committed to maintaining the security and privacy of PHI. The potential for enforcement action against us is nowgreater, as the U.S. Department of Health and Human Services (HHS) can take action directly against Business Associates. Thus, while we believe we are andwill be in compliance with all required HIPAA standards, there is no guarantee that the government will agree. Enforcement actions can be costly andinterrupt regular operations of our business.Foreign Corrupt Practices Act: The United States and foreign government regulators have increased regulation, enforcement, inspections andgovernmental investigations of the medical device industry, including increased United States government oversight and enforcement of the Foreign CorruptPractices Act. If the United States or another foreign governmental authority were to conclude that we are not in compliance with applicable laws orregulations, such governmental authority can impose fines, delay or suspend regulatory clearances, institute proceedings to detain or seize our products, issuea recall, impose operating restrictions, enjoin future violations and assess civil penalties against us or our officers or employees, and can recommend criminalprosecution to the Department of Justice. Moreover, governmental authorities can ban or request the recall, repair, replacement or refund of the cost of anydevice or product we manufacture or distribute. We are also potentially subject to the UK Bribery Act, which would also subject us to the imposition of civiland criminal fines. Any of the foregoing actions could result in decreased sales as a result of negative publicity and product liability claims, and could have amaterial adverse effect on our financial condition, results of operations and prospects.Physician Payments Sunshine Act of 2009 (Sunshine Act): The Sunshine Act was enacted into law in 2010 and requires public disclosure to the UnitedStates government of payments to physicians, including in-kind transfers of value such as free gifts or meals. The Act also provides penalties for non-compliance. The Centers for Medicare and Medicaid Services, or CMS, issued final regulations and the requirement of the collection of payments tophysicians began effective August 2013, with the first annual report due March 2014. This law, along with individual state reporting requirements, such as inMassachusetts and Vermont, increases the possibility that a healthcare company may run afoul of one or more of the requirements.Compliance Program: A compliance program is a set of internal controls established by a company to prevent and/or detect any non-compliantactivities and to address properly those issues that may be discovered. The United States government has recommended that healthcare companies, amongothers, develop and maintain an effective compliance program to reduce the likelihood of any such non-compliance by the company, its employees, agentsand contractors. In addition, some states, such as Massachusetts and California, now require certain healthcare companies to have a formal complianceprogram in place in order to do business within the state. For years, we have maintained a compliance program structured to meet the requirements of thefederal sentencing guidelines for an effective compliance program and the model compliance program guidance promulgated by HHS over the years. Ourprogram includes, but is not limited to, a Code of Ethical Business Conduct, designation of a compliance officer, oversight by a designated committee of ourBoard of Directors, policies and procedures, a confidential disclosure method (a hotline), and conducting periodic audits to ensure compliance.Foreign Government RegulationSales of medical devices outside the United States are subject to foreign government regulations, which vary substantially from country to country.The time required to obtain approval by a foreign country may be longer or shorter than that required for FDA approval, and the requirements may differ.The European Union has adopted numerous directives and standards regulating the design, manufacture, clinical trials, labeling, and adverse eventreporting for medical devices. Additionally, certain countries (such as Switzerland), have voluntarily adopted laws and regulations that mirror those of theEuropean Union with respect to medical devices. Devices that comply with the requirements of a relevant directive will be entitled to bear “CE” conformitymarking, and, accordingly, can be commercially distributed throughout Europe. The method of assessing conformity varies depending on the class of theproduct, but normally involves a combination of self-assessment by the manufacturer and a third-party assessment by a “Notified Body”. This third-partyassessment consists of an audit of the manufacturer’s quality system and technical review of the manufacturer’s product. We have now successfully passedseveral Notified Body audits since our original certification in 2001, granting us ISO registration and allowing the CE conformity marking to be applied tocertain of our devices under the European Union Medical Device Directive. 12Table of ContentsThe Japanese government in recent years made revisions to the Pharmaceutical Affairs Law (PAL) that made significant changes to the preapprovalregulatory systems. These changes have - in part - stipulated that, in addition to obtaining a manufacturing or import approval from the Ministry of Health,Labor and Welfare, certain low-risk medical devices can now be evaluated by third-party organizations. Based on the risk-based classification, manufacturersare provided three procedures for satisfying the PAL requirements prior to placing products on the market: Pre-market Submission (Todokede); Pre-marketCertification (Ninsho); and Pre-market Approval (Shonin). NuVasive intends to market devices in Japan that will be assessed by both government entities andthird-party organizations using all three procedures in place for manufacturers. The level of review and time line for medical device approval will depend onthe risk-based classification and subsequent regulatory procedure that the medical device is aligned based on assessment against the Pharmaceutical AffairsLaw. Manufacturers must also obtain a manufacturing or import license from the prefectural government prior to importing medical devices. We will also bepursuing authorizations required by the prefectural government.Device and tissue premarket approval and/or registration and/or facility licensing requirements also exist in other markets where internationalNuVasive facilities are established and/or where we may conduct business, including, but not limited to, Southeast Asia, Australia, and Latin America. Suchrequirements vary by country and NuVasive has established procedures to drive its compliance with these requirements.Third-Party ReimbursementBroadly speaking, payer pushback on spine surgery in the United States has increased in the recent past, and we believe this has had an overalldampening effect on spine procedure volumes and prices.We expect that sales volumes and prices of our products and services will continue to be largely dependent on the availability of reimbursement fromthird-party payers, such as governmental programs, for example, Medicare and Medicaid, private insurance plans, accountable care organizations andmanaged care programs. Reimbursement is contingent on established coding for a given procedure, coverage of the codes by the third-party payers, andadequate payment for the resources used.Physician coding for procedures is established by the American Medical Association (AMA). For coding related to spine surgery, the North AmericanSpine Society, or NASS, is the primary liaison to the AMA. In July of 2006, NASS established the proper physician coding for the XLIF procedure bydeclaring it to be encompassed in existing codes that describe an anterolateral approach to the spine. This position was confirmed in a formal statement byNASS in January 2010. Hospital coding is established by CMS. XLIF is included in the nomenclature for hospital codes as an additional descriptor underlong standing codes. All physician and hospital coding is subject to change which could impact reimbursement and physician practice behavior.Independent of the coding status, third-party payers may deny coverage based on their own criteria, including if they feel that a device or procedure isnot well established clinically, is not the most cost-effective treatment available, or is used for an unapproved indication. At various times in the past, certaininsurance providers have adopted policies of not providing reimbursement for the XLIF procedure. We have worked with our surgeon customers and NASSwho, in turn, have worked with these insurance providers to supply the information, explanation and clinical data they require to categorize the XLIFprocedure as a procedure entitled to reimbursement under their policies. At present, the majority of insurance companies provide reimbursement for XLIFprocedures.However, certain carriers, large and small, may have policies significantly limiting coverage of XLIF, Interlaminar Lumbar Interbody Fusion (ILIF),Osteocel Plus and Osteocel Pro, the PCM motion-preserving Cervical Disc System, cervical interbody implants, and/or other procedures, products or servicesthat we offer. We will continue to provide resources to patients, surgeons, hospitals, and insurers in order to ensure optimum patient care and clarity regardingreimbursement and work to remove any and all non-coverage policies. National and regional coverage policy decisions are subject to unforeseeable changeand have the potential to impact physician behavior and reimbursement for physician services. We cannot offer definitive time frames or final outcomesregarding reversal of the coverage-limiting policies, as the process is dictated by the third-party insurance providers. For a discussion of these risks, please seethe “Risk Factors” section of this Annual Report.Payment amounts are established by government and private payer programs and are subject to fluctuations which could impact physician practicebehavior. Third-party payers are increasingly challenging the prices charged for a wide range of medical products and services, including those in spine andintraoperative monitoring where we participate.In international markets, reimbursement and healthcare payment systems vary significantly by country and many countries have instituted priceceilings on specific product lines. There can be no assurance that our products will be accepted by third-party payers, that reimbursement will be available,and/or that the third-party payers’ reimbursement policies (if available) will not adversely affect our ability to sell our products profitably. 13Table of ContentsParticularly in the United States where major healthcare reform provisions are scheduled, third-party payers must demonstrate they can improvequality and reduce costs; we accordingly see an increase in pre-approval/prior authorizations and non-coverage policies citing higher levels of evidencerequired for medical therapies and technologies. In addition, insured individuals are facing increased premiums and higher out–of-pocket costs for medicalcoverage which can lead a patient to delay medical treatment. An increasing number of insured individuals receive their medical care through managed careprograms, which monitor and often require pre-approval of the services that a member will receive. The percentage of individuals covered by managed careprograms is expected to grow in the United States over the next decade.In addition, there is downward pressure on reimbursement for our IOM service offerings. Significant coding changes for IOM services took effect in2013 in the way of new Current Procedural Terminology (CPT) codes that have led to reduced reimbursement by private payers for the professional remoteoversight component of the service. Medicare patients were also subject to additional coding changes imposed by CMS which may restrict access to care andlimit Impulse Monitoring’s ability to cover, bill and collect for cases performed.We believe that the overall escalating cost of medical products and services has led to, and will continue to lead to, increased pressures on thehealthcare industry to reduce the costs of products and services. There can be no assurance that third-party reimbursement and coverage will be available oradequate, or that future legislation, regulation, or reimbursement policies of third-party payers will not adversely affect the demand for our products andservices or our ability to sell these products and services on a profitable basis. The unavailability or inadequacy of third-party payer coverage orreimbursement could have a material adverse effect on our business, operating results and financial condition. For a discussion of these risks, please see the“Risk Factors” section of this Annual Report.Shareowners (our employees)We refer to our employees as “shareowners”. As of December 31, 2014, we had approximately 1,500 shareowners. In addition to our shareowners, wepartner with exclusive independent sales agencies and independent distributors who sell our products in the United States and internationally. There areapproximately 450 individuals associated with such sales agencies and distributors. None of our shareowners are represented by a labor union, and webelieve our shareowner relations are good.Corporate InformationOur business was incorporated in Delaware in July 1997. Our principal executive offices are located at 7475 Lusk Boulevard, San Diego, California92121, and our telephone number is (858) 909-1800. Our website is located at www.nuvasive.com.We file our annual reports on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K, and any amendments to those reports,electronically with the Securities and Exchange Commission (the Commission). We make these reports available free of charge on our website under theinvestor relations page as soon as reasonably practicable after we electronically file such material with, or furnish it to, the Commission. All such reports weremade available in this fashion during 2014.The public can also obtain any documents that we file with the SEC at http://www.sec.gov. The public may read and copy any materialsthat we file with the SEC at the SEC’s Public Reference Room at 100 F Street, N.E., Room 1580, Washington, D.C. 20549. The public may obtaininformation on the operation of the Public Reference Room by calling the SEC at 1-800-SEC-0330.This report may refer to brand names, trademarks, service marks or trade names of other companies and organizations, and these brand names,trademarks, service marks and trade names are the property of their respective holders. Item 1A.Risk FactorsAn investment in our common stock involves a high degree of risk. Risk factors which could cause actual results to differ from our expectations andwhich could negatively impact our financial condition and results of operations are set forth below and elsewhere in this report. If any of these risksactually occurs, our business, financial condition, results of operations and future growth prospects could be materially and adversely affected. Underthese circumstances, the trading price of our common stock could decline, and you may lose all or part of your investment. Further, additional risks notcurrently known to us or that we currently believe are immaterial also may impair our business, operations, liquidity and stock price materially andadversely. You should consider carefully the risks and uncertainties described below and elsewhere in this report before you decide to invest in our commonstock. 14Table of ContentsRisks Related to Our Business and IndustryTo be commercially successful, we must convince spine surgeons that our minimally disruptive surgical products are an attractive alternative to ourcompetitors’ products for the treatment of spine disorders.Acceptance of our products by spine surgeons depends on educating and training spine surgeons as to the distinctive characteristics, perceivedbenefits, safety and cost-effectiveness of our minimally-disruptive surgical products as compared to our competitors’ products. Surgeons may be hesitant tochange their medical treatment practices for the following reasons, among others:·lack of experience with minimally disruptive surgical products and procedures;·lack or perceived lack of evidence supporting additional patient benefits;·perceived liability risks generally associated with the use of new products and procedures;·limited or lack of availability of coverage and reimbursement within healthcare payment systems;·increased competition in lateral procedural offerings;·lack of perceived differentiation among lateral procedures;·costs associated with the purchase of new products and equipment; and·the time commitment that may be required for training.If we are not successful in convincing spine surgeons of the merit of our minimally disruptive surgical products, educating them on the use of ourproducts and maintaining their support in the use of our minimally disruptive surgical products, we will be unable to increase our sales and sustain ourgrowth and profitability. Subsequently, if we fail to adequately and continually promote and market our products to spine surgeons or if spine surgeons adoptcompeting products into their practice, our sales could significantly decrease which could significantly impact our profitability and cash flow.Additionally, we compete with companies throughout the world, many of which have developed or plan to develop competing products for use inminimally-disruptive surgical spine procedures. Several of our current and potential competitors have substantially greater financial, technical and marketingresources than we do, and they may succeed in developing products that would render our products obsolete or noncompetitive. In addition, thesecompetitors may have significantly greater operating history and patent portfolios than we do in their respective fields. Our ability to compete successfullywill depend on our ability to develop proprietary products that reach the market in a timely manner, receive adequate reimbursement and are safer, lessinvasive and less expensive than alternatives available for the same purpose. Because of the significant size of the potential market, we anticipate thatcompanies will continue to dedicate significant resources to developing competing products.Our future success depends on our strategy of obsoleting our own products and our ability to timely acquire, develop and introduce new products orproduct enhancements that will be accepted by the market.We have the objective of staying ahead of the spine market by obsoleting our own products with new technologies. It is important to our business thatwe continue to build upon our product offering to surgeons and hospitals, and enhance the products we currently offer. As such, our success will depend inpart on our ability to acquire, develop and introduce new products and enhancements to our existing products to keep pace with the rapidly changing spinemarket. We cannot assure you that we will be able to successfully acquire, develop, obtain regulatory approval for or market new products or that any of ourfuture products or enhancements will be accepted by the surgeons who use our products or the third-party payers who financially support many of theprocedures performed with our products. Additionally, in our quest to obsolete our own products, we must effectively manage our inventory, the demand fornew and current products and the regulatory process for new products in order to avoid unintended adverse financial and accounting consequences.Additionally, the research and development of many of our new and improved products is vetted by the health care professionals we maintain relationshipswith. We rely on these professionals to provide us with considerable knowledge and experience in this regard. If we are unable to maintain our strongrelationships with these professionals and continue to receive their advice and input, the development of our products could suffer, which would have amaterial adverse effect on our business and results of operations. Additionally, if we do not effectively manage our strategy of obsoleting our own products by acquiring or developing new products or productenhancements that we can introduce in time to meet market demand or if there is insufficient demand for these products or enhancements, or if we do notmanage the product transitions well which would result in margin reducing write-offs for obsolete inventory, our results of operations may suffer. 15Table of ContentsChanges to third-party reimbursement policies and practices, including non-coverage decisions, can negatively impact our ability to sell ourproducts and services.Sales of our products and services depend on the availability of adequate reimbursement from third-party payers. We believe that future third-partyreimbursement for health care costs may be subject to changes in policies and practices, such as more restrictive criteria to qualify for surgery coverage orreduction in payment amounts to hospitals and surgeons for approved surgery and intraoperative monitoring, both in the United States and internationally.The continuing efforts of governmental authorities, insurance companies, and other payers of health care costs to contain or reduce these costs could lead topatients being unable to obtain approval for payment from these third-party payers. Future legislation, regulation or reimbursement policies of third-partypayers may adversely affect the demand for our products and services as healthcare providers (such as hospitals that purchase medical devices and services fortreatment of their patients) generally rely on third-party payers to reimburse all or part of the costs and fees associated with the procedures performed withthese devices and services. Likewise, spine surgeons, neurophysiologists and their supervising physicians rely primarily on third-party reimbursement for thesurgical or monitoring fees they earn. Spine surgeons are unlikely to use our products and services if they do not receive reimbursement adequate to cover thecost of their involvement in surgical procedures.Certain third-party payers have stated non-coverage decisions concerning our technologies and services and implementation of such decisions couldsignificantly alter our ability to sell our products.Additionally, there is downward pressure on reimbursement for the IOM services provided by Impulse Monitoring. Significant coding changes forIOM services took effect in 2013. New Current Procedural Terminology (CPT) codes were introduced in 2013 that have led to reduced reimbursement byprivate payers for the professional remote oversight component of the service. Medicare patients were also subject to additional coding changes imposed byCMS which may restrict access to care and limit Impulse Monitoring’s ability to cover, bill and collect for cases performed.As we sell our products internationally, market acceptance may depend, in part, upon the availability of reimbursement within respective healthcarepayment systems in the markets we compete in. In international markets, reimbursement and healthcare payment systems vary significantly by country andmany countries have instituted price ceilings on specific product lines. The volatilities in these international reimbursement and healthcare payment systemscan have a material effect on our ability to achieve financial guidance and our results of operations.Pricing pressure from our competitors, hospital customers and insurance providers can negatively impact our ability to sell our products andservices.The market for spine surgery products is large and this has attracted numerous new companies and technologies, and encouraged more establishedcompanies to intensify competitive pressure. New entrants to our markets include numerous niche companies with singular product focus, as well ascompanies owned partially by spine surgeons (physician-owned distributorships or PODs). PODs can have significant market knowledge and access to thesurgeons who use our products. We believe there will be continued pricing pressure as a result of this increased competition. In addition, we may experiencedecreasing prices for our products due to pricing pressure experienced by our hospital customers from managed care organizations, insurance providers andother third-party payers and increased market power of our hospital customers as the medical device industry consolidates.If competitive forces drive down the price we are able to charge for some of our products, and we are not able to counter that pressure as we havehistorically with the rapid introduction of new offerings, our profit margins will shrink, which will hinder our ability to generate profits and cash flow, and, asa result, to invest in and grow our business, including the investment into new and innovative technologies.Health care policy changes, including United States health care reform legislation signed in 2010, may have a material adverse effect on us.In recent years, in response to perceived increases in health care costs, there have been and continue to be proposals by the United States federalgovernment, state governments, regulators and third-party payers to control costs and generally reform the United States health care system. Certain of theseproposals could limit the acceptance and availability of our products and could therefore have a material adverse effect on our financial position and resultsof operations. 16Table of ContentsIn March 2010, President Obama signed into law the Patient Protection and Affordable Care Act and the Health Care and Education AffordabilityReconciliation Act of 2010. Certain provisions of the law will not be effective for a number of years and there are many programs and requirements for whichthe details have not yet been fully established, and it is unclear what the full impacts on us will be from the law. The legislation imposes significant new taxeson medical device makers in the form of a 2.3 percent excise tax on all U.S. medical device sales, which commenced in January 2013. Under the newlegislation, the total cost to the medical device industry is expected to be approximately $20 billion over the first 10 years of such tax. We continue to expectthe tax will have a material and adverse effect on our business and results of operations. The law also focuses on a number of Medicare provisions aimed atimproving quality and decreasing costs. It is uncertain what negative unintended consequences these provisions may have on patient access to newtechnologies. The Medicare provisions include value-based payment programs, increased funding of comparative effectiveness research, reduced hospitalpayments for avoidable readmissions and hospital acquired conditions, and pilot programs to evaluate alternative payment methodologies that promote carecoordination (such as bundled physician and hospital payments). Additionally, the law includes a reduction in the annual rate of inflation for Medicarepayments to hospitals that began in 2011 and the establishment of an independent payment advisory board to recommend ways of reducing the rate ofgrowth in Medicare spending. We cannot predict what health care programs and regulations will be ultimately implemented at the United States federal orstate level, or the effect any future legislation or regulation may have on us. Any changes that lower reimbursement for our products or reduce medicalprocedure frequency adversely affect our business and results of operations.We are in a highly competitive market segment that is subject to rapid change and face competition from large, well-established medical devicemanufacturers as well as new market entrants.The market for spine surgery products and procedures is intensely competitive, subject to rapid change and significantly affected by new productintroductions and other market activities of industry participants. With respect to our nerve monitoring systems and IOM services, we compete withMedtronic and VIASYS Healthcare, a division of CareFusion Corporation, which has announced it is being acquired by Becton Dickinson and Company,each of which have significantly greater resources than we do, as well as numerous regional nerve monitoring companies. With respect to MaXcess, ourminimally-disruptive surgical system, our largest competitors are Medtronic, DePuy/Synthes, Stryker Spine, Globus Medical, and Zimmer Spine. We competewith many of the same companies with respect to our other products. We also compete with numerous smaller companies with respect to our implantproducts, many of whom have a significant regional market presence. At any time, these companies may develop alternative treatments, products orprocedures for the treatment of spine disorders that compete directly or indirectly with our products.Many of our larger competitors are either publicly traded or divisions or subsidiaries of publicly traded companies, and enjoy several competitiveadvantages over us, including:·significantly greater name recognition;·established relations with a greater number of spine surgeons, hospitals, other healthcare providers and third-party payers;·larger and more well established distribution networks domestically and/or internationally;·products supported by long-term clinical data;·greater experience in obtaining and maintaining FDA and other regulatory approvals or clearances for products and product enhancements;·more expansive portfolios of intellectual property rights and greater funds available to engage in legal action; and·greater financial assets, cash flow, capital markets access and other resources for product research and development, sales and marketing, andlitigation.In addition, the spine industry is becoming increasingly crowded with new market entrants, including PODs. Many of these new competitors focus ona specific product or market segment, making it more difficult for us to expand our overall market position. If these companies are continually successful, weexpect that competition will become even more intense, leading to greater pricing pressure and making it more difficult for us to expand.The proliferation of physician-owned distributorships, as well as aggressive competitive tactics to attract away key customers, could result inincreased pricing pressure on our products and harm our ability to maintain or grow revenues.PODs are medical device distributors that are owned, directly or indirectly, by physicians. These physicians derive revenue from selling or arrangingfor the sale of medical devices via their POD that are used in the procedures they perform on their patients. We do not sell or distribute any of our products toPODs. However, the prevalence of PODs may reduce our market opportunities and may hamper our ability to grow or maintain revenues. In addition, we haveseen increasingly aggressive competitive tactics from PODs focused on attracting customers away from us. To the extent these tactics are successful, ourrevenues may materially suffer. 17Table of ContentsIf our acquisitions are unsuccessful, our business may be harmed.As part of our business strategy, we have acquired, and expect to continue to acquire, companies, technologies, and product lines to maintain ourobjectives of developing or acquiring innovative technologies and expanding our capabilities, increasing revenues, and widening our footprint. Acquisitionsinvolve numerous risks, including the following:·the possibility that we will pay more than the value we derive from the acquisition, which could result in future non-cash impairment chargesand/or a dilution of future earnings per share;·difficulties in integration of the operations, technologies, personnel, and products of the acquired companies, which may require significantattention of the Company’s management team that otherwise would be available for the ongoing development of our business;·the applicability of additional laws, regulations and policies that have particular application to our acquisitions, including those relating topatient privacy, insurance fraud and abuse, false claims, prohibitions against self-referrals, anti-kickbacks, direct billing practices, HIPAAcompliance, and prohibitions against the corporate practice of medicine and fee-splitting;·the assumption of certain known and unknown liabilities of the acquired companies;·difficulties in retaining key relationships with shareowners (employees), customers, partners and suppliers of the acquired company; and·difficulties in operating in different business markets where we may not have historical experience.Any of these factors could have a negative impact on our business, results of operations or financial position. Further, past and potential acquisitionsentail risks, uncertainties and potential disruptions to our business, especially where we have limited experience as a company developing or marketing aparticular product or technology. For example, we may not be able to successfully integrate an acquired company’s operations, business processes,technologies, products and services, information systems and personnel into our business. Acquisitions may also further strain our existing financial andmanagerial controls, and divert the Company’s management team’s attention away from our other business concerns.Our IOM business exposes us to risks inherent with the sale of services.We sell IOM services that are unique from the sale of our biologics, lumbar, thoracic, cervical and motion preservation products and have applicationsoutside of our core business of spinal surgery. Our IOM services involve neurophysiologists who oversee and interpret neurophysiological data gathered viabroadband transmission in real-time being located in the operating room and working in partnership with supervising physicians. Providing this servicesubjects us to malpractice exposure.Additionally, our ability to deliver our IOM services could be severely affected if we fail to manage our relationships with the supervising physiciansand the hospital customers. Any disruption to our technology infrastructure or the Internet could harm our service operations and our reputation among ourcustomers. Any disruption to our computer systems could adversely impact the performance of our neurophysiologists.Our Impulse Monitoring business also engages in direct billing of Medicare and commercial payers for IOM service which brings with it additionalrisks associated with proper billing practice regulations, HIPAA compliance, corporate practice of medicine laws, and new collections risk associated withthird-party payers.Due to the breadth of many healthcare laws and regulations, our IOM business could also be subject to healthcare fraud regulation and enforcement byboth the federal government and the states in which we conduct our business. The laws that may affect our ability to operate include: (i) the federal healthcareprograms Anti-Kickback Law, which prohibits, among other things, persons from knowingly and willfully soliciting, receiving, offering or payingremuneration, directly or indirectly, in exchange for or to induce either the referral of an individual for, or the purchase, order or recommendation of, anygood or service for which payment may be made under federal healthcare programs such as Medicare or Medicaid, (ii) federal false claims laws whichprohibit, among other things, individuals or entities from knowingly presenting, or causing to be presented, claims for payment from Medicare, Medicaid, orother third-party payors that are false or fraudulent, and which may apply to entities like us which bill federal healthcare programs, and/or (iii) state lawequivalents of each of the above federal laws, such as anti-kickback and false claims laws which may apply to items or services reimbursed by any third-partypayer, including commercial insurers, many of which differ from their federal counterparts in significant ways, thus complicating compliance efforts.If our operations are found to be in violation of any of the laws described above or any other governmental regulations that apply to us, we may besubject to penalties, including civil and criminal penalties, damages, fines and the curtailment or restructuring of our operations. Any penalties, damages,fines, curtailment or restructuring of our operations could adversely affect our ability to operate our business and our financial results. The risk of our beingfound in violation of these laws is increased by the fact that their provisions are open to a variety of interpretations. Any action against us for violation ofthese laws, even if we successfully defend against it, could cause us to incur significant legal expenses and divert Management’s attention from the operationof our business. 18Table of ContentsIf we are unable to maintain and expand our network of direct and independent sales representatives, we may not be able to generate anticipatedsales.In the United States, we sell our products through a combination of exclusive independent sales agencies and directly-employed sales shareowners(employees). Our international sales force is comprised of directly-employed sales shareowners as well as exclusive distributors and independent sales agents.We expect these sales representatives to develop long-lasting relationships with the spine surgeons they serve. If our sales representatives fail to adequatelypromote, market and sell our products, our sales could significantly decrease.We face significant challenges and risks in managing our geographically dispersed distribution network and retaining the individuals who make upthat network. For example, in 2012 and 2013, we experienced an increase in sales representatives leaving us (with year-over-year departures holding flat in2014). If any additional sales representatives were to leave us, our sales could be adversely affected. If sales representatives were to depart and be retained byone of our competitors, we may be unable to prevent them from helping competitors solicit business from our existing customers, which could furtheradversely affect our sales. Because of the intense competition for their services, we may be unable to recruit or retain sales representatives to work with us.Failure to hire or retain qualified sales representatives would prevent us from expanding our business and generating sales.If we are unable to recruit, hire and retain skilled and experienced personnel, our ability to effectively manage and expand our business will beharmed.Our success largely depends on attracting, motivating and retaining executive talent and other key shareowners. Specifically, ourperformance depends in part on the continued services of many of our current shareowners including members of management and other keypersonnel who may terminate their employment at any time. Competition for qualified personnel in our industry is significant. The loss of any ofour senior management team could harm our business and the announcement of the loss of one of our key employees could negatively affect ourstock price. Our ability to retain our skilled workforce and our success in attracting and hiring new skilled employees will be a critical factor indetermining whether we will be successful in the future. We face challenges in hiring, training, managing and retaining employees in certain areasincluding clinical, technical, sales and marketing. This could delay new product development and commercialization and hinder our marketing andsales efforts, which would adversely impact our competitiveness and financial results.Sales to customers outside the United States have accounted for a large portion of our revenues, which exposes us to risks inherent in internationalsales.As a key component of our business strategy to develop new markets, we intend to continue to expand our international sales, but success cannot beassured. The sale and shipment of our products across international borders, as well as the purchase of components and products from international sources,subject us to extensive U.S. and foreign governmental trade, import and export and customs regulations and laws. Compliance with these regulations andlaws is costly and we are subject to penalties for non-compliance. Other laws and regulations that can significantly affect us include various anti-bribery laws,including the U.S. Foreign Corrupt Practices Act (FCPA), and anti-boycott laws. Any failure to comply with applicable legal and regulatory obligations in theUnited States or abroad could adversely affect us in a variety of ways that include, but are not limited to, significant criminal, civil and administrativepenalties, including imprisonment of individuals, fines and penalties, denial of export privileges, seizure of shipments and restrictions on certain businessactivities. Also, the failure to comply with applicable legal and regulatory obligations could result in the disruption of our distribution and sales activities.Any reduction in international sales, or our failure to further develop our international markets, could have a material adverse effect on our business, results ofoperations and financial condition.Additionally, as we increasingly compete in markets outside of the United States, we are and will be exposed to foreign currency exchange risk relatedto our foreign operations. A significant portion of our foreign subsidiaries’ operating expenses are incurred in foreign currencies. If the U.S. dollar weakens,our consolidated operating expenses would increase. Should the U.S. dollar strengthen, our products may become more expensive for our internationalcustomers, and as a result, our results of operations and net cash flows from international operations may be adversely affected, especially if internationalsales continue to grow as a percentage of our total sales. Accordingly, fluctuations in the rate of exchange between the United States dollar and foreigncurrencies, primarily the pound sterling the euro, the Australian dollar and the yen, could adversely affect our financial results, including our revenues,revenue growth rates, gross margins, income and losses as well as assets and liabilities. 19Table of ContentsIf we fail to properly manage our anticipated international growth, our business could suffer.We have invested, and expect to increase our investment for the foreseeable future, in our expansion into international markets. To execute ouranticipated growth in international markets we must:·manage the complexities associated with a larger, faster growing and more geographically diverse organization;·expand our clinical development resources to manage and execute increasingly global, larger and more complex clinical trials;·manage our directly-employed sales shareowners as well as distributors and independent sales agents operating in international markets oftenpursuant to laws, regulations and customs that may be different than those that are customary for our United States operations;·expand our sales and marketing presence in international markets generally to avoid revenue concentration in a small number of markets thatwould subject us to the risk of business disruption as a result of economic or political problems in concentrated locations;·upgrade our internal business processes and capabilities (e.g., information technology platform and systems, product distribution and tracking) tocreate the scalability and properly handle the transaction volumes that our growing geographically diverse organization demands; and·expend time and resources to receive product approvals and clearances to sell and promote products.We expect that our operating expenses will continue to increase as we continue to expand into international markets. International markets may beslower than domestic markets in adopting our products and are expected, in many instances, to yield lower profit margins when compared to our domesticoperations. We have only limited experience in expanding into international markets as well as marketing and operating our products and services in suchmarkets.Additionally, our international endeavors may involve significant risks and uncertainties, including distraction of Company management fromdomestic operations, insufficient revenue to offset the expenses associated with our international strategy, and issues not discovered in our due diligence ofnew markets or ventures. Because expansion into international markets is inherently risky, no assurance can be given that such strategies and initiatives willbe successful and will not materially adversely affect our financial condition and operating results. Even if our international expansion is successful, ourexpenses may increase at a greater pace than our revenues and our operating results could be harmed.Further, our anticipated growth internationally will place additional strain on our suppliers and manufacturers, resulting in increased need for us tocarefully monitor quality assurance. Any failure by us to manage our growth effectively could have an adverse effect on our ability to achieve ourdevelopment and commercialization goals.Our reliance on single source suppliers and manufacturers could limit our ability to meet demand for our products in a timely manner or within ourbudget.We rely on third-party suppliers and manufacturers to supply and manufacture a majority of our products. To be successful, our contract manufacturersmust be able to provide us with products and components in substantial quantities, in compliance with regulatory requirements, in accordance with agreedupon specifications, at acceptable cost and on a timely basis. Among other factors, our anticipated growth could strain the ability of suppliers to deliver anincreasingly large supply of products, materials and components. If we are unable to obtain sufficient quantities of high quality components to meet customerdemand on a timely basis, we could lose customers, our reputation may be harmed and our business could suffer.We currently use one or two manufacturers (respectively) for many of our devices, biologics, and components. Our dependence on one or twomanufacturers for each such product line involves several risks, including limited control over pricing, availability, quality and delivery schedules. If anyone or more of our manufacturers cease to provide us with sufficient quantities of our components in a timely manner or on terms acceptable to us, cease tomanufacture components of acceptable quality or cease to do business in general, we would have to seek alternative sources of manufacturing. We couldincur delays while we locate and engage alternative qualified suppliers and we might be unable to engage alternative suppliers on favorable terms. Any suchdisruption or increased expenses could harm our commercialization efforts and adversely affect our ability to generate revenue. In the event we experiencedelays, shortages, or stoppages of supply with any supplier, we would be forced to locate a suitable alternative supplier which could take significant time andresult in significant expense. Any inability to meet our customers’ demands for these products could lead to decreased sales and harm our reputation andresult in the loss of customers to our competitors, which could cause the market price of our common stock to decline. 20Table of ContentsManufacturing risks may adversely affect our ability to manufacture products and could reduce our gross margins and negatively affect ouroperating results.In May 2013, we acquired a spine implant manufacturer based in Dayton, Ohio and currently manufacture a portion of our products at this facility. Aspart of our business strategy, we intend to expand our ability to manufacture our current and new products with exceptional quality and in sufficientquantities to meet demand, while complying with regulatory requirements and managing manufacturing costs. We are subject to numerous risks relating toour manufacturing capabilities, including both those of our owned manufacturing facilities and those of our third party suppliers, such as:·defects in product components that we source from third-party suppliers;·failing to increase production of products to meet demand;·potential adverse effects on existing business relationships with current third-party suppliers as we expand our in-house manufacturingcapabilities;·maintaining control over manufacturing expenses as production expands;·the inability to modify production lines to enable the efficient manufacture of new products or to quickly implement changes to current productsin response to regulatory requirements; and·potential damage to or destruction of our, or our suppliers’ manufacturing equipment or manufacturing facilities.These risks may be exacerbated by our limited experience with in-house manufacturing processes and procedures. In addition, as we seek to expandour manufacturing capabilities, we will have to continue to invest additional resources to hire and train personnel and enhance our production processes. Ifwe fail to increase our manufacturing capacity efficiently, our profit margins will shrink, which will negatively affect our operating results.Cyber security risks and the failure to maintain the confidentiality, integrity, and availability of our computer hardware, software,and Internet applications and related tools and functions could result in harm to our business and/or subject us to costs, fines orlawsuits.We rely on sophisticated information technology systems and network infrastructure to operate and manage our business. We also maintainpersonally identifiable information about our employees. Our business therefore depends on the continuous, effective, reliable, and secureoperation of our computer hardware, software, networks, Internet servers, and related infrastructure. To the extent that our hardware or softwaremalfunctions or access to our data by internal personnel, suppliers or customers through the Internet is interrupted or compromised, our businesscould suffer.The integrity and protection of our customer, employee, financial, research and development, and other confidential data is critical to ourbusiness and our customers and employees have a high expectation that we will adequately protect their personal information. The regulatoryenvironment governing information, security and privacy laws is increasingly demanding and continues to evolve. Although our computer andcommunications hardware is protected through physical and software safeguards, it is still vulnerable to system malfunction, computer viruses,and cyber-attacks. These events could lead to the unauthorized access of our information technology systems and result in the misappropriationor unauthorized disclosure of confidential information belonging to us, our employees, partners, customers, or our suppliers. The techniques usedby criminal elements to attack computer systems are sophisticated, change frequently and may originate from less regulated and remote areas ofthe world. As a result, we may not be able to address these techniques proactively or implement adequate preventative measures. If ourinformation technology systems are compromised, we could be subject to fines, damages, litigation and enforcement actions and we could losetrade secrets or other confidential information, the occurrence of which could harm our business. 21Table of ContentsRisks Related to Our Intellectual Property and LitigationWe are currently involved in patent litigation involving Medtronic, and, if we do not prevail in the litigation and/or on our appeal of the Medtronicverdict in phase one of the litigation, we could be liable for substantial damages and might be prevented from making, using, selling, offering to sell,importing or exporting certain of our products.On August 18, 2008, Medtronic filed suit against us in the U.S. District Court for the Southern District of California, alleging that certain of ourproducts infringe, or contribute to the infringement of, U.S. patents owned by Medtronic. Trial in the first phase of the case began in August 2011, and inSeptember 2011, a jury delivered an unfavorable verdict against us with respect to three Medtronic patents and a favorable verdict with respect to one of ourpatents. The jury awarded monetary damages of approximately $0.7 million to us which includes back royalty payments. Additionally, the jury awardedmonetary damages of approximately $101.2 million to Medtronic which includes lost profits and back royalties. On June 11, 2013, the District Courtdetermined that the amount of ongoing royalties owed by us to Medtronic was 13.75% on certain of NuVasive’s CoRoent XL implants and 8.25% on certainof NuVasive’s MaXcess III retractors and related products. On August 20, 2013, NuVasive and Medtronic filed their respective notices of appeal, and theappeal is now proceeding before the U.S. Court of Appeals for the Federal Circuit. We entered into an escrow arrangement in 2012 and transferred $113.3million of cash into a restricted escrow account to secure the amount of judgment, plus prejudgment interest, during pendency of appeal. As a result of theJune 2013 ruling, we will be required to escrow funds to secure accrued royalties, estimated at $29.4 million to date, as well as future ongoing royalties, plusprejudgment interest, which represents a material reduction in our cash resources available for investment.In August 2012, Medtronic filed additional patent claims (Phase 3) against us alleging that various NuVasive spinal implants (including our CoRoentXL family of spinal implants) and NuVasive’s Osteocel Plus bone graft product, along with the XLIF procedure, infringe Medtronic patents not asserted inprior phases of the case. We deny infringing any valid claims of these additional patents and on March 7, 2013, we filed counterclaims against Medtronicasserting that Medtronic’s MAST Quadrant retractor system, the NIM-Eclipse Spinal System, the Clydesdale Spinal System, the Capstone-L products, and theDirect Lateral Interbody Fusion (“DLIF”) procedure infringe eight NuVasive patents. No trial date has been set.If we do not prevail in the Medtronic litigation we could be required to stop selling certain of our products, pay substantial monetary amounts asdamages, and/or enter into expensive royalty or licensing arrangements. Such adverse results may limit our ability to generate profits and cash flow, and, as aconsequence, to invest in and grow our business, including investments into new and innovative technologies.We are currently involved in a trademark litigation action involving the NeuroVision brand name and, if we do not prevail, we could be liable forsubstantial damages.On September 25, 2009, Neurovision Medical Products, Inc. (NMP) filed suit against us in the U.S. District Court for the Central District of Californiaalleging trademark infringement and unfair competition. NMP sought cancellation of our “NeuroVision” trademark registrations, injunctive relief anddamages based on NMP’s common law use of the “NeuroVision” mark. Trial of the matter took place in October 2010, and an unfavorable jury verdict wasdelivered against us relating to our use of the NeuroVision trade name in the amount of $60.0 million plus attorney fees and costs, as well as an injunction.We promptly appealed the verdict to the Ninth Circuit Court of Appeals. During the pendency of the appeal, we were required to escrow the amount of thejudgment, plus interest. In September 2012, the Court of Appeals reversed and vacated the District Court’s judgment against us, and also reversed andvacated the injunction and the award of attorney fees and costs. The Court of Appeals remanded the case for a new trial and instructed the District Court toassign the case to a different judge. In December 2012, the full $62.5 million was released from escrow and returned to us. Retrial of the matter began onMarch 25, 2014, and on April 3, 2014, a jury returned a verdict in favor of NMP on its claims against us in the amount of $30.0 million. The Court affirmedthe jury’s verdict, and on September 4, 2014, we filed a notice of appeal. The Court entered a permanent injunction on September 24, 2014, enjoining ourfuture use of the NeuroVision trademark to market or promote our products. The Court also entered an order canceling our NeuroVision trademarkregistrations, but that order is stayed pending the appeal process. On December 2, 2014, the Court denied NMP’s motion for attorneys’ fees, costs, andprejudgment interest, and NMP filed a notice of appeal on December 17, 2014. The appeals were consolidated on February 2, 2015, and resolution of theappeals may take up to two years. During pendency of the appeal, we have agreed to escrow funds totaling $32.5 million to secure the amount of judgment,plus interest, attorney’s fees and costs.This litigation process has been expensive, complex and lengthy and its outcome is difficult to predict. We may also be subject to additional negativepublicity due to this trademark litigation. This litigation may significantly divert the attention of our technical and Management personnel. In the event thatwe are unsuccessful in our defense, we could be required to pay significant damages which are not covered under any of our insurance plans. In the event thisoutcome occurs, our business, liquidity, financial condition and results of operations would be materially adversely affected. 22Table of ContentsWe are currently, and may in the future be, subject to securities litigation, which is expensive and could divert Management attention. The market price of our common stock may be volatile, and in the past companies that have experienced volatility in the market price of their stockhave been subject to securities class action litigation. We are currently defending a purported securities class action lawsuit which alleges violations ofSections 10(b) and 20(a) of the Securities Exchange Act of 1934, as amended, and Rule 10b-5 promulgated thereunder and seeks unspecified monetary relief,interest, and attorneys’ fees. At December 31, 2014, the probable outcome of this litigation cannot be determined, nor can the Company estimate a range ofpotential loss. We may be the target of this type of litigation again in the future. Any securities litigation against us could result in substantial costs anddivert our Management's attention from other business concerns, which could seriously harm our business. We are currently involved in several additional litigation actions which could cause us to incur significant legal expenses and/or prevent us frommaking, using, selling, offering to sell, importing or exporting certain of our products.Intellectual property litigation is expensive, complex and lengthy and its outcome is difficult to predict. A court could enter orders that temporarily,preliminarily or permanently enjoin us or our customers from modeling, using, selling, offering to sell or importing our current or future products, or couldenter an order mandating that we undertake certain remedial activities. We may also be subject to negative publicity due to litigation. Pending or futurepatent litigation against us or any strategic partners or licensees may force us or any strategic partners or licensees to stop or delay developing, manufacturingor selling potential products that are claimed to infringe a third-party’s intellectual property, unless we develop alternative non-infringing technology or thatparty grants us or any strategic partners or licensees rights to use its intellectual property, and may significantly divert the attention of our technical andmanagement personnel. In the event that our right to market any of our products is successfully challenged, or if we fail to obtain a required license or areunable to design around a patent, our business, financial condition or results of operations could be materially adversely affected. In such cases, we may berequired to obtain licenses to patents or proprietary rights of others in order to continue to commercialize our products. However, we may not be able toobtain any licenses required under any patents or proprietary rights of third parties on acceptable terms, or at all, and any licenses may require substantialroyalties or other payments by us. Even if any strategic partners, licensees or we were able to obtain rights to the third-party’s intellectual property, theserights may be non-exclusive, thereby giving our competitors access to the same intellectual property. Furthermore, if we are found to infringe patent claims ofa third-party, we may, among other things, be required to pay damages, including up to treble damages and attorneys’ fees and costs, which may besubstantial.An unfavorable outcome for us in patent or other intellectual property litigation could significantly harm our business if such outcome makes usunable to commercialize some of our current or potential products or cease some of our business operations. In addition, costs of prosecution of claims anddefense, and any damages resulting from litigation may materially adversely affect our business and financial results. Litigation may also harm ourrelationships with existing customers and subject us to negative publicity, each of which could harm our business and financial results.Our ability to protect our intellectual property and proprietary technology through patents and other means is uncertain.Our success depends significantly on our ability to protect our proprietary rights to the technologies used in our products. We rely on patentprotection, as well as a combination of copyright, trade secret and trademark laws, and nondisclosure, confidentiality and other contractual restrictions toprotect our proprietary technology. However, these legal means afford only limited protection and may not adequately protect our rights or permit us to gainor keep any competitive advantage. For example, our pending U.S. and foreign patent applications may not issue as patents at all or not in a form that will beadvantageous to us or may issue and be subsequently successfully challenged by others and invalidated. In addition, our pending patent applications includeclaims to material aspects of our products and procedures that are not currently protected by issued patents. Both the patent application process and theprocess of managing patent disputes can be time consuming and expensive. Competitors may be able to design around our patents or develop products whichprovide outcomes which are comparable to ours. Moreover, competitors may challenge our issued patents through post-grant challenge procedures(domestically) and/or opposition proceedings (internationally). On March 16, 2012, the America Invents Act amended the post-grant challenge procedures inthe U.S. to eliminate inter partes reexamination, maintain ex parte reexamination, and add inter partes review and supplemental examination. Both Medtronicand Globus filed inter partes reexamination requests (before March 16, 2012) against the patents we asserted against them. Those inter partes reexaminationrequests were granted and those proceedings are in progress. Medtronic filed multiple inter partes review petitions (after March 16, 2012) against the patentswe asserted against them in phase 3. Those inter partes review petitions have not yet been decided. If the U.S. Patent Office ultimately cancels or narrows theclaims in any of our patents through these proceedings, it could prevent or hinder us from being able to enforce them against competitors. 23Table of ContentsAlthough we have taken steps to protect our intellectual property and proprietary technology, including entering into confidentiality agreements andintellectual property assignment agreements with our officers, shareowners, consultants and advisors, such agreements may not be enforceable or may notprovide meaningful protection for our trade secrets or other proprietary information in the event of unauthorized use or disclosure or other breaches of theagreements. To the extent that our shareowners, consultants, or contractors use intellectual property owned by others in their work for us, disputes may ariseas to the rights in related or resulting know-how and inventions. Furthermore, the laws of some foreign countries may not protect our intellectual propertyrights to the same extent as do the laws of the United States.In addition, recently enacted changes to the U.S. patent laws, together with proposed changes to the rules of the U.S. Patent Office to comport with thenewly enacted laws may have a significant impact on our ability to protect our technology and enforce our intellectual property rights. Of significance in thenewly enacted patent laws, the United States has shifted from a “first to invent” to a “first inventor to file” system, which went into effect on March 16, 2013.Consequently, the pool of prior art available to inhibit or limit our ability to obtain issued patents on the technology utilized in our products is expected toexpand and the grace period for filing a patent application has been reduced in some ways. It is now possible for a situation to arise in which a competitor isable to obtain patent rights to technology which we invented first. Furthermore, the newly enacted patent laws have expanded the types of post grantchallenges of issued patents and these proceedings may provide our competitors with additional opportunities to challenge the validity of our issued patents.In the event a competitor infringes upon our patent or other intellectual property rights, enforcing those rights may be costly, difficult and timeconsuming. We may not have sufficient resources to enforce our intellectual property rights or to defend our patents against a challenge.The medical device industry is characterized by the existence of a large number of patents and frequent litigation based on allegations of patentinfringement. It is not unusual for parties to exchange letters surrounding allegations of intellectual property infringement and licensing arrangements. Patentlitigation can involve complex factual and legal questions and its outcome is uncertain. Any claim relating to infringement of patents that is successfullyasserted against us may require us to pay substantial damages, including treble damages in some cases. Even if we were to prevail, any litigation could becostly and time-consuming and would divert the attention of Management and key personnel from our business operations. Our success will also depend inpart on our not infringing patents issued to others, including our competitors and potential competitors. If our products are found to infringe the patents ofothers, our development, manufacture and sale of such potential products could be severely restricted or prohibited. In addition, our competitors mayindependently develop technologies similar to ours. Because of the importance of our patent portfolio to our business, we may lose market share to ourcompetitors if we fail to adequately protect our intellectual property rights.As the number of entrants into our market increases, the possibility of a patent infringement claim against us grows. While we make an effort to ensurethat our products do not infringe other parties’ rights, our products and methods may be covered by patents held by our competitors. In addition, ourcompetitors may assert that future products we may market infringe their patents.A patent infringement suit brought against us or any of our strategic partners or licensees may force us or such strategic partners or licensees to stop ordelay developing, manufacturing or selling potential products that are claimed to infringe a third-party’s intellectual property, unless that party grants us orour strategic partners or licensees rights to use its intellectual property. In such cases, we may be required to obtain licenses to patents or proprietary rights ofothers in order to continue to commercialize our products. However, we may not be able to obtain any licenses required under any patents or proprietaryrights of third parties on acceptable terms, or at all, and any licenses may require substantial royalties or other payments by us. Even if our strategic partners,licensees or we were able to obtain rights to the third-party’s intellectual property, these rights may be non-exclusive, thereby giving our competitors accessto the same intellectual property. Ultimately, we may be unable to commercialize some of our potential products or may have to cease some of our businessoperations as a result of patent infringement claims, which could severely harm our business.Risks Related to our Legal and Regulatory EnvironmentWe are subject to rigorous governmental regulations regarding the development, manufacture, and sale of our products and we may incursignificant expenses to comply with these regulations and develop products that satisfy these regulations. In addition, failure to comply with theseregulations could subject us to substantial sanctions which could adversely affect our business, results of operations and financial condition.The medical devices we manufacture and market are subject to rigorous regulation by the FDA and numerous other federal, state and foreigngovernmental authorities, including regulations that cover, among other things, the composition, labeling, testing, clinical study, manufacturing, packaging,marketing and distribution of our products. 24Table of ContentsWe are required to register with the FDA as a device manufacturer and tissue bank. As a result, we are subject to periodic inspection by the FDA forcompliance with the FDA’s Quality System Regulation (QSR) and Good Tissue Practices requirements, which require manufacturers of medical devices andtissue banks to adhere to certain regulations, including testing, quality control and documentation procedures. Our compliance with applicable regulatoryrequirements is subject to continual review and is rigorously monitored through periodic inspections by the FDA. In the European Community, we arerequired to maintain certain ISO certifications in order to sell our products, and are subject to periodic inspections by Notified Bodies to obtain and maintainthese certifications. If we or our suppliers fail to adhere to QSR, ISO or other applicable regulations and standards, product production could be delayedand/or fines could be incurred, regulatory clearances and approvals might be challenged or difficult to obtain, recalls or other consequences might beincurred, any or all of which - in turn - could have a material adverse effect on our financial condition, results of operations, or prospects.Most medical devices must receive FDA clearance or approval before they can be commercially marketed. In addition, the FDA may require testingand surveillance programs to monitor the effects of approved products that have been commercialized, and can prevent or limit further marketing of a productbased upon the results of such post-marketing programs. In addition, the Federal Medical Device Reporting Regulations require us to provide information tothe FDA whenever there is evidence that reasonably suggests that a device may have caused or contributed to a death or serious injury or, if a malfunctionwere to occur, that could cause or contribute to a death or serious injury. Furthermore, most major markets for medical devices outside the United Statesrequire clearance, approval or compliance with certain standards before a product can be commercially marketed. The process of obtaining regulatoryapprovals to market a medical device, particularly from the FDA and certain foreign governmental authorities, can be costly and time-consuming, andapprovals may not be granted for future products or product improvements on a timely basis, if at all. Delays in receipt of, or failure to obtain, approvals forfuture products or product improvements could result in delayed realization of product revenues or in substantial additional costs, which could have amaterial adverse effect on our business or results of operations or prospects. At any time after approval of a product, the FDA may conduct periodicinspections to determine compliance with both QSR requirements and/or current Medical Device Reporting regulations. Product clearances or approvals bythe FDA can be withdrawn due to failure to comply with regulatory standards or the occurrence of unforeseen problems following initial clearance orapproval.Pursuant to FDA regulations, we can only market our products for cleared or approved uses. Although physicians are permitted to use medical devicesfor indications other than those cleared or approved by the FDA based on their medical judgment, we are prohibited from promoting products for such off-label uses. We market our products and provide promotional materials and training programs to physicians regarding the use of our products. Although webelieve our marketing, promotional materials and training programs for physicians do not constitute promotion of unapproved uses of our products, if it isdetermined that our marketing, promotional materials or training programs constitute promotion of unapproved uses, we could be subject to significant finesin addition to regulatory enforcement actions, including the issuance of a warning letter, injunction, seizure and criminal penalty.Additional laws that may affect our ability to operate include: (i) the federal healthcare programs Anti-Kickback Law, which prohibits, among otherthings, persons from knowingly and willfully soliciting, receiving, offering or paying remuneration, directly or indirectly, in exchange for or to induce eitherthe referral of an individual for, or the purchase, order or recommendation of, any good or service for which payment may be made under federal healthcareprograms such as Medicare or Medicaid, (ii) federal false claims laws which prohibit, among other things, individuals or entities from knowingly presenting,or causing to be presented, claims for payment from Medicare, Medicaid, or other third-party payors that are false or fraudulent, and which may apply toentities like us which provide coding and billing advice to customers, and/or (iii) state law equivalents of each of the above federal laws, such as anti-kickback and false claims laws which may apply to items or services reimbursed by any third-party payer, including commercial insurers, many of whichdiffer from their federal counterparts in significant ways, thus complicating compliance efforts.If our operations are found to be in violation of any of the laws described above or any other governmental regulations that apply to us, we may besubject to penalties, including civil and criminal penalties, damages, fines and the curtailment or restructuring of our operations. Any penalties, damages,fines, curtailment or restructuring of our operations could adversely affect our ability to operate our business and our financial results. The risk of our beingfound in violation of these laws is increased by the fact that their provisions are open to a variety of interpretations. Any action against us for violation ofthese laws, even if we successfully defend against it, could cause us to incur significant legal expenses and divert Management’s attention from the operationof our business.Also, the procurement and transplantation of allograft bone tissue is subject to the criminal statute NOTA and state rules and regulations whichgovern, among other things, payments we make to vendors in consideration for the services they provide in connection with the recovery and screening ofdonors. Failure to comply with such laws could result in enforcement action against us and a disruption to these product lines (and the revenues associatedtherewith). 25Table of ContentsPursuant to the Dodd-Frank Wall Street Reform and Consumer Protection Act, the SEC promulgated final rules regarding disclosure of the presence ina company’s products of certain metals, known as “conflict minerals”: tantalum, tin, tungsten (or their ores), and gold; which are metals mined from theDemocratic Republic of the Congo and adjoining countries. Under the rules, we are now required to disclose the procedures we employ to determine thesourcing of such minerals and metals produced from those minerals. There are costs associated with complying with these disclosure requirements, includingfor diligence in regards to the sources of any conflict minerals used in our products, in addition to the cost of remediation and other changes to products,processes, or sources of supply as a consequence of such verification activities. In addition, the implementation of these rules could adversely affect thesourcing, supply, and pricing of materials used in our products. As of the date of our conflict minerals report for the 2013 calendar year, we were unable toobtain the necessary information on conflict minerals from all of our suppliers and were unable to determine that all of our products are conflict free. We maycontinue to face difficulties in gathering this information in the future. We may face reputational challenges if we determine that certain of our productscontain minerals not determined to be conflict free or if we are unable to sufficiently verify the origins for all conflict minerals used in our products throughthe procedures we implement.Whenever the United States or another foreign governmental authority concludes that we are not in compliance with applicable laws or regulations,such governmental authority can impose fines, delay or suspend regulatory clearances, institute proceedings to detain or seize our products, issue a recall,impose operating restrictions, enjoin future violations and assess civil penalties against us or our officers or employees, and can recommend criminalprosecution to the Department of Justice (DOJ). Moreover, governmental authorities can ban or request the recall, repair, replacement or refund of the cost ofany device or product we manufacture or distribute. Any of the foregoing actions could result in decreased sales as a result of negative publicity and productliability claims, and could have a material adverse effect on our financial condition, results of operations and prospects. In addition to the sanctions fornoncompliance described above, commencement of an enforcement proceeding, inspection or investigation could divert substantial Management attentionfrom the operation of our business and have an adverse effect on our business, results of operations and financial condition.During the second quarter of 2013, we received a federal administrative subpoena from the Office of Inspector General of the U.S. Department ofHealth and Human Services (OIG) in connection with an investigation into possible false or otherwise improper claims submitted to Medicare and Medicaid.The subpoena seeks discovery of documents for the period January 2007 through April 2013. We cannot control the pace or scope of any investigation, andresponding to the subpoena requests and any investigation requires an allocation of resources, including Management time and attention. If we were tobecome the subject of an enforcement action, including any action resulting from the investigation by the OIG, it could result in negative publicity,penalties, fines, the exclusion of our products from reimbursement under federally-funded programs and/or prohibitions on our ability to sell our products,which could have a material adverse effect on our results of operations, financial condition and liquidity.We may fail to obtain or maintain foreign regulatory approvals to market our products in other countries.We currently market our products internationally and intend to expand our international marketing. International jurisdictions require separateregulatory approvals and compliance with numerous and varying regulatory requirements. The approval procedures vary among countries and may involverequirements for additional testing. The time required to obtain approval may differ from country to country and from that required to obtain FDA clearanceor approval.Clearance or approval by the FDA does not ensure approval or certification by regulatory authorities in other countries or jurisdictions, and approvalor certification by one foreign regulatory authority does not ensure approval or certification by regulatory authorities in other foreign countries or by theFDA. The foreign regulatory approval or certification process may include all of the risks associated with obtaining FDA clearance or approval. We may notobtain foreign regulatory approvals on a timely basis, if at all. We may not be able to file for regulatory approvals or certifications and may not receivenecessary approvals to commercialize our products in any market. If we fail to receive necessary approvals or certifications to commercialize our products inforeign jurisdictions on a timely basis, or at all, our business, results of operations and financial condition could be adversely affected.If we fail to obtain, or experience significant delays in obtaining, FDA clearances or approvals for our future products or product enhancements,our ability to commercially distribute and market our products could suffer.Our medical devices are subject to rigorous regulation by the FDA and numerous other federal, state and foreign governmental authorities. The processof obtaining regulatory clearances or approvals to market a medical device, particularly from the FDA, can be costly and time consuming, and there can be noassurance that such clearances or approvals will be granted on a timely basis, if at all. In particular, the FDA permits commercial distribution of a new medicaldevice only after the device has received clearance under Section 510(k) of the Federal Food, Drug and Cosmetic Act, or is the subject of an approvedpremarket approval application (PMA). If clinical trials of our current or future product candidates do not produce results necessary to support regulatoryapproval, we will be unable to commercialize these products, which could have a material adverse effect on our financial results. 26Table of ContentsThe FDA will clear marketing of a medical device through the 510(k) process if it is demonstrated that the new product is substantially equivalent toother 510(k)-cleared products. The PMA process is more costly, lengthy and uncertain than the 510(k) clearance process. Additionally, any modification to a510(k)-cleared device that could significantly affect its safety or efficacy, or that would constitute a major change in its intended use, requires a new 510(k)clearance or, possibly, a PMA. The FDA may not agree with any of our decisions regarding whether new clearances or approvals are necessary. More recently,in July 2012, President Obama signed into law the Food and Drug Administration Safety and Innovation Act, or FDASIA. Among other things, FDASIAincludes several reforms which are further intended to clarify and improve medical device regulation both pre- and post-approval. One of these provisionsobligates the FDA to prepare a report for Congress on the FDA’s approach for determining when a new 510(k) will be required for modifications or changes toa previously cleared device. After submitting this report, the FDA is expected to issue revised guidance to assist device manufacturers in making thisdetermination. Until receiving such revised guidance, manufacturers may continue to adhere to the FDA’s 1997 guidance on this topic when making adetermination as to whether or not a new 510(k) is required for a change or modification to a device, but the practical impact of the FDA’s continuingscrutiny of these issues remains unclear.Our failure to comply with such regulations could lead to the imposition of injunctions, suspensions or loss of regulatory approvals, product recalls,termination of distribution, or product seizures. In the most egregious cases, criminal sanctions or closure of our manufacturing facilities are possible.Pursuant to FDA regulations, we can only market our products for cleared or approved uses. If the FDA determines that our promotional materials ortraining constitute promotion of an unapproved use, it could request that we modify our training or promotional materials, or subject us to regulatoryenforcement actions, including the issuance of a warning letter, injunction, seizure, civil fine and criminal penalties. It is also possible that other federal, stateor foreign enforcement authorities might take action if they consider promotional or training materials to constitute promotion of an unapproved use, whichcould result in significant fines or penalties under other statutory authorities. Additionally, surgeons use several of our products for unapproved uses. Whilesurgeons are permitted by the FDA to use our products for unapproved uses, there is a heightened risk of an enforcement action against us by a governmentalenforcement authority when surgeons engage in this practice.Foreign governmental authorities that regulate the manufacture and sale of medical devices have become increasingly stringent and, to the extent wemarket and sell our products in foreign countries, we may be subject to rigorous regulation in the future. In such circumstances, we would rely significantlyon our foreign subsidiaries and independent sales agencies to comply with the varying regulations, and any failures on their part could result in restrictionson the sale of our products in foreign countries.The safety of many of our products is not yet supported by long-term clinical data and many of our products may therefore prove to be less safe andeffective than initially thought which could subject us to product liability claims.We obtained clearance to offer almost all of our medical device products that require FDA clearance through the FDA’s 510(k) premarket notificationclearance process. The FDA’s 510(k) process, much like other foreign premarket regulatory review processes to which our devices are subject, seldom requiresclinical data. As a result, we currently lack the breadth of published long-term clinical data supporting the safety and effectiveness of many of our products,devices and tissue that might have been generated in connection with a U.S. PMA-like application. For these reasons, spine surgeons may be slow to adoptour products, we may not have comparative data that our competitors have or are generating, and we may be subject to greater regulatory and productliability risks. Further, future patient studies or clinical experience may indicate that treatment with our products does not improve patient outcomes. Suchresults would reduce demand for our products, affect our ability to have sustainable reimbursement for our products from third-party payers, significantlyreduce our ability to achieve expected revenues and could prevent us from sustaining or increasing profitability. Moreover, if future results and experienceindicate that our products cause unexpected or serious complications or other unforeseen negative effects, we could be subject to significant legal liabilityand harm to our business reputation. The spine medical device market has been particularly prone to potential product liability claims that are inherent in thetesting, manufacture and sale of medical devices and products for spine surgery procedures.A product liability or other damages claim, product recall or product misuse, regardless of the ultimate outcome, could require us to spend significanttime and money in litigation or to pay significant damages or costs and could seriously harm our business. Any product liability claim brought against us,with or without merit, could result in the increase of our product liability insurance rates or the inability to secure coverage in the future. In addition, if ourproduct liability insurance proves to be inadequate to pay a damage award, we may have to pay the excess out of our cash reserves which may harm ourfinancial condition. If longer-term patient results and experience indicate that our products or any component of our products cause tissue damage, motorimpairment or other adverse effects, we could be subject to significant liability. Finally, even a meritless or unsuccessful product liability claim could harmour reputation in the industry, lead to significant legal fees and could result in the diversion of management’s attention from managing our business. Aproduct liability or other damages claim, product recall, or product misuse involving any of our products could also materially and adversely damage ourreputation and affect our ability to attract and retain customers, regardless of whether or not the claim or recall had merit. 27Table of ContentsIf we or our suppliers fail to comply with the FDA’s quality system regulations or equivalent regulations and standards internationally, themanufacture and processing of our products could be delayed and we may be subject to an enforcement action by the FDA or other government agencies.We and our suppliers are required to comply with the FDA’s quality system regulations, and other applicable standards and requirements, which coverthe methods and documentation of the design, testing, production or processing, control, quality assurance, labeling, packaging, storage and shipping of ourproducts. The FDA and other regulatory bodies enforce compliance with regulatory requirements and standards through periodic inspections. If we or one ofour suppliers fail an inspection or if any corrective action plan is not sufficient, the release of our products could be delayed. We have undergone FDA andother regulatory body’s inspections regarding our allograft business and FDA inspections regarding our medical device activities. In connection with theseinspections as well as prior inspections, regulatory agencies have requested minor corrective actions, which we have implemented. There can be no assurancethat the FDA will not subject us to further enforcement action and the FDA and other regulatory agencies may impose additional inspections at any time.Additionally, we are the legal manufacturer of record for the products that are distributed and labeled by NuVasive, regardless of whether the productsare manufactured by us or our suppliers. Thus, a failure by us or our suppliers to comply with applicable regulatory requirements can result in enforcementaction against us by the FDA, which may include any of the following sanctions:·fines, injunctions, and civil penalties;·recall or seizure of our products;·operating restrictions, partial suspension or total shutdown of production;·refusing our request for 510(k) clearance or premarket approval of new products;·withdrawing 510(k) clearance or premarket approvals that are already granted; and·criminal prosecution.We or our suppliers may be the subject of claims for non-compliance with FDA regulations in connection with the processing or distribution ofallograft products.It is possible that allegations may be made against us or against donor recovery groups or tissue banks, including those with which we have acontractual relationship, claiming that the acquisition or processing of tissue for allograft products does not comply with applicable FDA regulations or otherrelevant statutes and regulations. Allegations like these could cause regulators or other authorities to take investigative or other action against us, or couldcause negative publicity for us or our industry in general. These actions or any negative publicity could cause us to incur substantial costs, divert theattention of Management from our business, harm our reputation and cause the market price of our shares to decline.Failure to comply with highly regulated and frequently changing healthcare laws could adversely affect our ability to receive reimbursement forour services and subject us and our officers and agents to civil and criminal penalties.The healthcare industry is highly regulated and changes in laws and regulations can be significant. The federal government and all states andcountries in which we currently operate regulate various aspects of our business. Changes in the law or new interpretation of existing laws can have a materialeffect on our permissible activities, the relative costs associated with doing business and the amount of reimbursement by government and other third-partypayers. Failure to comply with these laws could adversely affect our ability to receive reimbursement for our services and subject us and our officers andagents to civil and criminal penalties.Any claims relating to our making improper payments or providing improper gifts or benefits to physicians or other potential violations of laws orregulations governing interactions between us and healthcare professionals and our involvement in federal healthcare programs could be time consumingand costly.Our relationship with healthcare professionals, such as physicians, hospitals and those that may market our products (e.g., distributors, etc.), are subjectto scrutiny under various state and federal laws, rules and regulations (e.g., anti-kickback statute, self-referral/Stark laws, false claims, etc.), often referred tocollectively as “healthcare fraud and abuse laws”. These laws are broad in scope and are subject to evolving interpretation, which could require us to incursubstantial costs to monitor compliance or to alter our practices if they are found not to be in compliance. Violations of these laws may be punishable bycriminal or civil sanctions, including substantial fines, imprisonment and exclusion from participation in governmental healthcare programs. Despiteimplementation of a comprehensive global healthcare compliance program, we cannot provide assurance that any of the healthcare fraud and abuse laws willnot change or be interpreted in the future in a manner which restricts or adversely affects our business activities or relationships with healthcare professionals,nor can we make any assurances that authorities will not challenge or investigate our current or future activities under these laws. 28Table of ContentsIn recent years, both the United States and foreign government regulators have increased regulation, enforcement, inspections and governmentalinvestigations of the medical device industry, including increased United States government oversight and enforcement of the FCPA. Despiteimplementation of a comprehensive global healthcare compliance program, we may be subject to more regulation, enforcement, inspections andinvestigations by governmental authorities in the future. Whenever the United States or another foreign governmental authority concludes that we are not incompliance with applicable laws or regulations, such governmental authority can – among other options available to them – impose fines, delay or suspendregulatory clearances, institute proceedings to detain or seize our products, issue a recall, impose operating restrictions, exclude or debar us from federalhealthcare programs, impose compliance obligations, enjoin future violations and assess civil penalties against us or our officers or employees, and canrecommend criminal prosecution to the DOJ. Any of the foregoing (or other possible) actions could result in decreased sales as a result of negative publicity,and could have a material adverse effect on our financial condition, results of operations and prospects.Although physicians are permitted to use medical devices for indications other than those cleared or approved by the FDA based on their medicaljudgment, we are prohibited from promoting products for such off-label uses. We market our products and provide promotional materials and trainingprograms to physicians regarding the use of our products. Although we believe our marketing, promotional materials and training programs for physicians donot constitute promotion of unapproved uses of our products, if it is determined that our marketing, promotional materials or training programs constitutepromotion of unapproved uses, we could be subject to significant fines in addition to regulatory enforcement actions, including the issuance of a warningletter, injunction, seizure and criminal penalty.In addition to the possible sanctions described above, commencement of an enforcement proceeding, inspection or investigation could divertsubstantial attention of the Company’s management team from the operation of our business, as well as could result in a material adverse effect on the marketprice of our common stock and on our business, results of operations and financial condition. For example, during the second quarter of 2013, we received a federal administrative subpoena from the OIG in connection with an investigation intopossible false or otherwise improper claims submitted to Medicare and Medicaid. Responding to the subpoena requests and investigation has required - andwill, until resolved, continue to require - an allocation of resources, including the time and attention of the Company’s management team. Furthermore, if wewere to become the subject of an enforcement action, including any action resulting from the investigation by the OIG, it could result in negative publicity,penalties, fines, the exclusion of our products from reimbursement under federally-funded programs and/or prohibitions on our ability to sell our products,which could have an adverse effect on our results of operations and financial condition.Additionally, we must comply with a variety of other laws, such as the (i) HIPAA and the HITECH Act which protects the privacy of individuallyidentifiable healthcare information, (ii) the Physician Payment Sunshine Act which requires medical device companies to begin reporting all compensation,gifts and benefits provided to certain healthcare professionals in 2013, and (iii) the Federal Trade Commission Act and similar laws regulating advertisementand consumer protections.Our international operations expose us to legal and regulatory risks, which could have a material effect on our business.The FCPA and similar worldwide anti-bribery laws in non-U.S. jurisdictions generally prohibit companies and their intermediaries from makingimproper payments to non-U.S. officials for the purpose of obtaining or retaining business. The FCPA also imposes accounting standards and requirements onpublicly traded U.S. corporations and their foreign affiliates, which are intended to prevent the diversion of corporate funds to the payment of bribes andother improper payments, and to prevent the establishment of “off books” slush funds from which such improper payments can be made. Because of thepredominance of government-sponsored healthcare systems around the world, many of our customer relationships outside of the United States are withgovernmental entities and are therefore subject to such anti-bribery laws. Our internal control policies and procedures may not always protect us from recklessor criminal acts committed by our employees or agents. Violations of these laws, or allegations of such violations, could disrupt our operations, involvesignificant Management distraction and result in a material adverse effect on our business, results of operations and financial condition. We also could suffersevere penalties, including criminal and civil penalties, disgorgement and other remedial measures, including further changes or enhancements to ourprocedures, policies and controls, as well as potential personnel changes and disciplinary actions.Furthermore, we are subject to the export controls and economic embargo rules and regulations of the United States, including, but not limited to, theExport Administration Regulations and trade sanctions against embargoed countries, which are administered by the Office of Foreign Assets Control withinthe Department of the Treasury, as well as the laws and regulations administered by the Department of Commerce. These regulations limit our ability tomarket, sell, distribute or otherwise transfer our products or technology to prohibited countries or persons. A determination that we have failed to comply,whether knowingly or inadvertently, may result in substantial penalties, including fines and enforcement actions and civil and/or criminal sanctions, thedisgorgement of profits and the imposition of a court-appointed monitor, as well as the denial of export privileges, and may have an adverse effect on ourreputation.These and other factors may have a material adverse effect on our international operations or on our business, results of operations and financialcondition generally. 29Table of ContentsRisks Related to Our Financial Results and Need for FinancingWe may be unable to grow our revenue or earnings as anticipated, which may have a material adverse effect on our future operating results.We have experienced rapid growth since our inception, and have increased our revenues from $38.4 million in 2004, the year of our initial publicoffering, to approximately $762.4 million in 2014. Our ability to achieve future growth will depend upon, among other things, the success of our growthstrategies, which we cannot assure will be successful. In addition, we may have more difficulty maintaining our prior rate of growth of revenues or recentlevels of profitability and cash flow. Our future success will depend upon various factors, including the strength of our brand image, the market success of ourcurrent and future products, competitive conditions and our ability to manage increased revenues, if any, or implement our growth strategy. In addition, weanticipate significantly expanding our infrastructure and adding personnel in connection with our anticipated growth, which we expect will cause ourselling, general and administrative expenses to increase in absolute dollars and as a percentage of revenue. Because these expenses are generally fixed,particularly in the short-to-medium term, our operating and financial results may be adversely impacted if we do not achieve our anticipated growth.Future deterioration or prolonged difficulty in worldwide economic conditions may adversely affect our liquidity and the liquidity of our customers.As of December 31, 2014, we had approximately $405.8 million in cash, cash equivalents and investments in marketable securities. Additionally, as ofthat date, we had approximately $123.2 million of cash in restricted accounts, and may have additional, material restricted or escrow account obligationsupcoming. Such arrangements meaningfully reduce the liquidity available to run or grow our business.We have historically invested our cash primarily in U.S. government sponsored entities and U.S. treasuries, corporate debt, and money market funds.Certain of these investments are subject to general credit, liquidity and other market risks. The general condition of the financial markets and the economymay exacerbate these risks and may affect the value of our current investments and restrict our ability to access the capital markets or even our own funds.The liquidity of our customers and suppliers may also be affected by adverse global economic conditions. The economic crisis in 2008 and 2009 andthe related worldwide financial industry turmoil caused extreme disruption in the financial markets, including severely diminished liquidity and creditavailability. Although these conditions have improved, we continue to monitor the creditworthiness of our customers and suppliers. If our suppliersexperience credit or liquidity problems, important sources of raw materials or manufactured goods may be affected. If our customers’ liquidity andcreditworthiness is negatively impacted by the condition of the economy, our ability to collect on our outstanding invoices and our collection cycles may beadversely affected.The sale of our 2.75% Senior Convertible Notes due 2017 significantly increased our amount of long-term debt, and our financial condition andresults of operations could be adversely affected if we do not efficiently manage our liabilities.In June 2011, we issued $402.5 million aggregate principal amount of our 2.75% Senior Convertible Notes due in 2017 (the 2017 Notes). As a resultof the sale of the 2017 Notes, we have a substantial amount of long-term debt. Our maintenance of such debt could adversely affect our financial conditionand results of operations.In addition, there are a large number of shares of common stock reserved for issuance upon the potential conversion of our 2017 Notes and our SeriesA Preferred Stock that may be available for future sale and the sale of these shares may depress the market price of our common stock.We could be subject to changes in tax rates, the adoption, evolution or change of new and/or amended U.S. or international tax legislation orexposure to additional tax liabilities.We are subject to taxes in the United States and numerous foreign jurisdictions, including Ireland and the Netherlands, where a number of oursubsidiaries are (or were) located. Significant judgment is required to determine and estimate our worldwide tax liabilities. Due to economic and politicalconditions, tax rates in various jurisdictions may be subject to significant change. Our effective income tax rates have recently been, and could in the futurebe adversely affected by changes in tax laws or interpretations of those tax laws, by stock-based compensation and other non-deductible expenses, bychanges in the mix of earnings in countries with differing statutory tax rates, or by changes in the valuation of our deferred tax assets and liabilities. 30Table of ContentsDuring 2013, we began work on a globalization initiative which became effective in January 2014. The initiative involved establishing newinternational operations and entering into new intercompany transfer pricing arrangements, including the licensing of intangibles. We intend to continue tostreamline our international operations to better align with and support our international business activities and markets through changes in how we develop,license and use our intangible property and how we structure our international procurement and customer service functions. We anticipate a negative impactto our effective tax rate over the next several years while achieving an overall reduction to our effective tax rate over the longer term. There can be noassurance that the taxing authorities of the jurisdictions in which we operate or will operate or to which we are otherwise deemed to have sufficient taxpresence will not challenge the tax benefits that we ultimately expect to realize as a result of implementing the new structure. In addition, future changes toU.S. or non-U.S. tax laws, including proposed legislation to reform the U.S. taxation of international business, could negatively impact the anticipated taxbenefits of the proposed new structure. Any long term benefits to our tax rate will also depend on our ability to achieve our anticipated international growthprojections and to operate our business in a manner consistent with the new structure. If we do not operate our business consistent with the new structure andapplicable tax provisions, we may fail to achieve the financial efficiencies that we anticipate as a result of the new structure and our future operating resultsand financial condition may be negatively impacted.Finally, we may be subject in the future to examination of our income tax returns by the Internal Revenue Service and other taxing authorities whichmay result in the assessment of additional income taxes. We regularly assess the likelihood of an adverse outcome resulting from these examinations todetermine the adequacy of our provision for taxes. There can be no assurance as to the outcome of these examinations. If our effective tax rates were toincrease, particularly in the U.S., Ireland, or the Netherlands or if the ultimate determination of our taxes owed is for an amount in excess of amountspreviously accrued, our financial condition, cash flows or results of operations could be adversely affected.Risks Related to the Securities Markets and Ownership of Our Common StockWe expect that the price of our common stock will fluctuate substantially, potentially adversely affecting the ability of investors to sell their shares.The market price of our common stock has been and may continue to be subject to wide fluctuations. For example, the closing price for our stock onthe last day of the past four quarters was: $47.16 on December 31, 2014, $34.87 on September 30, 2014, $35.57 on June 30, 2014 and $38.41 on March 31,2014. Fluctuation in the stock price may occur due to many factors, including, without limitation:·general market conditions and other factors related to the economy or otherwise, including factors unrelated to our operating performance or theoperating performance of our competitors. These conditions might include people’s expectations, favorable or unfavorable, as to the likely unitgrowth of the spine sector;·negative stock market reactions to the results of litigation;·negative publicity regarding spine surgeon’s practices or outcomes, whether warranted or not, that cast the sector in a negative light;·the introduction of new products or product enhancements by us or our competitors;·changes in the availability of third-party reimbursement in the United States or other countries;·disputes or other developments with respect to intellectual property rights or other potential legal actions;·our ability to develop, obtain regulatory clearance or approval for, and market new and enhanced products on a timely basis;·quarterly variations in our or our competitor’s results of operations;·sales of large blocks of our common stock, including sales by our executive officers and directors;·announcements of technological or medical innovations for the treatment of spine pathology;·changes in governmental regulations or in the status of our regulatory approvals, clearances or applications;·the acquisition or divestiture of businesses, products, assets or technology by us or by our competitors;·litigation (including intellectual property litigation) and any associated negative verdicts or ruling;·announcements of actions by the FDA or other regulatory agencies; and·changes in earnings or operating margin estimates or recommendations by us or by securities analysts.·Market price fluctuations may negatively affect the ability of investors to sell our shares at consistent prices. 31Table of ContentsAnti-takeover provisions in our organizational documents and Delaware law may discourage or prevent a change of control, even if an acquisitionwould be beneficial to our stockholders, which could affect our stock price adversely and prevent attempts by our stockholders to replace or remove ourcurrent Management.Our certificate of incorporation and bylaws contain provisions that could delay or prevent a change of control of our company or changes in our boardof directors that our stockholders might consider favorable. Some of these provisions:·authorize the issuance of preferred stock which can be created and issued by the board of directors without prior stockholder approval, with rightssenior to those of the common stock;·provide for a classified board of directors, with each director serving a staggered three-year term;·provide that our stockholders may remove our directors only for cause;·prohibit our stockholders from filling board vacancies, calling special stockholder meetings, or taking action by written consent;·prohibit our stockholders from making certain changes to our certificate of incorporation or bylaws except with 66 2/3% stockholder approval;and·require advance written notice of stockholder proposals and director nominations.In addition, we are subject to the provisions of Section 203 of the Delaware General Corporation Law, which may prohibit certain businesscombinations with stockholders owning 15% or more of our outstanding voting stock. These and other provisions in our certificate of incorporation, ourbylaws and Delaware law could make it more difficult for stockholders or potential acquirers to obtain control of our board of directors or initiate actions thatare opposed by our then-current board of directors, including delay or impede a merger, tender offer, or proxy contest involving our company. Any delay orprevention of a change of control transaction or changes in our board of directors could cause the market price of our common stock to decline.We do not intend to pay cash dividends.We have never declared or paid cash dividends on our capital stock. We currently intend to retain all available funds and any future earnings for use inthe operation and expansion of our business and do not anticipate paying any cash dividends in the foreseeable future. In addition, the terms of any futuredebt or credit facility may preclude us from paying any dividends. As a result, capital appreciation, if any, of our common stock will be our stockholders’source of potential gain for the foreseeable future. Item 1B.Unresolved Staff CommentsNone. 32Table of ContentsItem 2.PropertiesAs of December 31, 2014, we operated the following facilities:Description of UseSquare Footage LocationCorporate office and training facilities (1) 145,765 San Diego, CACorporate office facilities 62,367 San Diego, CAFulfillment and warehouse operations 100,000 Memphis, TNOffice and training facilities 63,761 Paramus, NJOffice facilities 10,579 Columbia, MDManufacturing facilities 32,754 Dayton, OHOffice facilities 800 Las VegasOffice facilities 3,440 Puerto RicoOffice facilities 7,210 UKOffice facilities 9,063 JapanOffice facilities 4,456 SingaporeOffice facilities 8,588 AustraliaOffice facilities and warehouse 7,383 GermanyOffice facilities 1,076 ItalyOffice facilities 753 SpainOffice facilities 3,000 IrelandOffice facilities 10,516 NetherlandsOffice facilities 775 PolandOffice facilities 44 Russia (1) Our corporate headquarters. Item 3.Legal Proceedings.Medtronic Sofamor Danek USA, Inc. LitigationAs reported by us previously, Warsaw Orthopedic, Inc., Medtronic Sofamor Danek USA, Inc. and other Medtronic related entities (collectively,Medtronic), on August 18, 2008, filed a patent infringement lawsuit against NuVasive (the Company) in the United States District Court for the SouthernDistrict of California, alleging that certain of NuVasive’s products or methods, including the XLIF® procedure, infringe, or contribute to the infringement of,twelve U.S. patents. Three of the patents were later withdrawn by Medtronic leaving the following nine patents in the lawsuit: Nos. 5,860,973; 5,772,661;6,936,051; 6,936,050; 6,916,320; 6,945,933; 6,969,390; 6,428,542; 6,592,586 assigned or licensed to Medtronic (Medtronic Patents).NuVasive counterclaimed alleging that NuVasive’s U.S. Patent Nos. 7,207,949; 7,582,058; and 7,470,236 are infringed by Medtronic’s NIM-EclipseSystem and accessories and Quadrant products, and DLIF (Direct Lateral Interbody Fusion) surgical technique.Given the number of patents asserted in the litigation, the first phase of the case included three Medtronic patents and one NuVasive patent. Trial onthe first phase of the case began in August 2011 and on September 20, 2011, a jury from the District Court, delivered an unfavorable verdict againstNuVasive with respect to three Medtronic patents and a favorable verdict with respect to the one NuVasive patent. The jury awarded monetary damages ofapproximately $101.2 million to Medtronic, which includes lost profits and back royalties (the 2011 verdict). Medtronic’s subsequent motion for apermanent injunction was denied by the District Court on January 26, 2012. On March 19, 2012, the District Court issued an order granting prejudgmentinterest, and on June 11, 2013, the District Court ruled on the ongoing royalty rates (the June 2013 ruling). On August 20, 2013, NuVasive and Medtronicfiled their respective notices of appeal. That appeal has been fully briefed and argued and the Company is awaiting the Court of Appeals for the FederalCircuit’s decision. In addition, the Company entered into an escrow arrangement in 2012 and transferred $113.3 million of cash into a restricted escrowaccount to secure the amount of judgment, plus prejudgment interest, during pendency of the appeal. These funds are included in restricted cash andinvestments on the Company’s December 31, 2014 consolidated balance sheet. 33Table of ContentsIn accordance with the authoritative guidance on the evaluation of loss contingencies, during the third quarter of 2011, the Company recorded anaccrual of $101.2 million for the 2011 verdict. In addition, on sales subsequent to the 2011 verdict and through March 31, 2013, the Company accruedroyalties at the royalty rates stated in the 2011 verdict. Upon receiving the District Court ruling in June 2013, the Company began accruing ongoingroyalties on sales at the royalty rates stated in the June 2013 ruling, and recorded a charge of approximately $7.9 million to account for the differencebetween using the royalty rates stated in the 2011 verdict and those in the June 2013 ruling on sales through March 31, 2013. As a result of the June 2013ruling, we have agreed to escrow funds to secure accrued royalties, estimated at $29.4 million to date, and ongoing royalties. NuVasive is also accruing post-judgment interest. With respect to the prejudgment interest award, the Company, based on its own assessment as well as that of outside counsel, believes areversal of the prejudgment interest award on appeal is probable, and therefore, in accordance with the authoritative guidance on the evaluation of losscontingencies, the Company has not recorded an accrual for this amount, which is estimated to approximate $13.0 million. Additional damages, includinginterest, may still be awarded, and at December 31, 2014, the Company cannot estimate a range of additional potential loss.The second phase of the case pending in the Southern District of California involved one Medtronic cervical plate patent. On April 25, 2013,NuVasive and Medtronic entered into a settlement agreement fully resolving the second phase of the case. The settlement also removes from the case thecervical plate patent (U.S. Patent No. 6,592,586) that was part of the first phase. As part of the settlement, NuVasive received a broad license to practice (i) theMedtronic patent (U.S. Patent No. 6,916,320) that was the sole subject of the second phase of the litigation, (ii) the Medtronic patent (U.S. PatentNo. 6,592,586) that was part of the first phase of the litigation, and (iii) each of the Medtronic patent families that collectively represent the vast majority ofMedtronic’s patent rights related to cervical plate technology. In exchange for these license rights, NuVasive made a one-time payment to Medtronic of $7.5million, which amount will be fully offset against any damage award ultimately determined to be owed by NuVasive in connection with a final resolution ofthe first phase of the litigation. In addition, Medtronic will receive a royalty on certain cervical plate products sold by NuVasive, including the Helix® andGradient® lines of products. As a result of this settlement, all current patent disputes between the parties related to cervical plate technology have beenresolved.In August 2012, Medtronic filed additional patent claims in the U.S. District Court for the Northern District of Indiana alleging that various NuVasivespinal implants (including its CoRoent XL family of spinal implants) infringe U.S. Patent No. 8,021,430 (the ‘430 patent), that NuVasive’s Osteocel Plusbone graft product infringes U.S. Patent No. 5,676,146 (the ‘146 Patent), and that NuVasive’s XLIF procedure and use of MaXcess IV retractor during theXLIF procedure infringe methodology claims of U.S. Patent No. 8,251,997 (the ‘997 patent). The case was later transferred to the Southern District ofCalifornia, and on March 7, 2013, NuVasive counterclaimed to allege infringement by Medtronic of U.S. Patent Nos. 8,000,782 (systems and related methodsfor performing surgical procedures), 8,005,535 (systems and related methods for performing surgical procedures), 8,016,767 (a surgical access systemincluding a tissue distraction assembly and a tissue retraction assembly), 8,192,356 (a system for accessing a surgical target site and related methods,involving an initial distraction system, among other things), 8,187,334 (spinal fusion implant), 8,361,156 (spinal fusion implant), D652,922 (dilator design)(the “ ‘922 Patent”), and D666,294 (dilator design). On June 27, 2013, NuVasive filed an inter partes review petition with the U.S. Patent Office challengingU.S. Patent No. 8,444,696 (the ‘696 Patent) which issued to Medtronic on May 21, 2013. On July 25, 2013, Medtronic amended its complaint to add a chargeof infringement of the ‘696 Patent. All patents asserted in this case have been stayed except for Medtronic’s ‘146 Patent and NuVasive’s ‘922Patent. Summary judgment on the ‘146 Patent and ‘922 Patent is set for February 2015. No trial date has been set for this case. At December 31, 2014, theprobable outcome of this litigation cannot be determined, nor can the Company estimate a range of potential loss. In accordance with the authoritativeguidance on the evaluation of loss contingencies, the Company has not recorded an accrual related to this litigation. 34Table of ContentsTrademark Infringement LitigationIn September 2009, Neurovision Medical Products, Inc. (NMP) filed suit against NuVasive in the U.S. District Court for the Central District ofCalifornia (Case No. 2:09-cv-06988-R-JEM) alleging trademark infringement and unfair competition. NMP sought cancellation of NuVasive’s“NeuroVision” trademark registrations, injunctive relief and damages based on NMP’s common law use of the “Neurovision” mark. On November 23, 2009,the Company denied the allegations in NMP’s complaint. The matter was tried in October 2010 and an unfavorable jury verdict was delivered against theCompany relating to its use of the “NeuroVision” trade name. The verdict awarded damages to NMP of $60.0 million, which was upheld in a January 2011judgment ordered by the District Court. NuVasive appealed the judgment and during pendency of the appeal, NuVasive was required to escrow funds totaling$62.5 million to secure the amount of judgment, plus interest, attorney’s fees and costs. In September 2012, the Court of Appeals reversed and vacated theDistrict Court judgment and ordered the case back to the District Court for a new trial before a different judge. As a result of the reversal of the judgment, thefull $62.5 million was released from escrow and returned to the Company. Retrial of the matter began on March 25, 2014, and on April 3, 2014, a juryreturned a verdict in favor of NMP on its claims against the Company in the amount of $30.0 million. The Court affirmed the jury’s verdict, and onSeptember 4, 2014, the Company filed a notice of appeal. The Court entered judgment and a permanent injunction on September 24, 2014, enjoining theCompany's future use of the NeuroVision trademark to market or promote its products. The Court also entered an order canceling the Company's NeuroVisiontrademark registrations, but that order is stayed pending the appeal process. On December 2, 2014, the Court denied NMP’s motion for attorneys’ fees, costs,and prejudgment interest, and NMP filed a notice of appeal on December 17, 2014. The appeals were consolidated on February 2, 2015, and resolution of theappeals may take up to two years. During pendency of the appeal, NuVasive has agreed to escrow funds totaling $32.5 million to secure the amount ofjudgment, plus interest, attorney’s fees and costs. In accordance with the authoritative guidance on the evaluation of loss contingencies, the Company hasrecorded an accrual related to this litigation in the amount of the judgment.Securities LitigationOn August 28, 2013, a purported securities class action lawsuit was filed by Danny Popov in the U.S. District Court for the Southern District ofCalifornia naming NuVasive and certain of its current and former executive officers for allegedly making false and materially misleading statementsregarding the Company’s business and financial results, specifically relating to the purported improper submission of false claims to Medicare and Medicaid.In December 2013, Brad Mauss was appointed lead plaintiff (Plaintiff). The complaint asserts a putative class period stemming from October 22, 2008 toJuly 30, 2013. The complaint alleges violations of Sections 10(b) and 20(a) of the Securities Exchange Act of 1934, as amended, and Rule 10b-5promulgated thereunder and seeks unspecified monetary relief, interest, and attorneys’ fees. Plaintiff filed a consolidated amended complaint on February 13,2014. NuVasive filed a motion to dismiss the consolidated amended complaint on March 28, 2014. On August 19, 2014, the Court issued an order grantingthe Company’s motion to dismiss and gave Plaintiff leave to file an amended complaint. On September 8, 2014, Plaintiff filed a Second AmendedComplaint. On September 22, 2014, NuVasive filed a motion to dismiss the Second Amended Complaint. On December 9, 2014, the court issued an ordergranting the Company’s motion to dismiss and gave Plaintiff leave to file an amended complaint. On December 23, 2014 Plaintiff filed a Third AmendedComplaint. NuVasive filed a motion to dismiss the Third Amended Complaint on January 9, 2015. While NuVasive’s motion was pending, Plaintiff soughtleave to file a Fourth Amended Complaint. The Court took the hearing on NuVasive’s motion to dismiss the Third Amended Complaint off calendar andscheduled a hearing on Plaintiff’s motion to file an amended complaint is pending. At December 31, 2014, the probable outcome of this litigation cannot bedetermined, nor can the Company estimate a range of potential loss.Item 4.Mine Safety Disclosures.Not applicable. 35Table of ContentsPART IIItem 5.Market for the Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity SecuritiesCommon Stock Market PriceOur common stock is traded on the NASDAQ Global Select Market under the symbol “NUVA.” The following table presents the high and low pershare sale prices of our common stock during the periods indicated, as reported on NASDAQ. High Low 2013: First Quarter $21.46 $15.70 Second Quarter 24.90 19.74 Third Quarter 27.20 22.44 Fourth Quarter 33.91 23.83 2014: First Quarter $39.39 $31.84 Second Quarter 39.25 32.26 Third Quarter 38.22 32.48 Fourth Quarter 48.10 34.40 We had approximately 103 stockholders of record as of January 31, 2015. We believe that the number of beneficial owners is substantially greaterthan the number of record holders because a large portion of our common stock is held of record through brokerage firms in “street name.”Recent Sales of Unregistered SecuritiesDuring the fourth quarter of 2014, we did not issue any securities that were not registered under the Securities Act of 1933, as amended (the SecuritiesAct).Dividend PolicyWe have never declared or paid any cash dividends on our capital stock. We currently intend to retain future earnings, if any, for development of ourbusiness and do not anticipate that we will declare or pay cash dividends on our capital stock in the foreseeable future. 36Table of ContentsEquity Compensation Plan Information The following table provides certain information with respect to all of our compensation plans in effect as of December 31, 2014: Plan Category (A)Number of Securities tobe Issued Upon Exerciseof Outstanding Options,Warrants and Rights (B)Weighted AverageExercise Price ofOutstandingOptions, Warrantsand Rights (C)Number of SecuritiesRemaining Available forFuture Issuance UnderEquity CompensationPlans (excludingsecurities reflected incolumn(A)) Equity Compensation Plans approved by stockholders 8,348,784 (1)$32.11 4,274,662 (2)Equity Compensation Plans not approved by stockholders — — — Total 8,348,784 $32.11 4,274,662 (1)Consists of shares subject to outstanding options and restricted stock units under our 2004 Equity Incentive Plan and our 2014 Equity IncentivePlan, some of which are vested and some of which remain subject to the vesting and/or performance criteria of the respective equity award.(2)Consists of shares available for future issuance under our 2014 Equity Incentive Plan and 2004 Employee Stock Purchase Plan (ESPP). Asof December 31, 2014, an aggregate of 2,516,338 shares of common stock were available for issuance under the 2014 Equity Incentive Plan(some of which are yet to be registered for issuance) and 1,758,324 shares of common stock were available for issuance under the 2004 EmployeeStock Purchase Plan. 37Table of ContentsPERFORMANCE GRAPHThe following graph compares the cumulative total stockholder return data on our common stock with the cumulative return of (i) The NASDAQStock Market Composite Index, and (ii) NASDAQ Medical Equipment Index over the five year period ending December 31, 2014. The graph assumes that$100 was invested on December 31, 2009 in our common stock and in each of the comparative indices. The stock price performance on the following graphis not necessarily indicative of future stock price performance.The following graph and related information shall not be deemed “soliciting material” or be deemed to be “filed” with the SEC, nor shall suchinformation be incorporated by reference into any future filing, except to the extent that we specifically incorporate it by reference into such filing.COMPARISON OF 5 YEAR CUMULATIVE TOTAL RETURN*AMONG NUVASIVE, INC.,THE NASDAQ COMPOSITE INDEXAND THE NASDAQ MEDICAL EQUIPMENT INDEX*$100 invested on December 31, 2009 in stock or index, including reinvestment of dividends. 38Table of ContentsItem 6.Selected Financial Data.The selected consolidated financial data set forth in the table below has been derived from our audited financial statements. The data set forth belowshould be read in conjunction with “Management’s Discussion and Analysis of Financial Condition and Results of Operations” and our audited financialstatements and notes thereto appearing elsewhere in this report. Year Ended December 31, 2014 (1) 2013 (1) 2012 (1) 2011 (1) 2010 (In thousands, except per share amounts) Statement of Operations Data: Total revenues $762,415 $685,173 $620,255 $540,506 $478,237 Gross profit 580,057 504,689 466,846 428,395 393,098 Consolidated net income (loss) (17,496) 6,985 2,442 (71,021) 76,533 Net income (loss) attributable to NuVasive,Inc. (16,720) 7,902 3,144 (69,849) 78,285 Net income (loss) per share attributable toNuVasive, Inc.: Basic $(0.36) $0.18 $0.07 $(1.73) $1.99 Diluted $(0.36) $0.17 $0.07 $(1.73) $1.85 December 31, 2014 (1) 2013 (1) 2012 (1) 2011 (1) 2010 (In thousands, except per share amounts) Balance Sheet Data: Cash, cash equivalents and marketablesecurities $405,758 $326,103 $346,116 $342,223 $229,690 Working capital 490,972 418,856 349,474 384,457 262,795 Total assets 1,343,459 1,179,568 1,163,785 1,123,562 802,029 Senior Convertible Notes, net of currentportion 360,746 346,060 332,404 394,019 230,000 Non-current litigation liability 93,700 93,700 101,200 - - Other long-term liabilities 25,756 17,778 18,328 17,413 16,821 Non-controlling interests (2) - - 10,003 10,705 11,877 Total equity 648,358 604,878 537,575 494,045 434,355 (1)Consolidated statement of operations and balance sheet data for the years ended December 31, 2014, 2013, 2012 and2011 include Impulse Monitoring from October 7, 2011, the date of acquisition.(2)On June 13, 2013, the non-controlling interest in Progentix Orthobiology, B.V. became non-redeemable and thereforewas reclassified out of mezzanine equity to its own component of total equity within the Company’s consolidatedbalance sheet. 39Table of ContentsItem 7.Management’s Discussion and Analysis of Financial Condition and Results of Operations As noted earlier in this Annual Report on Form 10-K, this Annual Report on Form 10-K, including the following discussion and analysis, maycontain forward-looking statements that involve risks, uncertainties, assumptions and other factors which, if they do not materialize or prove correct, couldcause our results to differ from historical results or those expressed or implied by such forward-looking statements. Please review this Annual Report andthe following discussion and analysis in light of the forward-looking statements provisions outlined at the outset of Part I. You should read the following discussion and analysis of our financial condition and results of operations in conjunction with the ConsolidatedFinancial Statements and the Notes to those statements included in this Annual Report on Form 10-K. OverviewWe are the third largest medical device company in the global spine market, focused on developing minimally-disruptive surgical productsand procedurally-integrated solutions for the spine. Our currently-marketed product portfolio is focused on applications for spine fusion surgery,including biologics, a combined market estimated to be approximately $9.0 billion globally in 2015. Our principal product offering includes aminimally-disruptive surgical platform called Maximum Access Surgery (MAS). The MAS platform combines three categories of solutions thatcollectively minimize soft tissue disruption during spine fusion surgery, provide maximum visualization and are designed to enable safe andreproducible outcomes for the surgeon and the patient. The platform includes our proprietary software-driven nerve detection and avoidancesystems, NVM5 and NVJJB, and Intra-Operative Monitoring (IOM) support; MaXcess, an integrated split-blade retractor system; and a widevariety of specialized implants. The individual components of our MAS platform, and many of our products, can also be used in open or traditionalspine surgery. Our spine surgery product line offerings, which include products for the thoracolumbar and the cervical spine, are primarily used toenable access to the spine and to perform restorative and fusion procedures in a minimally disruptive fashion. Our biologic product line offeringsused to aid the spinal fusion process or bone healing include allograft (donated human tissue), Osteocel Plus and Osteocel Pro, an allograftcellular matrix containing viable mesenchymal stem cells (MSCs), FormaGraft, a collagen synthetic product, and AttraX, a synthetic bone graftmaterial, currently available commercially only in select markets outside of the United States. Our subsidiary, Impulse Monitoring, Inc. providesIOM services for insight into the nervous system during spine and other surgeries. We continue to focus significant research and developmentefforts to expand our MAS product platform and advance the applications of our unique technology into procedurally integrated surgical solutions.We have dedicated and continue to dedicate significant resources toward training spine surgeons who are new to our MAS product platform as wellas surgeons previously trained on our MAS product platform who are attending advanced training courses.Our MAS platform, with the unique advantages provided by our nerve monitoring systems, enables an innovative lateral procedure known aseXtreme Lateral Interbody Fusion (XLIF), in which surgeons access the spine for a fusion procedure from the side of the patient's body, rather thanfrom the front or back. Our MaXcess instruments provide access to the spine in a manner that affords direct visualization and our nerve monitoring systemsassist surgeons in avoiding critical nerves.At various times in the past, certain insurance providers have adopted policies of not providing reimbursement for the XLIF procedure orsome of its components. We have worked with our surgeon customers and the North American Spine Society who, in turn, have worked with theseinsurance providers to supply the information, explanation and clinical data they require to categorize the XLIF procedure as a procedure entitled toreimbursement under their policies. At present, the majority of insurance companies provide reimbursement for XLIF procedures. However, certaincarriers - large and small - may have policies significantly limiting coverage of XLIF, Interlaminar Lumbar Instrumented Fusion, Osteocel Plus andOsteocel Pro, and/or other procedures or products we sell. We cannot offer definitive time frames or final outcomes regarding reversal of thecoverage-limiting policies, as the process is dictated by the third-party insurance providers.In recent years, we have significantly expanded our product offerings relating to procedures in the cervical spine. Our cervical productoffering now provides a full set of solutions for cervical, both motion preservation and fusion surgery, including both allograft andCoRoent® implants, as well as cervical plating and posterior fixation products.In mid-2013, we received a federal administrative subpoena from the Office of the Inspector General of the U.S. Department of Health andHuman Services (OIG) in connection with an investigation into possible false or otherwise improper claims submitted to Medicare and Medicaid.The subpoena seeks discovery of documents for the period January 2007 through April 2013. We are working with the OIG to understand thescope of the subpoena and to provide the requested documents. We intend to fully cooperate with the OIG's request and will provide periodicupdates as information becomes available. Responding to the subpoena requires management's attention and results in significant legal expense.Any adverse findings related to this investigation could result in significant financial penalties against us. 40Table of ContentsRevenues and Operations. To date, the majority of our revenues are derived from the sale of implants, biologics and disposables and we expect thistrend to continue for the foreseeable future. We loan our proprietary software-driven nerve monitoring systems and surgical instrument sets at no cost tosurgeons and hospitals that purchase disposables and implants for use in individual procedures. In addition, we often place our proprietary software-drivennerve monitoring systems, MaXcess and other MAS or cervical surgical instrument sets with hospitals for an extended period at no up-front cost to them. Ourimplants, biologics and disposables are currently sold and shipped from our primary distribution and warehousing operations facility located in Memphis,Tennessee. We generally recognize revenue for implants, biologics and disposables upon receiving acknowledgement of a purchase order and uponcompletion of delivery. We sell MAS instrument sets, MaXcess devices, and our proprietary software-driven nerve monitoring systems, however this does notmake up a material part of our business.IOM monitoring service revenue consists of hospital based revenues and net patient service revenues, and is recorded in the period theservice is provided. Hospital based revenues are recorded based upon contracted billing rates. Net patient services are billed to various payers,including Medicare, commercial insurance companies, other directly billed managed healthcare plans, employers, and individuals. We reportrevenues based on the amount expected to be collected.There is a downward pressure on reimbursement for IOM services such as those provided by our subsidiary Impulse Monitoring. Significant codingchanges for IOM services took effect in 2013. New Current Procedural Terminology (CPT) codes were introduced that have led to reduced reimbursement byprivate payers for the professional remote oversight component of the service. Medicare patients were also subject to additional coding changes imposed byCMS which may restrict access to care and limit Impulse Monitoring’s ability to cover, bill and collect for cases performed. Private payers may also elect toadopt these coding changes.The majority of our operations are located and the majority of our sales have been generated in the United States. We sell our products inthe United States through a sales force comprised of exclusive independent sales agents and directly-employed sales employees (“shareowners”),both engaged to sell only NuVasive products. Our sales force provides a delivery and consultative service to our surgeon and hospital customersand is compensated based on sales and product placements in their territories. Sales force commissions are reflected in our statement ofoperations in the sales, marketing and administrative expenses line. We are continuing to invest in our expansion of international sales efforts withthe focus on European, Asian and Latin American markets. Our international sales force is comprised of directly-employed sales shareowners aswell as exclusive distributors and independent sales agents.As of December 31, 2014 the Company does not have any significant backlog.Critical Accounting PoliciesOur discussion and analysis of our financial condition and results of operations is based upon our audited consolidated financial statements, whichhave been prepared in accordance with accounting principles generally accepted in the United States (GAAP). The preparation of these financial statementsrequires us to make estimates and judgments that affect the reported amounts of assets, liabilities, revenues and expenses. On an ongoing basis, we evaluateour estimates including those related to revenue recognition, bad debts, inventories, valuation of financial instruments, goodwill, intangibles, property andequipment, stock-based compensation, income taxes, and legal proceedings. We base our estimates on historical experience and on various otherassumptions we believe to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values ofassets and liabilities not readily apparent from other sources. Actual results may differ from these estimates.We believe the following accounting policies to be critical to the judgments and estimates used in the preparation of our consolidated financialstatements. Revenue Recognition. In accordance with the Securities and Exchange Commission’s guidance, we recognize revenue when all four of the followingcriteria are met: (i) persuasive evidence that an arrangement exists; (ii) delivery of the products and/or services has occurred; (iii) the selling price is fixed ordeterminable; and (iv) collectability is reasonably assured. Specifically, revenue from the sale of implants and disposables is generally recognized uponacknowledgement of a purchase order from the hospital indicating product use or implantation or upon shipment to third-party customers who immediatelyaccept title. Revenue from the sale of our instrument sets is recognized upon receipt of a purchase order and the subsequent shipment to customers whoimmediately accept title. 41Table of ContentsMonitoring service revenue consists of hospital based revenues and net patient service revenues and is recorded in the period the service is provided.Hospital based revenues are recorded based upon contracted billing rates. Net patient services are billed to various payers, including Medicare, commercialinsurance companies, other directly billed managed healthcare plans, employers, and individuals. We report revenues from contracted payers, includingMedicare, certain insurance companies and certain managed healthcare plans, based on the contractual rate, or in the case of Medicare, the published feeschedules. We report revenues from non-contracted payers, including certain insurance companies and individuals, based on the amount expected to becollected. The difference between the amount billed and the amount expected to be collected from non-contracted payers is recorded as a contractualallowance to arrive at net revenues. The expected revenues from non-contracted payers are based on the historical collection experience of each payer orpayer group, as appropriate. In each reporting period, we review our historical collection experience for non-contracted payers and adjust our expectedrevenues for current and subsequent periods accordingly. See Note 10 to the Consolidated Financial Statements included in this Annual Report for furtherdiscussion on our product offerings.Allowance for Doubtful Accounts and Sales Return Reserve. We maintain an allowance for doubtful accounts for estimated losses resulting from theinability of our customers to make required payments. The allowance for doubtful accounts is reviewed quarterly and is estimated based on the aging ofaccount balances, collection history and known trends with current customers and in the economy in general. As a result of this review, the allowance isadjusted on a specific identification basis. The Company also reviews the overall quality and age of those invoices not specifically identified. In determiningthe provision for invoices not specifically reviewed, the Company analyzes historical collection experience and current economic trends. An increase to theallowance for doubtful accounts results in a corresponding charge to sales, marketing and administrative expenses. If the historical data used to calculate theallowance provided for doubtful accounts does not reflect the Company’s future ability to collect outstanding receivables or if the financial condition ofcustomers were to deteriorate, resulting in impairment of their ability to make payments, an increase in the provision for doubtful accounts may be required.We maintain a relatively large customer base that mitigates the risk of concentration with any one particular customer. Historically, the Company’s reserveshave been adequate to cover losses.In addition, we establish a reserve for estimated sales returns that is recorded as a reduction to revenue. This reserve is maintained to account for futurereturn of products sold in the current period. This reserve is reviewed quarterly and is estimated based on an analysis of our historical experience related toproduct returns. The product returns were immaterial for the years presented.Excess and Obsolete Inventory. We provide an inventory reserve for estimated obsolescence and excess inventory based upon historical turnoverand assumptions about future demand for our products and market conditions. Our allograft products have shelf lives ranging from two to five years and aresubject to demand fluctuations based on the availability and demand for alternative products. Our inventory, which consists primarily of disposables andspecialized implants, is at risk of obsolescence following the introduction and development of new or enhanced products. Our estimates and assumptions forexcess and obsolete inventory are reviewed and updated on a quarterly basis. The estimates we use for demand are also used for near-term capacity planningand inventory purchasing and are consistent with our revenue forecasts. Increases in the reserve for excess and obsolete inventory result in a correspondingcharge to cost of goods sold. Historically, the Company’s reserves have been adequate to cover losses.A stated goal of our business is to focus on continual product innovation and to obsolete our own products. While we believe this provides acompetitive edge, it also results in the risk that our products and related capital instruments will become obsolete prior to sale or to the end of theiranticipated useful lives.Financial Instruments and Fair Value. ASC Topic 820, Fair Value Measurements and Disclosures defines fair value and requires the Company toestablish a framework for measuring fair value and disclosure about fair value measurements. The framework requires the valuation of assets and liabilitiessubject to fair value measurements using a three tiered approach and fair value measurement be classified and disclosed in one of the following threecategories. Inputs to valuation techniques are observable or unobservable. Observable inputs reflect market data obtained from independent sources, whileunobservable inputs reflect our market assumptions.Level 1: Quoted prices (unadjusted) in active markets that are accessible at the measurement date for assets or liabilities.Level 2: Observable prices that are based on inputs not quoted on active markets, but corroborated by market data.Level 3: Unobservable inputs are used when little or no market data is available.Carrying value of the financial instruments measured and classified within Level 1 is based on quoted prices.The types of instruments that trade in markets that are not considered to be active, but are valued based on quoted market prices, broker or dealerquotations, or alternative pricing sources with reasonable levels of price transparency are generally classified within Level 2 of the fair value hierarchy.Certain contingent consideration liabilities are classified within Level 3 of the fair value hierarchy because they use unobservable inputs. For thoseliabilities, fair value is determined using a probability-weighted discounted cash flow model, the significant inputs which are not observable in the market. 42Table of ContentsProperty and Equipment. Property and equipment is carried at cost less accumulated depreciation. Depreciation is computed using the straight-linemethod based on an asset’s estimated useful life. Effective January 1, 2014, we changed the estimated useful lives from three to four for certain surgicalinstrument sets that we loan to or place with hospitals outside of the United States, to align with the useful life of similar types of assets utilized in the UnitedStates. Maintenance and repairs on all property and equipment are expensed as incurred.Valuation of Goodwill and Intangible Assets with Indefinite Lives. Our goodwill represents the excess of the cost over the fair value of net assetsacquired from our business combinations. The determination of the value of goodwill and intangible assets arising from business combinations and assetacquisitions requires extensive use of accounting estimates and judgments to allocate the purchase price to the fair value of the net tangible and intangibleassets acquired, including capitalized in-process research and development (IPR&D). Intangible assets acquired in a business combination that are used forin-process research and development activities are considered indefinite lived until the completion or abandonment of the associated research anddevelopment efforts. Upon reaching the end of the relevant research and development project, the Company will amortize the acquired in-process researchand development over its estimated useful life or expense the acquired in-process research and development should the research and development project beunsuccessful with no future alternative use.Goodwill and IPR&D are not amortized, however, they are assessed for impairment using fair value measurement techniques on an annual basis ormore frequently if facts and circumstance warrant such a review. The goodwill or IPR&D are considered to be impaired if we determine that the carrying valueof the reporting unit or IPR&D exceeds its respective fair value. In accordance with our policy, we completed our most recent annual evaluation forimpairment of goodwill and IPR&D using a discounted cash flow valuation methodology based on discounted cash flows as of October 1, 2014 anddetermined that no impairment existed.The Company performs its goodwill impairment analysis at the reporting unit level, which aligns with the Company’s reporting structure andavailability of discrete financial information. Our evaluation included Management estimates of cash flow projections based on internal future projections.Key assumptions from these projections included revenue growth and future gross and operating margin growth. The Company also makes key assumptionsrelated to its weighted cost of capital and terminal growth rates. The revenue and margin growth was based on increased sales of new and existing products aswe expect to maintain our investment in research and development. Additional value creators assumed included increased efficiencies from capital spending.The resulting cash flows were discounted using a weighted average cost of capital. Operating mechanisms and requirements to ensure that these growth andefficiency assumptions will ultimately be realized were also considered in our evaluation, including timing and probability of regulatory approvals for ourproducts to be commercialized domestically or internationally. Our market capitalization at October 1, 2014 was also considered as a part of analysis and asensitivity analysis was performed on our assumptions. The potential events and/or changes in circumstances that could reasonably be expected tonegatively affect the key assumptions would be significant declines in our stock price, unexpected and/or adverse outcome of clinical studies, significantdeclines in growth rate, or failure to implement planned efficiencies. Based on our assessment and analysis, it was determined that no reporting unit of theCompany was at risk of impairment when assessing the unit’s fair value compared to its carrying value. In addition, no indicators of impairment were notedthrough December 31, 2014 and consequently, no impairment charge has been recorded during the year.As of October 1, 2014 and October 1, 2013, at our annual evaluation date for impairment, the Company had two reporting units; the Progentixreporting unit and the remainder of the Company (the “primary reporting unit”). For the impairment assessment performed as of October 1, 2012, we hadthree reporting units; Progentix reporting unit, Impulse Monitoring reporting unit, and the primary reporting unit. The Company determined that, consistentwith continued integration of Impulse Monitoring into our core business, Impulse Monitoring was no longer a reporting unit since discrete financialinformation for Impulse Monitoring was no longer available which resulted in the combination of Impulse Monitoring reporting unit into our primaryreporting unit for future goodwill impairment assessment. During 2012, when Impulse Monitoring was a reporting unit that provided discrete financial information, we updated our discounted cash flowvaluation model for Impulse Monitoring and based on Management’s updated estimates of revenues and expenses, related cash flows and the discount rateused in the model, the estimated fair value of the then Impulse Monitoring’s reporting unit at the time was less than its carrying value. Management’sestimates of revenues and related cash flows reflected the impacts of the significant coding changes for IOM services which took effect in 2013 and resultedin reduced reimbursement for IOM services. During the year ended December 31, 2012, we recorded an impairment charge to Impulse Monitoring’s goodwillof $8.3 million. Additionally, during the year ended December 31, 2012, we recorded an impairment charge of $1.4 million, related to the IPR&D recordedfor the technology acquired from Cervitech in 2009. The primary factor contributing to this impairment charge was the reduction in Management’s revenueestimate and the related decrease to the estimated cash flows for the technology.Significant judgment is required in the forecasts of future operating results that are used in the discounted cash flow valuation models. It is possiblethat plans may change and estimates used may prove to be inaccurate. If our actual results, or the plans and estimates used in future impairment analyses arelower than the original estimates used to assess the recoverability of these assets, we could incur additional impairment charges. 43Table of ContentsValuation of Intangible Assets. Our intangible assets are comprised primarily of purchased technology, customer relationships, manufacturing know-how and trade secrets, and trade name and trademarks. We make significant judgments in relation to the valuation of intangible assets resulting from businesscombinations and asset acquisitions. Intangible assets are amortized on a straight-line basis over their estimated useful lives of 1 to 17 years. We base the useful lives and relatedamortization or depreciation expense on our estimate of the period that the assets will generate revenues or otherwise be used by the Company. We alsoperiodically review the lives assigned to our intangible assets to ensure that our initial estimates do not exceed any revised estimated periods from which weexpect to realize cash flows from the technologies. If a change were to occur in any of the above-mentioned factors or estimates, the likelihood of a materialchange in our reported results would increase. We evaluate our intangible assets with finite lives for indications of impairment whenever events or changes in circumstances indicate that thecarrying value may not be recoverable. Factors that could trigger an impairment review include significant under-performance relative to expected historicalor projected future operating results, significant changes in the manner of our use of the acquired assets or the strategy for our overall business or significantnegative industry or economic trends. If this evaluation indicates that the value of the intangible asset may be impaired, we make an assessment of therecoverability of the net carrying value of the asset over its remaining useful life. If this assessment indicates that the intangible asset is not recoverable,based on the estimated undiscounted future cash flows of the technology over the remaining amortization period, we reduce the net carrying value of therelated intangible asset to fair value and may adjust the remaining amortization period.During the year ended December 31, 2014, we recorded an impairment charge of $10.7 million related to developed technology acquired fromCervitech in 2009. The primary factor contributing to this impairment charge was the reduction in Management’s revenue estimate and the related decreaseto the estimated cash flows for this technology.Significant judgment is required in the forecasts of future operating results that are used in the discounted cash flow valuation models. It is possiblethat plans may change and estimates used may prove to be inaccurate. If our actual results, or the plans and estimates used in future impairment analyses, arelower than the original estimates used to assess the recoverability of these assets, we could incur additional impairment charges.Valuation of Stock-Based Compensation. The estimated fair value of stock-based awards exchanged for shareowner (employee) and non-employeedirector services are expensed over the requisite service period. Awards issued to non-employees (excluding non-employee directors) are recorded at fairvalue and remeasured periodically as determined in accordance with authoritative guidance, and recognized as expense over respective service periods.For purposes of calculating stock-based compensation, we estimate the fair value of stock options and shares issued under the Employee StockPurchase Plan using a Black-Scholes option-pricing model. The determination of the fair value of stock-based payment awards utilizing the Black-Scholesmodel is affected by our stock price and a number of assumptions, including expected volatility, expected term, risk-free interest rate and expected dividends.The expected volatility is based on the historical volatility of our common stock over the most recent period commensurate with the estimated expected termof the stock options. The expected term of the stock options is based on historical and other economic data trended into the future. The risk-free interest rateassumption is based on observed interest rates appropriate for the expected terms of our stock options. The dividend yield assumption is based on our historyand expectation of no dividend payouts. The fair value of restricted stock units granted is based on the market price of our common stock on the date ofgrant. The Company uses historical forfeiture rate trends as a basis for estimating pre-vesting forfeitures.The fair value of performance-based restricted stock units (PRSUs) that have pre-defined Company-specific performance criteria is determined basedon the stock price at the date of grant. We recognize the stock-based compensation expense on PRSUs granted based on the probability of achieving thespecified performance criteria, as defined in the performance award agreements. Expense is recognized using the accelerated method over the remainingrecognition period based on these probabilities. Due to the nature of the performance goals, assessing the probability of achieving those goals is a highlysubjective process that requires judgment. Additionally, certain of our PRSUs are earned based on the achievement of pre-defined market conditions. The fairvalue of PRSUs with market conditions is estimated on the date of grant using a Monte Carlo valuation model and key assumptions are expected volatilityand the risk free interest rate. We collectively refer to PRSUs with both Company-specific performance criteria and pre-defined market conditions asperformance awards.If factors change and we employ different assumptions, stock-based compensation expense may differ significantly from what we have recorded in thepast. If there is a difference between the assumptions used in determining stock-based compensation expense and the actual factors which become knownover time, specifically with respect to anticipated forfeitures, we may change the input factors used in determining stock-based compensation costs for futuregrants. These changes, if any, may materially impact our results of operations in the period such changes are made.Stock-based compensation expense was $33.7 million, $33.2 million, and $26.3 million for 2014, 2013, and 2012, respectively. The expenses for2014 and 2013 were relatively consistent, and increased $6.9 million in 2013 compared to 2012. This increase in 2013 was primarily attributed to theincrease in compensation expense related to market-based performance awards. 44Table of ContentsAs of December 31, 2014, there was approximately $18.5 million and $4.8 million of unrecognized compensation expense for restricted stock unitsissued under our equity incentive plans (RSUs) and Performance Awards, respectively, which is expected to be recognized over a weighted-average period ofapproximately 1.7 years and 1.5 years, respectively. In addition, as of December 31, 2014, there was $1.1 million of unrecognized compensation expense forshares expected to be issued under the Employee Stock Purchase Plan which is expected to be recognized through April 2016. Unrecognized amortizationexpense for options was immaterial as of December 31, 2014.Accounting for Income Taxes. Significant judgment is required in determining our provision for income taxes, our deferred tax assets and liabilitiesand the valuation allowance recorded against our net deferred tax assets. Deferred tax assets and liabilities are determined using the enacted tax rates in effectfor the years in which those tax assets are expected to be realized. A valuation allowance is established when it is more likely than not the future realizationof all or some of the deferred tax assets will not be achieved. The evaluation of the need for a valuation allowance is performed on a jurisdiction-by-jurisdiction basis, and includes a review of all available positive and negative evidence. Factors reviewed include projections of pre-tax book income for theforeseeable future, determination of cumulative pre-tax book income after permanent differences, earnings history, and reliability of forecasting.At December 31, 2013, as a result of three years of cumulative profits and projected future taxable income, we determined that it was more likely thannot that most of our foreign deferred tax assets would be realized and, accordingly, we reversed a valuation allowance totaling approximately $2.2 millionthat was recorded against these deferred tax assets.As a result of the litigation award accrual totaling $101.2 million recorded in the third quarter of 2011, we evaluated the need for a valuationallowance on our deferred tax assets by reviewing all available positive and negative evidence. Based on our review, we concluded that it was more likelythan not that we would be able to realize the benefit of our U.S. federal deferred tax assets and our deferred tax assets for all states except California in thefuture. This conclusion was primarily based on historical and projected operating performance, as well as our expectation that our operations will generatesufficient taxable income in future periods to realize the tax benefits associated with the federal deferred tax assets well within the statutory carryover periods.Accordingly, we did not establish a valuation allowance on our federal or non-California state deferred tax assets as of December 31, 2014 or 2013.Based on this same evidence and consideration of the state of California’s past suspension of the use of net operating loss carryforwards, the state ofCalifornia’s statutory carryover periods and our apportionment election beginning in 2011, we concluded that it is more likely than not that we will not beable to utilize our California deferred tax assets. Therefore, we established a full valuation allowance on our California deferred tax assets as of December 31,2011. A full valuation allowance on our California deferred tax assets continues to exist as of December 31, 2014.We will continue to assess the need for a valuation allowance on our deferred tax assets by evaluating both positive and negative evidence that mayexist. Any adjustment to the net deferred tax asset valuation allowance would be recorded in the statement of operations for the period that the adjustment isdetermined to be required.Legal Proceedings. We are involved in a number of legal actions arising out of the normal course of our business. The outcomes of these legalactions are not within our complete control and may not be known for prolonged periods of time. In some actions, the claimants seek damages as well as otherrelief, including injunctions barring the sale of products that are the subject of the lawsuit, that could require significant expenditures or result in lostrevenues. In accordance with authoritative guidance, we disclose information regarding each material claim where the likelihood of a loss contingency isprobable or reasonably possible. An estimated loss contingency is accrued in our financial statements if it is both probable that a liability has been incurredand the amount of the loss can be reasonably estimated. If a loss is reasonably possible and can be reasonably estimated, the estimated loss or range of loss isdisclosed in the notes to the consolidated financial statements. In most cases, significant judgment is required to estimate the amount and timing of a loss tobe recorded. Our significant legal proceedings are discussed in Note 11 to the consolidated financial statements included in this Annual Report. While it isnot possible to predict the outcome for the matters discussed in Note 11 to the consolidated financial statements, we believe it is possible that costsassociated with them could have a material adverse impact on our consolidated earnings, financial position or cash flows.The above listing is not intended to be a comprehensive list of all of our accounting policies. In many cases, the accounting treatment of a particulartransaction is specifically dictated by GAAP. See our consolidated financial statements and notes thereto included in this report, which contain accountingpolicies and other disclosures required by GAAP. 45Table of ContentsResults of OperationsRevenue Year Ended December 31, 2013 to 2014 2012 to 2013 2014 2013 2012 $ Change % Change $ Change % Change (Dollars in thousands) Spine Surgery Products $590,471 $530,370 $471,186 $60,101 11% $59,184 13%Biologics 129,570 115,633 110,179 13,937 12% 5,454 5%Monitoring Service 42,374 39,170 38,890 3,204 8% 280 1%Total revenue $762,415 $685,173 $620,255 $77,242 11% $64,918 10%Our Spine Surgery Product line offerings, which include products for the thoracolumbar product offerings, cervical product offerings and disposables,are primarily used to enable access to the spine and to perform restorative and fusion procedures in a minimally disruptive fashion. Our Biologic product lineofferings include allograft (donated human tissue), FormaGraft® (a collagen synthetic product), Osteocel® Plus and Osteocel® Pro (each an allograft cellularmatrix containing viable mesenchymal stem cells, or MSCs), and AttraX® (a synthetic bone graft material), all of which are used to aid the spinal fusion orbone healing process. Our Monitoring Service line offering includes hospital-based revenues and net patient service revenues related to IOM servicesperformed.The continued adoption of minimally invasive procedures for spine has led to the expansion of our procedure volume. In addition, increased marketacceptance in our international markets contributed to the increase in revenues noted for the periods presented. We expect continued adoption of ourinnovative minimally invasive procedures and deeper penetration into existing accounts and international markets as our sales force executes on our strategyof selling the full mix of our products. However, the continued consolidation and increased purchasing power of our hospital customers and grouppurchasing organizations, the continued existence of physician-owned distributorships, recent changes in the public and private insurance markets regardingreimbursement, and ongoing policy and legislative changes in the United States have created less predictability in the lumbar portion of the spine market andhave limited the domestic spine market's procedural growth rate. Accordingly, we believe that our growth in revenue in 2015 will continuously comeprimarily from share gains in the shift toward less invasive spinal surgery and international growth.Our total revenues increased $77.2 million in 2014 compared to 2013 and $64.9 million in 2013 compared to 2012, representing total revenue growthof 11% and 10%, respectively. To date, foreign currency fluctuations have not materially impacted our revenues.Revenue from our Spine Surgery Products increased $60.1 million, or 11%, in 2014 compared to 2013 and $59.2 million, or 13%, in 2013 comparedto 2012. These increases resulted from increases in volume of approximately 14% and 15% for the years ended December 31, 2014 and 2013 respectively,compared to the prior periods, offset by unfavorable changes in price of approximately 2% for each period compare to the prior period.Revenue from Biologics increased $13.9 million, or 12%, in 2014 compared to 2013, and $5.5 million, or 5%, in 2013 compared to 2012. Theseincreases resulted from increases in volume of approximately 12% and 6% for the years ended December 31, 2014 and 2013, respectively, compared to theprior periods. Increase in revenue in 2013 was offset by small unfavorable changes in price of approximately 1% compared to the same period in 2012. Theimpact from changes in price was insignificant in 2014 comparing to the same period in 2013.Revenue from Monitoring Services increased $3.2 million or 8% in 2014 compared to 2013 and $0.3 million, or 1%, in 2013 compared to 2012. Theincrease in revenue in 2014 was primarily from increased medical billing collections and volume in 2014. The increase from 2012 to 2013 resulted primarilyfrom increases in volume offset by unfavorable changes in reimbursement rates. Cost of Goods Sold, excluding amortization of purchased technology Year Ended December 31, 2013 to 2014 2012 to 2013 2014 2013 2012 $ Change % Change $ Change % Change (Dollars in thousands) Cost of Goods Sold $182,358 $180,484 $153,409 $1,874 1% $27,075 18%% of total revenue 24% 26% 25% Cost of goods sold consists primarily of raw materials, labor and overhead associated with product manufacturing, purchased goods, inventory-relatedcosts and royalty expenses, as well as the cost of providing IOM services, which includes personnel and physician oversight costs. To date, foreign currencyfluctuations have not materially impacted our cost of goods sold. 46Table of ContentsCost of goods sold as a percentage of revenue decreased during the year ended December 31, 2014 compared to 2013. This decrease in cost of goodssold as a percentage of revenue, which resulted in higher gross margin, was primarily due to an approximate 2% decrease in cost or reserve requirements dueto inventory efficiencies and margin improvements gained from the acquisition of the spine implant manufacturer ANC, LLC in May 2013 (now named“NuVasive Manufacturing Limited”) and overall operational efficiencies realized during 2014 including increased medical billing collections and volume inmonitoring services. In addition, during 2013, a non-recurring royalty charge of $7.9 million, or 1% as a percentage of revenue, was recognized related to theMedtronic litigation ruling that determined ongoing royalty rates (see Note 11 to the Consolidated Financial Statements included in this Annual Report forfurther discussion). These improvements were offset by sales price decreases, incremental royalty charges due to an increased revenue base and a shift ofrevenue mix towards lower margin products and countries during 2014, by approximately 1%. Cost of goods sold as a percentage of revenue increased during the year ended December 31, 2013 compared to 2012. The increase was a result of boththe medical device excise tax effective January 1, 2013 of approximately 1% and the aforementioned non-recurring royalty charge of $7.9 million in 2013.On a long term basis, we expect cost of goods sold, as a percentage of revenue, to decrease moderately.Operating Expenses Year Ended December 31, 2013 to 2014 2012 to 2013 2014 2013 2012 $ Change % Change $ Change % Change (Dollars in thousands) Sales, marketing, and administrative $469,648 $420,064 $372,416 $49,584 12% $47,648 13%% of total revenue 62% 61% 60% Research and development 37,986 32,209 35,296 5,777 18% (3,087) (9)%% of total revenue 5% 5% 6% Amortization of intangibles 13,571 19,326 12,430 (5,755) (30)% 6,896 55%% of total revenue 2% 3% 2% Impairment of intangible assets 10,708 — 9,700 10,708 100% (9,700) (100)%% of total revenue 1% —% 2% Litigation liability 30,000 — — 30,000 100% — —%% of total revenue 4% —% —% Sales, Marketing and Administrative Sales, marketing and administrative expenses consist primarily of compensation costs, commissions and training costs for shareowners engaged insales, marketing and customer support functions. The expense also includes distributor commissions, freight expenses, surgeon training costs, depreciationexpense for property and equipment such as surgical instrument sets, and administrative expenses for both shareowners and third party service providers. Sales, marketing and administrative expenses increased by $49.6 million or 12% during the year ended December 31, 2014 compared to the sameperiod in 2013, of which $29.4 million was related to increases in variable costs and $20.2 million was related to increases in fixed costs. Sales, marketingand administrative expenses increased by $47.6 million or 13% during the year ended December 31, 2013 compared to the same period in 2012 of which$19.6 million was related to increases in variable costs and $28.0 million was related to increases in fixed costs. To date, foreign currency fluctuations havenot materially impacted our sales, marketing, and administrative expense.Costs that tend to vary based on revenue, or variable costs, primarily consist of commissions, depreciation expense for loaned surgicalinstrument sets, domestic sales force headcount, distribution and customer support headcount, freight expenses, and continued investment in theexpansion of our international markets.Variable costs increased by $29.4 million during the year ended December 31, 2014 compared to the same period in 2013. The increase invariable costs was driven by the costs associated with the expansion in our international markets of $15.2 million, which primarily consists of anincrease in direct and indirect sales force’s salary, benefits, and commissions of $10.7 million, increased facility, freight, and depreciation chargesof $0.8 million, and an increase in outside service costs of $0.9 million. Included in variable costs was also an increase of $11.2 million in salary,benefits, and commissions for the sales force to support the expansion of our domestic markets, and increase in freight and depreciation expenseof $4.1 million.Variable costs increased $19.6 million in 2013 compared to 2012, of which, $19.0 million was primarily a result of our continued investmentin our international markets, revenue growth and increases in freight expenses. Fixed costs are primarily comprised of compensation and other shareowner related expenses for our marketing and administrative supportfunctions. It also includes facility charges, professional services and legal fees. 47Table of ContentsFixed costs increased $20.2 million during the year ended December 31, 2014 compared to the same period in 2013. Of this $20.2 millionincrease, $10.5 million was due to an increase in facility related charges. Salary and benefit for shareowners in our marketing and administrative supportfunctions increased by $7.8 million to support the overall expansion of our domestic and international markets. Legal expenses also increased by$1.6 million which primarily related to certain intellectual property and litigation related legal matters. Fixed costs for our marketing and administrative support functions increased $28.0 million in 2013 compared to 2012. Of which, $6.7 million was dueto an increase in compensation and other shareowner related expenses, resulting from an increase in headcount and computer-related expenses. Legalexpenses increased $7.8 million in 2013 compared to 2012. Legal expenses incurred in connection with the Medtronic litigation and the OIG subpoenareceived during 2013 increased $6.1 million. In addition, legal expenses incurred in connection with other matters increased by $2.9 million in 2013compared to 2012. These increases are offset by the reimbursement of $1.2 million related to legal expenses in connection with the settlement of severallawsuits related to a competitor during 2013. Stock-based compensation increased $7.3 million in 2013 compared to 2012. This increase is primarilyattributed to the increase in compensation expense related to market-based performance awards. The fixed cost for 2013 and 2012 also included $8.0 millionand $4.0 million, respectively, of investments in our Japanese operations, which is now considered variable costs as majority of the initial set up ofoperations had been completed in 2013 and its costs started to relatively vary with revenue growth during the operations in 2014.As a percentage of revenue, sales, marketing and administrative expenses increased from 2012 to 2013 and 2013 to 2014 mainly because of non-recurring expenses incurred during each year, including facility charges during 2014 and higher legal and stock based compensation expenses during 2013as aforementioned above. On a long-term basis, we expect total sales, marketing and administrative costs, as a percentage of revenue, to decrease moderately.Research and Development Research and development expense consists primarily of product research and development, clinical trial and study costs, regulatory and clinicalfunctions, and compensation and other shareowner related expenses. In the last several years, we have introduced numerous new products and productenhancements that have significantly expanded our MAS platform, enhanced the applications of the XLIF procedure, and expanded our offering of cervicalproducts. We have also acquired complementary and strategic assets and technology, particularly in the area of spine surgery products. We continue to investin research and development programs.Research and development expense increased by $5.8 million in 2014 compared to 2013 primary related to compensation and othershareowner related expenses due to increased headcount and the costs related to ongoing development projects of $5.5 million in 2014, andincreased expenses of $0.7 million related to facility and depreciation charges. These expenses were partially offset by reduction in expenses of$0.9 million related to acquisitions of in-process research and development intangible assets charged to expense in 2014 compared to 2013.Research and development expense decreased by $3.1 million in 2013 compared to 2012. Expenses incurred in connection with clinical trials,various studies, and ongoing development projects, including outside professional services, decreased approximately $1.0 million in 2013 compared to 2012as a result of the completion of enrollment in a clinical trial and ongoing study related activities. Research and development facilities expenses andcompensation and other shareowner related expenses, including performance-based and stock-based compensation, decreased $4.0 million due to a decreasein headcount and shareowner related expenses. Expenses incurred related to the acquisition of in-process research and development intangible assets chargedto expense in accordance with the authoritative accounting guidance increased $2.1 million in 2013 compared to 2012.On a long-term basis, we expect total research and development costs as a percentage of revenue to increase moderately in support of our ongoingdevelopment and 510k product approval efforts.Amortization of Intangible Assets Amortization of intangible assets relates to the amortization of finite-lived intangible assets acquired. Amortization expense decreased $5.8 million in2014 compared to 2013, primarily due to certain intangible assets reaching the end of their useful lives subsequent to December 31, 2013. Amortizationexpense increased $6.9 million in 2013 compared to 2012, primarily due to the acquisition of intangible assets acquired in 2013, and additional expenseresulting from IPR&D which commercialized during the fourth quarter of 2012.We expect amortization of intangible assets as a percentage of revenue to be relatively consistent.Impairment of Goodwill and Intangible Assets During the years ending December 31, 2014 and 2012, we recorded $10.7 million and $1.4 million, respectively, of impairment charges related tointangible assets acquired from Cervitech in 2009. The primary factor contributing to these impairment charges were the reduction in management'sestimates of current and future revenue and the related cash flows due to updated views of the competitive and regulatory landscape in the cervical market. 48Table of ContentsDuring the year ended December 31, 2012, we updated our discounted cash flow valuation model for Impulse Monitoring and based onManagement’s estimates on revenues, expenses, related cash flows and the discount rate used in the model, the estimated fair value of the then ImpulseMonitoring reporting unit was less than its carrying value. Management’s updates on the estimates reflect the impacts of the significant coding changes forIOM services which took effect in 2013 and resulted in reduced reimbursement for IOM services. As a result, we recorded an impairment charge of $8.3million to its goodwill.Litigation Award The litigation liability relates to the unfavorable jury verdict that was delivered against us during the year ended December 31, 2014 relating to ouruse of the trade name "NeuroVision". The amount of the jury verdict represents a probable loss that can be reasonably estimated (see Note 11 to theConsolidated Financial Statements included in this Annual Report for further discussion).Interest and Other Expense, Net Year Ended December 31, 2013 to 2014 2012 to 2013 2014 2013 2012 $ Change % Change $ Change % Change (Dollars in thousands) Interest income $968 $755 $915 $213 28% $(160) (17)%Interest expense (27,911) (27,178) (27,710) (733) (3)% 532 2%Other income (expense), net (2,411) 3,101 1,047 (5,512) (178)% 2,054 196%Total interest and other expense, net $(29,354) $(23,322) $(25,748) $(6,032) (26)% $2,426 9%% of total revenue (4)% (3)% (4)% Total interest and other expense, net, consists principally of interest expense incurred on our 2013 and 2017 Senior Convertible Notes, andother income (expense), offset by income earned on marketable securities.Total interest and other expense, net, increased by $6.0 million for the year ended December 31, 2014 compared to the same periodin 2013. The interest expense increased by $0.7 million during the year ended December 31, 2014, compared to 2013 for the same period due toamortization schedule of the debt discount offset with lower interest expense incurred due to the 2013 Senior Convertible Notes settlement duringMarch 2013. The increase in other expense, net, of $5.5 million during the year ended December 31, 2014, compared to 2013 for the same periodwas due to the recognition of other income of approximately $2.8 million in connection with the settlement of several lawsuits related to acompetitor in 2013, and losses on foreign currency rate changes in 2014 of $2.6 million, net of hedges. The loss on foreign currency was primarilydue to the fluctuation in the pound sterling, the euro, the Australian dollar and the yen.Total interest and other expense, net, decreased by $2.4 million in 2013 compared to 2012 primarily driven by changes in interest expense and otherincome, net, as compared to prior year. Interest expense decreased $0.5 million in 2013 as a result of the maturity of the 2013 Senior Convertible Notes onMarch 15, 2013. During the year ended December 31, 2013, other income, net, included gains of $2.8 million related to the settlement of several lawsuitswith a competitor.Income Tax Expense Year Ended December 31, 2013 to 2014 2012 to 2013 2014 2013 2012 $ Change % Change $ Change % Change (Dollars in thousands) Income Tax Expense $6,286 $2,783 $8,814 $3,503 126% $(6,031) (68)%Effective income tax rate 56% 28% 78% The effective income tax expense rate for 2014 was 56% compared to 28% in 2013. The effective tax rate for 2014 was negative mainly due to thenegative impact from our Globalization Initiative project and non-deductible expenses primarily relating to executive compensation, offset by generalbusiness and domestic manufacturing credits and discrete benefits relating to disqualifying dispositions of qualified stock grants.The effective income tax expense rate for 2013 of 28% reflects the benefits of the reversal of valuation allowances on foreign deferred tax assets ofapproximately $2.2 million. Excluding the impact of the reversal of the valuation allowances, the effective income tax rate for 2013 would have differed fromthe U.S. federal statutory rate of 35% due to foreign taxes, state income taxes, general business credits and non-deductible stock based compensation. 49Table of ContentsIn January 2013, the American Taxpayer Relief Act of 2012 was signed into law in the U.S. This legislation includes the temporary extension ofseveral expired business tax incentives retroactively to calendar year 2012 and prospectively through calendar year 2013. Among the expired tax provisionswas the research and development tax credit. The effects of the change in the tax law were recognized in our first quarter of 2013, the quarter during which thelaw was enacted. Had the legislation been enacted during 2012, our income tax expense in 2012 would have been reduced by approximately $0.8 million forthe year ended December 31, 2012. Because of the timing of enactment, we effectively benefited from two years’ worth of research and development creditsin 2013 for a total benefit to tax expense in 2013 of approximately $1.7 million.The effective income tax expense rate for 2012 of 78% reflects the impact of the non-deductible goodwill impairment charge of $8.3 million.Excluding the impact of the non-deductible goodwill impairment charge, the effective tax rate for 2012 would have differed from the U.S. federal statutoryrate of 35% due primarily to state income taxes, and nondeductible stock based compensation.As a result of the litigation award accrual totaling $101.2 million recorded in 2011, we evaluated the need for a valuation allowance on our deferredtax assets by reviewing all available positive and negative evidence. Based on our review, we concluded that it was more likely than not that we would beable to realize the benefit of our U. S. federal deferred tax assets and our deferred tax assets for all states except California in the future. This conclusion wasprimarily based on historical and projected operating performance, as well as our expectation that our operations will generate sufficient taxable income infuture periods to realize the tax benefits associated with the federal deferred tax assets well within the statutory carryover periods. Accordingly, we did notestablish a valuation allowance on our federal or non-California state deferred tax assets as of December 31, 2014.Based on this same evidence and consideration of the state of California’s past suspension of the use of net operating loss carryforwards, the state ofCalifornia’s statutory carryover periods and our apportionment election beginning in 2011, we concluded that it is more likely than not that we will not beable to utilize our California deferred tax assets. Therefore, we established a full valuation allowance on our California deferred tax assets as of December 31,2011. A full valuation allowance on our California deferred tax assets continues to exist at December 31, 2014.We are subject to audits by federal, state, local, and foreign tax authorities. We believe that adequate provisions have been made for any adjustmentsthat may result from tax examinations. However, the outcome of tax audits cannot be predicted with certainty. Should any issues addressed in our tax auditsbe resolved in a manner not consistent with Management’s expectations, we could be required to adjust our provision for income taxes in the period suchresolution occurs. We will continue to assess the likelihood of realization of our tax credits and other net deferred tax assets. If future events occur that do notmake the realization of such assets more likely than not, a valuation allowance will be established against all or a portion of the net deferred tax assets.We expect our future effective income tax rate to exceed the U.S federal and statutory income tax rates due to various factors, including non-deductible expenses, state income taxes, net of federal benefits, and the continuing impacts of the implementation of our planned globalization initiativewhich became effective in January 2014. The initiative involved establishing new international operations and entering into new intercompany transferpricing arrangements, including the licensing of intangibles. We intend to continue to streamline our international operations over time, includingprocurement, logistics and customer service functions, with the expectation of achieving overall operational efficiencies, including asset utilization, cost andexpense savings, and standardization and compliance benefits. As international tax rules and regulations change, the Company may be subjected to changesin tax rates. At the current time the Company believes the jurisdictions in which it operates and the options available to the Company would therefore notsubject the Company to major changes in tax obligations with a change in tax regulation.Liquidity, Cash Flows and Capital ResourcesLiquidity and Capital ResourcesOur principal sources of liquidity are our existing cash, cash equivalents and marketable securities, cash generated from operations and proceeds fromour convertible debt financing issued in June 2011. We expect that cash provided by operating activities may fluctuate in future periods as a result of anumber of factors, including fluctuations in our operating results, working capital requirements and capital deployment decisions. We have historicallyinvested our cash primarily in the U.S. treasuries and government agencies, corporate debt, and money market funds. Certain of these investments are subjectto general credit, liquidity and other market risks. The general condition of the financial markets and an economy may increase those risks and may affect thevalue and liquidity of our current investments and restrict our ability to access the capital markets.Our future capital requirements will depend on many factors including our rate of revenue growth, the timing and extent of spending to supportdevelopment efforts, the expansion of sales, marketing and administrative activities, the timing of introductions of new products and enhancements toexisting products, successful vertical integration of our manufacturing process, the continuing market acceptance of our products, the expendituresassociated with possible future acquisitions or other business combination transactions, the outcome of current and future litigation, the evolution of ourglobalization initiative, and continuous international expansions of our business. We believe our current cash and cash equivalents, investments and cashprovided by operations will satisfy our working capital requirements, debt obligations and capital expenditures for the foreseeable future. In the event theCompany was to access the debt market, the Company believes it could do so at reasonable borrowing costs. 50Table of ContentsA substantial portion of our operations are located in the United States, and the majority of our sales and cash generation since inception have beenmade in the United States. Accordingly, we do not have material cash flow exposure to foreign currency rate fluctuations. However, as our business in marketsoutside of the United States continues to increase, we will be exposed to foreign currency exchange risk related to our foreign operations. Fluctuations in therate of exchange between the United State dollar and foreign currencies, primarily in the pound sterling, the euro, the Australian dollar and the yen, couldadversely affect our financial results, including our revenues, revenue growth rates, gross margins, income and losses as well as assets and liabilities. TheCompany does enter into forward contracts as necessary to partially offset the impact from fluctuations of the foreign currency rates. At December 31, 2014,the cash balance held by our foreign subsidiaries was approximately $14.5 million and it is the Company’s intention to indefinitely reinvest all of currentforeign earnings in order to partially support foreign working capital and to expand its existing operations outside the United States. As of December 31,2014, $19.6 million of account receivable was held in other than United States dollar.In connection with the Medtronic litigation, a jury from the U.S. District Court, Southern District of California delivered an unfavorable verdictto us and awarded monetary damages of approximately $101.2 million to Medtronic. In May 2012, in accordance with an escrow arrangement, wetransferred $113.3 million of cash into a restricted escrow account to secure the amount of the judgment, plus prejudgment interest, duringpendency of our appeal of the judgment. These funds are included in restricted cash and investments in our December 31, 2014 consolidatedbalance sheet. Further, as a result of the June 2013 District Court ruling on the ongoing royalty rates, we will be required to escrow funds to secureaccrued royalties, estimated at $29.4 million to date, as well as future ongoing royalties. During 2013, the Company and Medtronic entered into asettlement agreement fully resolving the second phase of the case and the Company made a one-time payment to Medtronic of $7.5million. Accordingly, the Company's accrual for the case as of December 31, 2014 was $93.7 million, after giving effect to the reduction of theoriginal verdict of $101.2 million by the second phase settlement of $7.5 million (see Note 11 to the Consolidated Financial Statements included in thisAnnual Report for further discussion).On April 3, 2014, an unfavorable jury verdict was delivered against us relating to our use of the trade name “NeuroVision”. We established aliability of $30.0 million for this matter, which remained unchanged as of December 31, 2014. During pendency of the appeal, we have agreed to escrowfunds totaling $32.5 million to secure the amount of judgment, plus interest, attorney’s fees and costs. Such funds will be classified as restricted cash,and held pending the outcome of post-trial motions and the likely appellate process. In the event that we are unable to prevail in future legal action,we could be required to outlay such escrowed cash.Cash, cash equivalents and marketable securities was $405.8 million and $326.1 million at December 31, 2014 and 2013, respectively. We believethat our existing cash, cash equivalents and short-term marketable securities will be sufficient to meet our anticipated cash needs for the next 12 months. AtDecember 31, 2014, we have cash and investments totaling $123.2 million in restricted accounts which are not available to us to meet any ongoing capitalrequirements if and when needed. This could materially impact our liquidity and our ability to invest in and run our business on an ongoing basis.Cash FlowsThe following table summarizes our consolidated statements of cash flows (in thousands): Year Ended December 31, 2013 to 2014 2012 to 2013 2014 2013 2012 $ Change % Change $ Change % Change Cash provided by operating activities $115,548 $97,439 $130,082 $18,109 19% $(32,643) (25)%Cash used in investing activities (104,825) (64,570) (147,894) (40,255) (62)% 83,324 56%Cash provided by (used in) financing activities 30,277 (52,482) (22,556) 82,759 158% (29,926) (133)%Effect of exchange rate changes on cash (1,438) (861) 175 (577) (67)% (1,036) (592)%Increase (decrease) in cash and cash equivalents $39,562 $(20,474) $(40,193) $60,036 293% $19,719 49% Cash flows from operating activitiesCash provided by operating activities was $115.5 million in 2014, compared to $97.4 million in 2013. The increase of $18.1 million cash provided byoperating activities was primarily due to cash inflow from changes in net operating assets of $39.0 million and increased non-cash add backs of $3.6 million,which was offset by the decrease in net income of $24.5 million. The change in net operating assets included a litigation liability accrual of $30.0 millionthe Company recognized during the year ended December 31, 2014 and increased payroll accrual of $4.0 million due to increased headcount in support ofour expanding domestic and international operations. Non-cash add backs were primarily driven by adding back an impairment charge of $10.7 million,offset with a change in deferred income tax benefit of $11.9 million which includes the impact from the aforementioned litigation accrual (see Note 9 to theConsolidated Financial Statements included in this Annual Report for further discussion). 51Table of ContentsCash flows from operating activities also included $13.6 million of cash tax payments in 2014, net with the incremental tax benefit related to stockbased compensation of $11.9 million which is considered cash flows from financing activities.Cash provided by operating activities was $97.4 million in 2013, compared to $130.1 million in 2012. The $32.6 million decrease in cash providedby operating activities in 2013 as compared to 2012 is due to a small increase in days sales outstanding which affects our accounts receivable balance and isconsistent with our international growth, an increase in amounts paid for other current assets, driven primarily by a refund of $11.2 million received in thefirst quarter of 2012 relating to an overpayment at December 31, 2011, and increased investments in inventory. These decreases in cash flows from operatingactivities were offset by increases in accounts payable and accrued liabilities primarily related to an increase in royalty accruals.Cash flows used in investing activitiesCash used in investing activities was $104.8 million in 2014, compared to $64.6 million in 2013. The $40.3 million increase in cash used in investingactivities in 2014 as compared to 2013 is primarily due to a net increase in purchases of marketable securities of $44.0 million, including restrictedinvestments and increases in purchases of property and equipment of $10.8 million, offset by less cash paid for acquisitions and investments by $14.3million. Additionally, the Company had an accrual of $27.4 million as of December 31, 2014 for the purchase of intangible assets which was paid in early2015.The Company had immaterial contingent consideration obligations related to its 2012 business combination that were paid in cash in early 2014 andin mid February 2015.As of December 31, 2014, the Company has obligations under certain consultancy arrangements to pay up to approximately $23.2 million in theaggregate in the event that specified revenue-based milestones are achieved prior to the year 2024. Any such payment will be made in a combination of cashand the Company’s common shares as provided in the agreements. Any payments in satisfaction of theses contingent obligations are considered a cost ofgoods sold and are recognized as and if milestones are achieved. During 2014, the Company paid $6.2 million in aggregate – $3.0 million in cash and $3.2million in common shares - in connection with these agreements.Cash used in investing activities was $64.6 million in 2013, compared to $147.9 million in 2012. The $83.3 million decrease in cash used ininvesting activities in 2013 as compared to 2012 is primarily due to a net decrease in purchases of marketable securities, including restricted investments,offset by slight increases in purchases of property and equipment and cash paid for business and asset acquisitions.For 2015, the Company expects capital expenditures to support expansions of our business globally to be in the range of $60 million to $65 millionwhich is expected to be sourced by the cash generated from the operations.Cash flows from financing activitiesCash provided by financing activities was $30.3 million in 2014, compared to cash used in financing activities of $52.5 million in 2013. The $82.8million increase in cash provided by financing activities is primarily due to the repayment of the 2013 Senior Convertible Notes of $74.3 million made in2013 and the increase in cash proceeds from the issuance of common stock of $14.9 million, offset by purchases of treasury shares of $3.8 million in 2014 foremployee minimum tax withholding payments, and decrease in excess tax benefit of $1.7 million related to stock based compensations. Our equity incentive plans allow for net share settlement of certain equity awards. Net share settlement is generally used in lieu of sales of equityawards and subsequent cash payments by shareowners in satisfaction of minimum tax withholding obligations associated with, or exercise costs for equityawards. These net share settlement transactions are accounted for as treasury share repurchase transactions, with the cost of any deemed repurchased sharesincluded in treasury stock and reported as a reduction in total equity at the time of settlement. Additionally, net share settlement for minimum taxwithholdings requires us to fund a significant amount of cash for certain shareowner tax payment obligations from time-to-time with respect to their settledequity awards. During 2015, the Company approximates at least $30.0 million of such cash tax payments will be made, however the actual remittance can belargely different depending on a share price at the date of RSU release or option exercises or actual volume of such activities. We anticipate using cashgenerated from operating activities to fund all such payments.Cash used in financing activities was $52.5 million in 2013, compared to $22.6 million in 2012. The $29.9 million increase in 2013 in cash used infinancing activities is primarily due the repayment of the 2013 Senior Convertible Notes of $74.3 million, offset by a decrease in cash paid for contingentconsideration of $29.7 million. 52Table of ContentsIn June 2011, we issued $402.5 million principal amount of Senior Convertible Notes with a stated interest rate of 2.75% and a maturity dateof July 1, 2017. The net proceeds from the offering, after deducting initial purchasers' discounts and costs directly related to the offering,were $359.2 million. The 2017 Notes may be settled in cash, stock, or a combination thereof, solely at our discretion. It is our current intent andpolicy to settle all conversions through combination settlement, which involves repayment of an amount of cash equal to the principal amount andany excess of the conversion value over the principal amount in shares of the Company’s common stock. The initial conversion rate of the 2017Notes is 23.7344 shares per $1,000 principal amount, or equivalent to conversion price of approximately $42.13 per share, which is subject toadjustment. Interest on the 2017 Notes is payable semi-annually on January 1st and July 1st of each year.In connection with the offering of the 2017 Notes, the Company entered into convertible note hedge transactions (the “2017 Hedge”) with theinitial purchasers and/or their affiliates (the Counterparties) entitling the Company to purchase up to 9,553,096 shares of the Company’s commonstock at an initial stock price of $42.13 per share, each of which is subject to adjustment. The cost of the 2017 Hedge was $80.1 million. The 2017Hedge expires on July 1, 2017. The 2017 Hedge is expected to reduce the potential equity dilution upon conversion of the 2017 Notes if the dailyvolume-weighted average price per share of the Company’s common stock exceeds the strike price of the 2017 Hedge. In addition, the Company sold warrants to the Counterparties to acquire up to 477,654 shares of the Company’s Series A ParticipatingPreferred Stock (the 2017 Warrants), at an initial strike price of $988.51 per share, subject to adjustment. Each share of Series A ParticipatingPreferred Stock is initially convertible into 20 shares of the Company’s common stock. The 2017 Warrants expire on various dates fromSeptember 2017 through January 2018 and may be settled in cash or net shares. It is the Company’s current intent and policy to settle allconversions in shares of the Company’s common stock, should the conversion occur. The Company received $47.9 million in cash proceeds fromthe sale of the 2017 Warrants. The 2017 Warrants could have a dilutive effect on the Company’s earnings per share to the extent that the price ofthe Company’s common stock during a given measurement period (the quarter or year-to-date period) exceeds the strike price of the 2017Warrants.In March 2008, we issued $230.0 million principal amount of 2.25% unsecured Senior Convertible Notes (the "2013 Notes"). During the yearended December 31, 2011, we repurchased approximately $155.7 million in principal of its 2013 Notes in privately negotiated transactions. Theserepurchases were made using a portion of the net proceeds from the issuance of the 2017 Notes. The remaining balance of the 2013 Notesmatured on March 15, 2013, and, accordingly, during the year ended December 31, 2013, we repaid the total outstanding principal amount of $74.3million in cash. In connection with the offering of the 2013 Notes, we sold to the initial purchasers and/or their affiliates warrants to acquire upto 5.1 million shares of our common stock (the "2013 Warrants"). All 2013 Warrants expired unexercised on or before October 8, 2013.Contractual Obligations and CommitmentsContractual obligations and commitments represent future cash commitments and liabilities under agreements with third parties, including our 2017Senior Convertible Notes (the “2017 Notes”), operating leases and other contractual obligations. The following table summarizes our long-term contractualobligations and commitments as of December 31, 2014 (in thousands): Payments Due by Period Total Less Than1 Year 1 to 3 Years 4 to 5 Years After 5 Years 2017 Notes(1) $430,127 $11,069 $419,058 $— $— Operating leases 62,526 9,046 17,805 12,384 23,291 Capital leases 1,249 557 683 9 — Uncertain tax liabilities 8,647 105 530 8,012 — Total $502,549 $20,777 $438,076 $20,405 $23,291 (1)See Note 6 to the Consolidated Financial Statements included in this Annual Report for further discussion of theterms of the 2017 Notes.Total contractual obligations exclude potential contingent consideration payments pursuant to certain purchase or product developmentagreements. See Note 4 and Note 7 to the Consolidated Financial Statements included in this Annual Report for further discussion on the contingentconsideration obligations. Amounts disclosed in our Note 4 as contingent or milestone-based obligations are depend on the achievement of the milestones orthe occurrence of the contingent events and can vary significantly.The expected timing of payments of the obligations discussed above is estimated based on current information. Timing of payment and actualamounts paid may be different depending on the time of receipt of services or changes to agreed-upon amounts for some obligations.Off-Balance Sheet ArrangementsWe have not engaged in any off-balance sheet activities. 53Table of ContentsItem 7A.Quantitative and Qualitative Disclosures About Market Risk.Interest Rate Sensitivity and Risk. Our exposure to interest rate risk at December 31, 2014 is related to our investment portfolio which consists largelyof debt instruments of high quality corporate issuers and the U.S. government and its agencies. Due to the short-term nature of these investments, we haveassessed that there is no material exposure to interest rate risk arising from our investments. Fixed rate investments and borrowings may have their fair marketvalue adversely impacted from changes in interest rates. At December 31, 2014, we do not hold any material asset-backed investment securities and in 2014,we did not realize any losses related to asset-backed investment securities. Based upon our overall interest rate exposure as of December 31, 2014, a changeof 10 percent in interest rates, assuming the amount of our investment portfolio and overall economic environment remains constant, would not have amaterial effect on interest income.The primary objective of our investment activities is to preserve the principal while at the same time maximizing yields without significantlyincreasing the risk. To achieve this objective, we maintain our portfolio of cash equivalents and investments in instruments that meet high credit qualitystandards, as specified in our investment policy. None of our investments are held for trading purposes. Our policy also limits the amount of credit exposureto any one issue, issuer and type of instrument.As of December 31, 2014, the stated maturities of our available-for-sale securities are $256.0 million within one year and $101.6 million from one totwo years. These investments are recorded on the balance sheet at fair market value with unrealized gains or losses reported as a separate component ofaccumulated other comprehensive income (loss).Market Price Sensitive Instruments. In order to reduce the potential equity dilution, we entered into a convertible note hedge transaction (the “2017Hedge”) in connection with the issuance of the 2017 Notes entitling us to purchase our common stock. Upon conversion of the 2017 Notes, the 2017 Hedgeis expected to reduce the equity dilution if the daily volume-weighted average price per share of our common stock exceeds the strike price of the 2017Hedge. We also entered into warrant transactions with the counterparties of the 2017 Hedge entitling them to acquire shares of our common stock. Thewarrant transaction could have a dilutive effect on our earnings per share to the extent that the price of our common stock during a given measurement period(the quarter or year to date period) exceeds the strike price of the warrants (see Note 6 to the Consolidated Financial Statements included in this AnnualReport for further discussion).Foreign Currency Exchange Risk. A substantial portion of our operations are located in the United States, and the majority of our sales since inceptionhave been made in the United States dollars. Accordingly, we have assessed that we do not have any material exposure to foreign currency rate fluctuations.However, as our business in markets outside of the United States continues to increase, we will be exposed to foreign currency exchange risk related to ourforeign operations. Fluctuations in the rate of exchange between the United States dollar and foreign currencies, primarily the pound sterling the euro, theAustralian dollar and the yen, could adversely affect our financial results, including our revenues, revenue growth rates, gross margins, income and losses aswell as assets and liabilities. We translate the financial statements of our foreign subsidiaries with functional currencies other than the United States dollar into the United Statesdollar for consolidation using end-of-period exchange rates for assets and liabilities and average exchange rates during each reporting period for results ofoperations. Net gains or losses resulting from the translation of foreign financial statements and the effect of exchange rate changes on intercompanyreceivables and payables of a long-term investment nature are recorded as a separate component of stockholders’ equity. These adjustments will affect netincome only upon sale or liquidation of the underlying investment in foreign subsidiaries. Exchange rate fluctuations resulting from the translation of theshort-term intercompany balances between domestic entities and our foreign subsidiaries are recorded as foreign currency transaction gains or losses and areincluded in other income (expense) in the consolidated statement of operations. For those short-term intercompany balances, the Company enters into theforeign currency forward contracts to partially offset the impact from fluctuation of the foreign currency rates. The notional amount of the outstandingforeign currency forward contracts was $26.0 million as of December 31, 2014, which was settled in January 2015. During the year ended December 31, 2014,a gain of $0.7 million was recognized in other income due to the change in the fair value of the derivative instruments, and the fair value of the hedgecontracts we held was immaterial on our Consolidated Balance Sheet as of December 31, 2014. The notional principal amounts provide one measure of thetransaction volume outstanding as of period end, but do not represent the amount of our exposure to market loss. The estimates of fair value are based onapplicable and commonly used pricing models using prevailing financial market information. The amounts ultimately realized upon settlement of thesefinancial instruments, together with the gains and losses on the underlying exposures, will depend on actual market conditions during the remaining life ofthe instruments. The financial exposures by exchange rate fluctuations are monitored and managed by us as an integral part of our overall risk managementprogram, which recognizes the unpredictability of financial markets and seeks to reduce potentially adverse effects on our results. The Company expects theexposure on the foreign currency rate fluctuations to our financial results will be immaterial for the foreseeable future.Item 8.Financial Statements and Supplementary Data.The consolidated financial statements and supplementary data required by this item are set forth at the pages indicated in Item 15. 54Table of ContentsItem 9.Changes in and Disagreements with Accountants on Accounting and Financial Disclosure.None Item 9A.Controls and ProceduresDisclosure Controls and Procedures. We maintain disclosure controls and procedures that are designed to ensure that information required to bedisclosed in our reports under the Securities Exchange Act of 1934, as amended (Exchange Act) is recorded, processed, summarized and reported within thetimelines specified in the SEC’s rules and forms, and that such information is accumulated and communicated to our Management, including our ChiefExecutive Officer and Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosure. In designing and evaluating thedisclosure controls and procedures, Management recognized that any controls and procedures, no matter how well designed and operated, can only providereasonable assurance of achieving the desired control objectives, and in reaching a reasonable level of assurance, Management necessarily was required toapply its judgment in evaluating the cost-benefit relationship of possible controls and procedures.Under the supervision and with the participation of our Management, including our Chief Executive Officer and our Chief Financial Officer, wecarried out an evaluation of the effectiveness of the Company’s disclosure controls and procedures (as defined in SEC Rules 13a — 15(e) and 15d — 15(e) ofthe Exchange Act) as of December 31, 2014. Based on such evaluation, our Management has concluded as of December 31, 2014, the Company’s disclosurecontrols and procedures are effective.Management’s Report on Internal Control over Financial Reporting. Our Management is responsible for establishing and maintaining adequateinternal control over financial reporting as defined in Rule 13a-15(f) under the Exchange Act. Internal control over financial reporting refers to the processdesigned by, or under the supervision of, our Chief Executive Officer and Chief Financial Officer, and effected by our board of directors, Management andother personnel, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for externalpurposes in accordance with U.S. generally accepted accounting principles.Management has used the framework set forth in the report entitled Internal Control — Integrated Framework published by the Committee ofSponsoring Organizations of the Treadway Commission (2013 framework) to evaluate the effectiveness of the Company’s internal control over financialreporting. On May 14, 2013, the Committee of Sponsoring Organizations of the Treadway Commission published a 2013 framework and related illustrativedocuments. We adopted the new framework during 2014. Management has concluded that the Company’s internal control over financial reporting waseffective as of December 31, 2014, based on those criteria. Ernst & Young LLP, the Company’s independent registered public accounting firm, has issued anattestation report on the Company’s internal control over financial reporting which is included herein.Changes in Internal Control over Financial Reporting. We are involved in ongoing evaluations of internal controls. In anticipation of the filing ofthis Form 10-K, our Chief Executive Officer and Chief Financial Officer, with the assistance of other members of our Management, performed an evaluation ofany change in internal control over financial reporting that occurred during our last fiscal quarter that has materially affected, or is likely to materially affect,our internal controls over financial reporting. There has been no change to our internal control over financial reporting during our most recent fiscal quarterthat has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting. 55Table of ContentsREPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRMThe Board of Directors and Stockholders ofNuVasive, Inc.We have audited NuVasive, Inc.’s internal control over financial reporting as of December 31, 2014, based on criteria established in Internal Control— Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission (2013 framework) (the COSO criteria).NuVasive, Inc.’s Management is responsible for maintaining effective internal control over financial reporting, and for its assessment of the effectiveness ofinternal control over financial reporting included in the accompanying Management’s Report on Internal Control Over Financial Reporting. Ourresponsibility is to express an opinion on the Company’s internal control over financial reporting based on our audit.We conducted our audit in accordance with the standards of the Public Company Accounting Oversight Board (United States). Those standardsrequire that we plan and perform the audit to obtain reasonable assurance about whether effective internal control over financial reporting was maintained inall material respects. Our audit included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weaknessexists, testing and evaluating the design and operating effectiveness of internal control based on the assessed risk, and performing such other procedures aswe considered necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion.A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financialreporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company’sinternal control over financial reporting includes those policies and procedures that (1) pertain to the maintenance of records that, in reasonable detail,accurately and fairly reflect the transactions and dispositions of the assets of the company; (2) provide reasonable assurance that transactions are recorded asnecessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of thecompany are being made only in accordance with authorizations of Management and directors of the company; and (3) provide reasonable assuranceregarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on thefinancial statements.Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of anyevaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degreeof compliance with the policies or procedures may deteriorate.In our opinion, NuVasive, Inc. maintained, in all material respects, effective internal control over financial reporting as of December 31, 2014, basedon the COSO criteria.We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), the consolidated balancesheets of NuVasive, Inc. as of December 31, 2014 and 2013, and the related consolidated statements of operations, comprehensive income (loss), equity, andcash flows for each of the three years in the period ended December 31, 2014 of NuVasive, Inc. and our report dated February 24, 2015 expressed anunqualified opinion thereon./s/ Ernst & Young LLPSan Diego, CaliforniaFebruary 24, 2015 56Table of ContentsItem 9B.Other InformationNone.PART IIICertain information required by Part III is omitted from this report because the Company will file a definitive proxy statement within 120 days afterthe end of its fiscal year pursuant to Regulation 14A (the Proxy Statement) for its annual meeting of stockholders to be held on May 22, 2015, and certaininformation included in the Proxy Statement is incorporated herein by reference. Item 10.Directors, Executive Officers and Corporate Governance.We have adopted a Code of Ethical Business Conduct for all officers, directors and shareowners. The Code of Ethical Business Conduct is availableon our website, www.nuvasive.com, and in our filings with the Securities and Exchange Commission. We intend to disclose future amendments to, or waiversfrom, provisions of our Code of Ethical Business Conduct that apply to our Principal Executive Officer, Principal Financial Officer, Principal AccountingOfficer, or Controller, or persons performing similar functions, within four business days of such amendment or waiver.The other information required by this Item 10 will be set forth in the Proxy Statement and is incorporated in this report by reference. Item 11.Executive Compensation.The information required by this item will be set forth in the Proxy Statement and is incorporated in this report by reference. Item 12.Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters.The information required by this item will be set forth in the Proxy Statement and is incorporated in this report by reference. Item 13.Certain Relationships and Related Transactions, and Director Independence.The information required by this item will be set forth in the Proxy Statement and is incorporated in this report by reference. Item 14.Principal Accountant Fees and Services.The information required by this item will be set forth in the Proxy Statement and is incorporated in this report by reference.PART IV Item 15.Exhibits, Financial Statement Schedules(a)The following documents are filed as a part of this report:(1)Report of Independent Registered Public Accounting FirmConsolidated Balance Sheets as of December 31, 2014 and 2013Consolidated Statements of Operations for the years ended December 31, 2014, 2013 and 2012Consolidated Statements of Comprehensive Income (Loss) for the years ended December 31, 2014, 2013 and 2012Consolidated Statements of Stockholders’ Equity for the years ended December 31, 2014, 2013 and 2012Consolidated Statements of Cash Flows for the years ended December 31, 2014, 2013 and 2012Notes to Consolidated Financial Statements(2)Financial Statement Schedules: Schedule II — Valuation AccountsAll other financial statement schedules have been omitted because they are not applicable, not required or the information required isshown in the financial statements or the notes thereto. 57Table of Contents(3)Exhibits. See subsection (b) below.(b) Exhibits. The following exhibits are filed as part of this report: ExhibitNumber Description 3.1 Restated Certificate of Incorporation (incorporated by reference to our Quarterly Report on Form 10-Q filed with the Commission onAugust 13, 2004) 3.2 Certificate of Amendment to the Restated Certificate of Incorporation (incorporated by reference to our Current Report on Form 8-K filedwith the Commission on September 28, 2011) 3.3 Restated Bylaws (incorporated by reference to our Current Report on Form 8-K filed with the Commission on January 6, 2012) 3.4 Amendment No. 1 to the Restated Bylaws (incorporated by reference to our Current Report on Form 8-K filed with the Commission on May19, 2014) 4.1 Specimen Common Stock Certificate (incorporated by reference to our Annual Report on Form 10-K filed with the Commission onMarch 16, 2006) 4.2 Certificate of Designations of Series A Participating Preferred Stock filed with the Delaware Secretary of State on June 28, 2011(incorporated by reference to our Current Report on Form 8-K filed with the Commission on June 29, 2011) 4.3 Indenture dated June 28, 2011 between the Company and the Trustee (incorporated by reference to our Current Report on Form 8-K filedwith the Commission on June 29, 2011) 4.4 Form of 2.75% Convertible Senior Note due 2017 (incorporated by reference to our Current Report on Form 8-K filed with the Commissionon June 29, 2011) 10.1# 2004 Amended and Restated Equity Incentive Plan (incorporated by reference to our Quarterly Report on Form 10-Q filed with theCommission on July 26, 2012) 10.2# Amendment No. 1 to the 2004 Amended and Restated Equity Incentive Plan (incorporated by reference to our Annual Report on Form 10-Kfiled with the Commission on March 3, 2014) 10.3# Form of Stock Option Award Notice under the 2004 Equity Incentive Plan (incorporated by reference to Amendment No. 1 to ourRegistration Statement on Form S-1 filed with the Commission on April 8, 2004) 10.4# Form of Option Exercise and Stock Purchase Agreement under the 2004 Equity Incentive Plan (incorporated by reference to AmendmentNo. 1 to our Registration Statement on Form S-1 filed with the Commission on April 8, 2004) 10.5# Form of Restricted Stock Unit Award Agreement under the 2004 Equity Incentive Plan (incorporated by reference to our Annual Report onForm 10-K filed with the Commission on February 26, 2010) 10.6# Form of Restricted Stock Grant Notice and Restricted Stock Agreement under the 2004 Amended and Restated Equity Incentive Plan(incorporated by reference to Amendment No.1 to our Registration Statement on Form S-1 filed with the Commission on April 8, 2004) 10.7# NuVasive, Inc. 2004 Amended and Restated Employee Stock Purchase Plan (incorporated by reference to our Quarterly Report on Form 10-Qfiled with the Commission on October 30, 2014) 10.8# 2014 Equity Incentive Plan (incorporated by reference to Exhibit A to our Definitive Proxy Statement filed with the Commission on March27, 2014) 10.9# NuVasive, Inc. 2014 Executive Incentive Compensation Plan (incorporated by reference to Exhibit B to our Definitive Proxy Statement filedwith the Commission on March 27, 2014) 10.10# Form of Indemnification Agreement between the Company and its directors and certain executives thereof (incorporated by reference to ourCurrent Report on Form 8-K filed with the Commission on May 19, 2014) 10.11# NuVasive, Inc. Executive Severance Plan (incorporated by reference to our Current Report on Form 8-K filed with the Commission on May19, 2014) 58Table of ContentsExhibitNumber Description 10.12# Form of Change in Control Agreement between the Company and certain executives thereof (incorporated by reference to our CurrentReport on Form 8-K filed with the Commission on May 19, 2014) 10.13# Form of Compensation Letter Agreement dated March 4, 2011 between the Company and Keith C. Valentine (incorporated by reference toour Quarterly Report on Form 10-Q filed with the Commission on May 6, 2011) 10.14# Separation Letter Agreement dated December 13, 2013 between the Company and Craig Hunsaker (incorporated by reference to our AnnualReport on Form 10-K filed with the Commission on March 3, 2014) 10.15# Transition Services Agreement dated April 29, 2014 between the Company and Michael J. Lambert (incorporated by reference to our CurrentReport on Form 8-K filed with the Commission on April 29, 2014) 10.16# Non-Employee Director Cash Compensation Plan (incorporated by reference to our Annual Report on Form 10-K filed with the Commissionon March 3, 2014) 10.17 Lease Agreement for Sorrento Summit entered into November 6, 2007 between the Company and HCPI/Sorrento, LLC. (incorporated byreference to our Quarterly Report on Form 10-Q filed with the Commission on November 8, 2007) 10.18 Confirmation for base call option transaction dated June 22, 2011, between the Company and Bank of America, N.A. (incorporated byreference to our Current Report on Form 8-K filed with the Commission on June 29, 2011) 10.19 Confirmation for additional call option transaction dated June 24, 2011, between the Company and Bank of America, N.A. (incorporated byreference to our Current Report on Form 8-K filed with the Commission on June 29, 2011) 10.20 Confirmation for base call option transaction dated June 22, 2011, between the Company and Goldman, Sachs & Co. (incorporated byreference to our Current Report on Form 8-K filed with the Commission on June 29, 2011) 10.21 Confirmation for additional call option transaction, dated June 24, 2011, between the Company and Goldman, Sachs & Co. (incorporated byreference to our Current Report on Form 8-K filed with the Commission on June 29, 2011) 10.22 Confirmation for base warrant transaction, dated June 22, 2011, between the Company and Bank of America, N.A. (incorporated by referenceto our Current Report on Form 8-K filed with the Commission on June 29, 2011) 10.23 Confirmation for additional warrant transaction, dated June 24, 2011, between the Company and Bank of America, N.A. (incorporated byreference to our Current Report on Form 8-K filed with the Commission on June 29, 2011) 10.24 Confirmation for base warrant transaction, dated June 22, 2011, between the Company and Goldman, Sachs & Co. (incorporated by referenceto our Current Report on Form 8-K filed with the Commission on June 29, 2011) 10.25 Confirmation for additional warrant transaction, dated June 24, 2011, between the Company and Goldman, Sachs & Co. (incorporated byreference to our Current Report on Form 8-K filed with the Commission on June 29, 2011) 10.26 Preferred Stock Purchase Agreement, dated January 13, 2009, among the Company, Progentix Orthobiology, B.V. and the sellers listed onSchedule A thereto (incorporated by reference to our Annual Report on Form 10-K filed with the Commission on February 26, 2010) 10.27† Option Purchase Agreement, dated January 13, 2009, among the Company, Progentix Orthobiology, B.V. and the sellers listed onSchedule A thereto (incorporated by reference to our Annual Report on Form 10-K filed with the Commission on February 26, 2010) 10.28† Exclusive Distribution Agreement, dated January 13, 2009, between the Company and Progentix Orthobiology, B.V. (incorporated byreference to our Quarterly Report on Form 10-Q filed with the Commission on May 8, 2009) 10.29† Settlement and License Agreement, dated April 25, 2013, among the Company, Medtronic Sofamor Danek USA, Inc., Warsaw Orthopedic,Inc., Medtronic Puerto Rico Operations Co. and Medtronic Sofamor Danek Deggendorf, GmbH (incorporated by reference to our QuarterlyReport on Form 10-Q filed with the Commission on July 30, 2013) 21.1 List of subsidiaries of the Company 23.1 Consent of Independent Registered Public Accounting Firm 31.1 Certification of Chief Executive Officer pursuant to Rule 13a-14(a) and 15d-14(a) of the Securities Exchange Act of 1934, as amended 59Table of ContentsExhibitNumber Description 31.2 Certification of Chief Financial Officer pursuant to Rule 13a-14(a) and 15d-14(a) of the Securities Exchange Act of 1934, as amended 32.1* Certifications of the Chief Executive Officer and Chief Financial Officer pursuant to Rule 13a-14(b) of the Securities Exchange Act of 1934,as amended, and 18 U.S.C. section 1350 101 XBRL Instance Document 101 XBRL Taxonomy Extension Schema Document 101 XBRL Taxonomy Calculation Linkbase Document 101 XBRL Taxonomy Label Linkbase Document 101 XBRL Taxonomy Presentation Linkbase Document 101 XBRL Taxonomy Definition Linkbase Document†Certain confidential information contained in this exhibit was omitted by means of redacting a portion of the text and replacing it with an asterisk. Wehave filed separately with the Commission an unredacted copy of the exhibit.#Indicates management contract or compensatory plan.*These certifications are being furnished solely to accompany this annual report pursuant to 18 U.S.C. Section 1350, and are not being filed forpurposes of Section 18 of the Securities Exchange Act of 1934 and are not to be incorporated by reference into any filing of NuVasive, Inc., whethermade before or after the date hereof, regardless of any general incorporation language in such filing. 60Table of ContentsSUPPLEMENTAL INFORMATIONCopies of the Registrant’s Proxy Statement for the Annual Meeting of Stockholders to be held on May 22, 2015, and copies of the form of proxy to beused for such Annual Meeting, will be furnished to the SEC prior to the time they are distributed to the Registrant’s Stockholders. 61Table of ContentsSIGNATURESPursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed onits behalf by the undersigned, thereunto duly authorized. NUVASIVE, INC.Date: February 24, 2015 By: /s/ Alexis V. Lukianov Alexis V. LukianovChairman and Chief Executive Officer(Principal Executive Officer)Date: February 24, 2015 By: /s/ Quentin S. Blackford Quentin S. BlackfordExecutive Vice President andChief Financial Officer(Principal Financial Officer) 62Table of ContentsPOWER OF ATTORNEYKNOW ALL PERSONS BY THESE PRESENTS, that each person whose signature appears below constitutes and appoints Alexis V. Lukianov andQuentin S. Blackford, jointly and severally, his or her attorneys-in-fact, each with the power of substitution, for him or her in any and all capacities, to signany amendments to this Report on Form 10-K, and to file the same, with exhibits thereto and other documents in connection therewith with the Securities andExchange Commission, hereby ratifying and confirming all that each of said attorneys-in-fact, or his or her substitute or substitutes may do or cause to bedone by virtue hereof.Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the following persons on behalf of theregistrant and in the capacities and on the dates indicated. Signature Title Date /s/ Alexis V. Lukianov Chairman and Chief Executive Officer(Principal Executive Officer) February 24, 2015Alexis V. Lukianov /s/ Quentin S. Blackford Executive Vice President and ChiefFinancial Officer (Principal Financial andAccounting Officer) February 24, 2015Quentin S. Blackford /s/ Jack R. Blair Director February 24, 2015Jack R. Blair /s/ Peter C. Farrell, Ph.D, AM Director February 24, 2015Peter C. Farrell, Ph.D, AM /s/ Lesley H. Howe Director February, 24, 2015Lesley H. Howe /s/ Leslie V. Norwalk, Esq. Director February 24, 2015Leslie V. Norwalk, Esq. /s/ Eileen M. More Director February 24, 2015Eileen M. More /s/ Peter M. Leddy, Ph.D. Director February 24, 2015Peter M. Leddy, Ph.D. /s/ Gregory T. Lucier Director February 24, 2015Gregory T. Lucier 63Table of ContentsNUVASIVE, INC.INDEX TO CONSOLIDATED FINANCIAL STATEMENTS Report of Independent Registered Public Accounting Firm 65Consolidated Balance Sheets as of December 31, 2014 and 2013 66Consolidated Statements of Operations for the years ended December 31, 2014, 2013 and 2012 67Consolidated Statements of Comprehensive Income (Loss) for the years ended December 31, 2014, 2013 and 2012 68Consolidated Statements of Equity for the years ended December 31, 2014, 2013 and 2012 69Consolidated Statements of Cash Flows for the years ended December 31, 2014, 2013 and 2012 70Notes to Consolidated Financial Statements 71 64Table of ContentsREPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRMThe Board of Directors and Stockholders ofNuVasive, Inc.We have audited the accompanying consolidated balance sheets of NuVasive, Inc. as of December 31, 2014 and 2013, and the related consolidatedstatements of operations, comprehensive income (loss), equity, and cash flows for each of the three years in the period ended December 31, 2014. Our auditsalso included the financial statement schedule listed in the Index at Item 15(a). These financial statements and schedule are the responsibility of theCompany’s management. Our responsibility is to express an opinion on these financial statements and schedule based on our audits.We conducted our audits in accordance with the standards of the Public Company Accounting Oversight Board (United States). Those standardsrequire that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An auditincludes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing theaccounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe thatour audits provide a reasonable basis for our opinion.In our opinion, the financial statements referred to above present fairly, in all material respects, the consolidated financial position of NuVasive, Inc. atDecember 31, 2014 and 2013, and the consolidated results of its operations and its cash flows for each of the three years in the period ended December 31,2014, in conformity with U.S. generally accepted accounting principles. Also, in our opinion, the related financial statement schedule, when considered inrelation to the basic financial statements taken as a whole, presents fairly in all material respects the information set forth therein.We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), NuVasive, Inc.’s internalcontrol over financial reporting as of December 31, 2014, based on criteria established in Internal Control — Integrated Framework issued by the Committeeof Sponsoring Organizations of the Treadway Commission (2013 framework) and our report dated February 24, 2015 expressed an unqualified opinionthereon./s/ Ernst & Young LLPSan Diego, CaliforniaFebruary 24, 2015 65Table of ContentsNUVASIVE, INC.CONSOLIDATED BALANCE SHEETS(In thousands, except par value and shares) December 31, 2014 2013 ASSETS Current assets: Cash and cash equivalents $142,387 $102,825 Short-term marketable securities 220,329 143,449 Accounts receivable, net of allowances of $5,844 and $3,481, respectively 118,959 104,774 Inventory, net 154,638 136,937 Deferred tax assets 47,912 37,076 Prepaid expenses and other current assets 21,646 10,947 Total current assets 705,871 536,008 Property and equipment, net 128,565 128,064 Long-term marketable securities 43,042 79,829 Intangible assets, net 96,555 93,986 Goodwill 154,443 154,944 Deferred tax assets, non-current 65,330 42,863 Restricted cash and investments 123,233 119,195 Other assets 26,420 24,679 Total assets $1,343,459 $1,179,568 LIABILITIES AND EQUITY Current liabilities: Accounts payable and accrued liabilities $146,867 $86,057 Accrued payroll and related expenses 38,032 31,095 Litigation liability 30,000 — Total current liabilities 214,899 117,152 Senior Convertible Notes 360,746 346,060 Deferred tax liabilities 3,879 2,934 Non-current litigation liability 93,700 93,700 Other long-term liabilities 21,877 14,844 Commitments and contingencies Stockholders’ equity: Preferred stock, $0.001 par value; 5,000,000 shares authorized, none outstanding — — Common stock, $0.001 par value; 120,000,000 shares authorized at December 31, 2014 and 2013,respectively, 47,691,744 and 44,943,422 issued and outstanding at December 31, 2014 and 2013, respectively 48 45 Additional paid-in capital 847,145 769,203 Accumulated other comprehensive loss (9,670) (3,238)Accumulated deficit (186,938) (170,218)Treasury stock at cost; 233,369 shares and no shares at December 31, 2014 and 2013, respectively (10,537) — Total NuVasive, Inc. stockholders’ equity 640,048 595,792 Non-controlling interests $8,310 $9,086 Total equity $648,358 $604,878 Total liabilities and equity $1,343,459 $1,179,568 See accompanying notes to Consolidated Financial Statements. 66Table of ContentsNUVASIVE, INC.CONSOLIDATED STATEMENTS OF OPERATIONS(In thousands, except per share amounts) Year Ended December 31, 2014 2013 2012 Revenue $762,415 $685,173 $620,255 Cost of goods sold (excluding amortization of purchased technology) 182,358 180,484 153,409 Gross profit 580,057 504,689 466,846 Operating expenses: Sales, marketing and administrative 469,648 420,064 372,416 Research and development 37,986 32,209 35,296 Amortization of intangible assets 13,571 19,326 12,430 Impairment of goodwill and intangible assets 10,708 — 9,700 Litigation liability 30,000 — — Total operating expenses 561,913 471,599 429,842 Interest and other expense, net: Interest income 968 755 915 Interest expense (27,911) (27,178) (27,710) Other income (expense), net (2,411) 3,101 1,047 Total interest and other expense, net (29,354) (23,322) (25,748)(Loss) income before income taxes (11,210) 9,768 11,256 Income tax expense (6,286) (2,783) (8,814)Consolidated net (loss) income $(17,496) $6,985 $2,442 Add back net loss attributable to non-controlling interests $(776) $(917) $(702)Net (loss) income attributable to NuVasive, Inc. $(16,720) $7,902 $3,144 Net (loss) income per share attributable to NuVasive, Inc.: Basic $(0.36) $0.18 $0.07 Diluted $(0.36) $0.17 $0.07 Weighted average shares outstanding: Basic 46,715 44,461 43,328 Diluted 46,715 46,786 44,272 See accompanying notes to Consolidated Financial Statements. 67Table of ContentsNUVASIVE, INC.CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS)(In thousands) Year Ended December 31, 2014 2013 2012 Consolidated net (loss) income $(17,496) $6,985 $2,442 Other comprehensive (loss) income: Unrealized (loss) gain on marketable securities, net of tax (161) (27) 4 Translation adjustments, net of tax (6,271) (3,997) 305 Other comprehensive (loss) income: (6,432) (4,024) 309 Total consolidated comprehensive (loss) income (23,928) 2,961 2,751 Net loss attributable to non-controlling interests 776 917 702 Comprehensive (loss) income attributable to NuVasive, Inc. $(23,152) $3,878 $3,453 See accompanying notes to Consolidated Financial Statements. 68Table of ContentsNUVASIVE, INC.CONSOLIDATED STATEMENTS OF EQUITY(In thousands) Accumulated Total Additional Other NuVasive,Inc. Non- Common Stock Paid-in Comprehensive Accumulated Treasury Stock Stockholders' controlling Total Shares Amount Capital Income (Loss) Deficit Shares Amount Equity Interest Equity Balance at December 31, 2011 42,455 $42 $674,790 $477 $(181,264) — $— $494,045 $— $494,045 Issuance of common stock under employeeand director stock option and purchase plans 756 1 4,883 — — — — 4,884 — 4,884 Issuance of common stock in connectionwith asset acquisitions 475 1 7,559 — — — — 7,560 — 7,560 Stock-based compensation expense — — 26,312 — — — — 26,312 — 26,312 Tax benefits related to stock-basedcompensation awards — — 1,321 — — — — 1,321 — 1,321 Net income attributable to NuVasive, Inc. — — — — 3,144 — — 3,144 — 3,144 Other comprehensive income — — — 309 — — — 309 — 309 Balance at December 31, 2012 43,686 $44 $714,865 $786 $(178,120) — $— $537,575 $— $537,575 Issuance of common stock under employeeand director stock option and purchase plans 1,257 1 8,421 — — — — 8,422 — 8,422 Stock-based compensation expense — — 33,240 — — — — 33,240 — 33,240 Tax benefits related to stock-basedcompensation awards — — 12,677 — — — — 12,677 — 12,677 Reclassification of non-controlling interestfrom mezzanine to equity — — — — — — — — 9,489 9,489 Net income attributable to NuVasive, Inc. — — — — 7,902 — — 7,902 — 7,902 Net loss attributable to non-controllinginterests — — — — — — — — (403) (403)Other comprehensive loss — — — (4,024) — — — (4,024) — (4,024)Balance at December 31, 2013 44,943 $45 $769,203 $(3,238) $(170,218) — $— $595,792 $9,086 $604,878 Issuance of common stock under employeeand director stock option and purchase plans 2,660 3 30,106 — — (233) (10,537) 19,572 — 19,572 Stock-based compensation expense — — 33,687 — — — — 33,687 — 33,687 Tax benefits related to stock-basedcompensation awards — — 10,988 — — — — 10,988 — 10,988 Issuance of common stock in connectionwith contingent consideration 88 — 3,161 — — — — 3,161 — 3,161 Net loss attributable to NuVasive, Inc. — — — — (16,720) — — (16,720) — (16,720)Net loss attributable to non-controllinginterests — — — — — — — — (776) (776)Other comprehensive loss — — — (6,432) — — — (6,432) — (6,432)Balance at December 31, 2014 47,691 $48 $847,145 $(9,670) $(186,938) (233) $(10,537) $640,048 $8,310 $648,358 See accompanying notes to Consolidated Financial Statements. 69Table of ContentsNUVASIVE, INC.CONSOLIDATED STATEMENTS OF CASH FLOWS(In thousands) Year Ended December 31, 2014 2013 2012 Operating activities: Consolidated net (loss) income $(17,496) $6,985 $2,442 Adjustments to reconcile net (loss) income to net cash provided by operating activities: Depreciation and amortization 65,837 63,106 51,909 Deferred income tax (benefit) expense (23,231) (11,341) 4,525 Amortization of non-cash interest 16,490 15,336 14,569 Stock-based compensation 33,687 33,240 26,312 Impairment of intangible assets and goodwill 10,708 - 9,700 Reserves on current assets 1,856 7,468 5,578 Other non-cash adjustments 13,191 7,116 7,283 Changes in operating assets and liabilities, net of effects from acquisitions: Accounts receivable (18,465) (17,384) (2,005)Inventory (21,343) (21,002) (11,022)Prepaid expenses and other current assets (5,183) (3,608) 12,725 Accounts payable and accrued liabilities 22,318 21,803 2,938 Litigation liability 30,000 (7,500) - Accrued payroll and related expenses 7,179 3,220 5,128 Net cash provided by operating activities 115,548 97,439 130,082 Investing activities: Cash paid for acquisitions and investments (500) (14,818) (11,088)Proceeds from disposal of assets 241 - - Purchases of property and equipment (58,424) (47,597) (41,189)Purchases of marketable securities (217,158) (218,454) (235,919)Sales of marketable securities 174,816 216,299 246,504 Purchases of restricted investments (3,800) - (113,281)Sales of restricted investments - - 7,079 Net cash used in investing activities (104,825) (64,570) (147,894)Financing activities: Principal payment of 2013 Senior Convertible Notes - (74,311) - Incremental tax benefits related to stock-based compensation awards 11,896 13,569 3,003 Proceeds from the issuance of common stock 23,354 8,422 4,884 Payment of contingent consideration (498) - (29,722)Purchase of treasury stock (3,782) Other assets (693) (162) (721)Net cash provided by (used in) financing activities 30,277 (52,482) (22,556)Effect of exchange rate changes on cash (1,438) (861) 175 Increase (decrease) in cash and cash equivalents 39,562 (20,474) (40,193)Cash and cash equivalents at beginning of year 102,825 123,299 163,492 Cash and cash equivalents at end of year $142,387 $102,825 $123,299 Supplemental disclosure of non-cash transactions: Intangible asset purchase $27,389 $- $- Issuance of common stock for contingent consideration and asset acquisitions $3,161 $- $7,560 Supplemental cash flow information: Interest paid $11,069 $12,035 $12,741 Income taxes paid $13,640 $3,196 $2,934 See accompanying notes to Consolidated Financial Statements. 70Table of ContentsNUVASIVE, INC.NOTES TO CONSOLIDATED FINANCIAL STATEMENTS1. Organization and Significant Accounting PoliciesDescription of Business. NuVasive, Inc. (the “Company” or “NuVasive”) was incorporated in Delaware on July 21, 1997, and began commercializingits products in 2001. The Company is focused on developing minimally disruptive surgical products and procedurally integrated solutions for the spine.NuVasive’s principal product offering includes a minimally disruptive surgical platform called Maximum Access Surgery, or MAS, as well as an offering ofbiologics, and cervical products. The MAS platform combines three categories of solutions that collectively minimize soft tissue disruption during spinefusion surgery, provide maximum visualization and are designed to enable reproducible outcomes for the surgeon and the patient. The platform includes aproprietary software-driven nerve detection and avoidance systems, NVM5 and NVJJB, and Intra-Operative Monitoring (IOM) support; MaXcess®, anintegrated split-blade retractor system; and a wide variety of specialized implants. The individual components of NuVasive’s MAS platform, and many of theCompany’s products, can also be used in open or traditional spine surgery. The Company continues to focus significant research and development efforts toexpand its MAS product platform and advance the applications of its unique technology into procedurally integrated surgical solutions. The Companydedicates significant resources toward training spine surgeons on its unique technology and products.The Company’s primary business model is to loan its MAS systems to surgeons and hospitals who purchase implants, biologics and disposables foruse in individual procedures. In addition, for larger customers, the Company’s proprietary nerve monitoring systems, MaXcess and surgical instrument setsare placed with hospitals for an extended period at no up-front cost to them. The Company also offers a range of bone allograft in patented saline packaging,disposables and spine implants, which include its branded CoRoent® products and fixation devices such as rods, plates and screws. The Company sells MASinstrument sets, MaXcess and nerve monitoring systems to hospitals however such sales are immaterial to the Company’s results of operations.Basis of Presentation and Principles of Consolidation. The accompanying consolidated financial statements include the accounts of the Companyand its majority-owned or controlled subsidiaries, collectively referred to as either NuVasive or the Company. The Company translates the financialstatements of its foreign subsidiaries using end-of-period exchange rates for assets and liabilities and average exchange rates during each reporting period forresults of operations. When there is a portion of equity in an acquired subsidiary not attributable, directly or indirectly, to the respective parent entity, theCompany records the fair value of the non-controlling interests at the acquisition date and classifies the amounts attributable to non-controlling interestsseparately in equity in the Company's Consolidated Financial Statements. Any subsequent changes in a parent's ownership interest while the parent retains itscontrolling financial interest in its subsidiary are accounted for as equity transactions. All significant intercompany balances and transactions have beeneliminated in consolidation. Use of Estimates. To prepare financial statements in conformity with generally accepted accounting principles (“GAAP”) accepted in the UnitedStates, management must make estimates and assumptions that affect the amounts reported in the financial statements and accompanying notes. Actualresults could differ from those estimates.Change in Accounting Estimate. Based on historical useful life information, as well as forecasted product life cycles and demand expectations, theuseful life of certain surgical instrument sets held in the international business was extended from three to four years. In accordance with ASC Topic 250Accounting Changes and Error Corrections, this was accounted for as a change in accounting estimate and was made on a prospective basis effectiveJanuary 1, 2014 for these international surgical instruments. The net effect of the change in useful life estimate for the international instruments on the yearended December 31, 2014 depreciation expense, net income, basic and diluted earnings per share, is each considered immaterial.During the year ended December 31, 2014, the Company committed to a plan to consolidate its offices located in San Diego, California into onecorporate headquarters for efficiency purposes. This project commenced during the year ended December 31, 2014 and is expected to be completed byMarch 31, 2015. As a result, certain long-lived assets, primarily leasehold improvements, will be abandoned and replaced during the respective constructionperiod. In accordance with the authoritative guidance, the Company has shortened the depreciable lives of impacted assets, which resulted in approximately$4.2 million of accelerated depreciation, which is included in sales, marketing and administrative expenses, during the year ended December 31, 2014 thatwould have otherwise been recorded in future periods. There is no impact to the Company’s Consolidated Statement of Operations over the life of therespective assets. The net effect of this change in estimate on net income and earnings per share for the year ended December 31, 2014 is $1.8 million and$0.04, respectively. 71Table of ContentsCertain prior period amounts in Note 9 to the Consolidated Financial Statements included in this Annual Report have been reclassified to conform tothe current period presentation. Any reclassification of prior period amounts does not affect any content or total of prior period financial statements.Recently Adopted Accounting Standards. In May 2014, the Financial Accounting Standards Board (“FASB”) issued Accounting Standard UpdateNo. 2014-09, Revenue from Contracts with Customers, (“ASU 2014-09”) an updated standard on revenue recognition. ASU 2014-09 provides enhancementsto the quality and consistency of how revenue is reported by companies while also improving comparability in the financial statements of companiesreporting using International Financial Reporting Standards or GAAP. The main purpose of the new standard is for companies to recognize revenue to depictthe transfer of goods or services to customers in amounts that reflect the consideration to which a company expects to be entitled in exchange for those goodsor services. The new standard also will result in enhanced disclosures about revenue, provide guidance for transactions that were not previously addressedcomprehensively and improve guidance for multiple-element arrangements. ASU 2014-09 will be effective for the Company in the first quarter of fiscal year2017 and may be applied on a full retrospective or modified retrospective approach. The Company is evaluating the impact of implementation and transitionapproach of this standard on its financial statements.Revenue Recognition. In accordance with the Securities and Exchange Commission’s guidance, the Company recognizes revenue when all four of thefollowing criteria are met: (i) persuasive evidence that an arrangement exists; (ii) delivery of the products and/or services has occurred; (iii) the selling price isfixed or determinable; and (iv) collectability is reasonably assured. Specifically, revenue from the sale of implants, biologics and disposables is generallyrecognized upon acknowledgment of a purchase order from the hospital indicating product use or implantation or upon shipment to third-party customerswho immediately accept title. Revenue from the sale of instrument sets is recognized upon receipt of a purchase order and the subsequent shipment tocustomers who immediately accept title.Monitoring service revenue consists of hospital based revenues and net patient service revenues and is recorded in the period the service is provided.Hospital based revenues are recorded based upon contracted billing rates. Net patient services are billed to various payers, including Medicare, commercialinsurance companies, other directly billed managed healthcare plans, employers, and individuals. The Company reports revenues from contracted payers,including Medicare, certain insurance companies and certain managed healthcare plans, based on the contractual rate, or in the case of Medicare, thepublished fee schedules. The Company reports revenues from non-contracted payers, including certain insurance companies and individuals, based on theamount expected to be collected. The difference between the amount billed and the amount expected to be collected from non-contracted payers is recordedas a contractual allowance to arrive at net revenues. The expected revenues from non-contracted payers are based on the historical collection experience ofeach payer or payer group, as appropriate. In each reporting period, the Company reviews the historical collection experience for non-contracted payers andadjusts the expected revenues for current and subsequent periods accordingly.Accounts Receivable and Related Valuation Accounts. Accounts receivable in the accompanying consolidated balance sheets are presented net ofallowances for doubtful accounts.The Company performs credit evaluations of its customers’ financial condition and, generally, requires no collateral from its customers. The Companymakes judgments as to its ability to collect outstanding receivables and provides an allowance for specific receivables if and when collection becomesdoubtful. Provisions are made based upon a specific review of all significant outstanding invoices as well as a review of the overall quality and age of thoseinvoices not specifically reviewed. In determining the provision for invoices not specifically reviewed, the Company analyzes historical collectionexperience and current economic trends.In addition, the Company establishes a reserve for estimated sales returns that is recorded as a reduction to revenue. This reserve is maintained toaccount for the future return of products sold in the current period. Product returns were not material for the years presented.Concentration of Credit Risk and Significant Customers. Financial instruments, which potentially subject the Company to concentrations of creditrisk, consist primarily of cash and cash equivalents, short-term and long-term marketable securities and accounts receivable. The Company limits its exposureto credit loss by placing its cash and investments with high credit quality financial institutions. Additionally, the Company has established guidelinesregarding diversification of its investments and their maturities, which are designed to maintain principal and maximize liquidity. No single customerrepresented greater than ten percent of sales or accounts receivable for any of the periods presented.Fair Value of Financial Instruments. The Company’s financial instruments consist principally of cash and cash equivalents, short-term and long-termmarketable securities, accounts receivable, accounts payable, accrued expenses, and Senior Convertible Notes. 72Table of ContentsThe carrying amounts of financial instruments such as cash equivalents, accounts receivable, accounts payable and accrued expenses approximate therelated fair values due to the short-term maturities of these instruments. Marketable securities consist of available-for-sale securities that are reported at fairvalue with the related unrealized gains and losses included in accumulated other comprehensive income (loss), a component of stockholders’ equity.See Note 6 to the Consolidated Financial Statements included in this Annual Report for further discussion on the Company’s Senior ConvertibleNotes’ carrying value.Cash and Cash Equivalents. The Company considers all highly liquid investments that are readily convertible into cash and have an original maturityof three months or less at the time of purchase to be cash equivalents.Marketable Securities. The Company defines marketable securities as income yielding securities that can be readily converted into cash. Marketablesecurities consist of certificates of deposit, corporate notes, commercial paper, U.S. government treasury securities, and securities of government-sponsoredentities.Derivatives. To manage foreign currency exposure risks, the Company uses derivatives for activities in entities that have short term intercompanyreceivables and payables denominated in a currency other than the entity’s functional currency. Realized and unrealized gains or losses on the value offinancial contracts entered into to hedge the exchange rate exposure of these receivables and payables are included in the determination of net income asthey have not been designated for hedge accounting under ASC Topic 815, Derivatives and Hedging. These contracts, which settle monthly, effectively fixthe exchange rate at which these specific receivables and payables will be settled in, so that gains or losses on the forward contracts offset the gains or lossesfrom changes in the value of the underlying receivables and payables. At December 31, 2014, the Company had a notional principal amount of $26.0 millionin foreign currency forward contracts outstanding to hedge currency risk relative to our foreign receivables and payables. During the year ended December31, 2014, a gain of $0.7 million was recognized in other income due to the change in the value of the derivative instruments, and as of December 31, 2014,there was an immaterial value of hedge contracts recorded in our Consolidated Balance Sheet.Inventory. Inventory consists primarily of purchased finished goods, which includes specialized implants and disposables, and is stated at the lower ofcost or market determined by a weighted average cost method. Approximately $6.0 million and $5.9 million of inventory was held at consigned locations atDecember 31, 2014 and 2013, respectively. The Company reviews the components of its inventory on a periodic basis for excess and obsolescence andrecords a reserve for the identified items. At December 31, 2014 and 2013, the balance of the allowance for excess and obsolete inventory is $22.6 millionand $21.9 million, respectively.Goodwill and Intangible Assets. Our goodwill represents the excess of the cost over the fair value of net assets acquired from our businesscombinations. The determination of the value of goodwill and intangible assets arising from business combinations and asset acquisitions requiresextensive use of accounting estimates and judgments to allocate the purchase price to the fair value of the net tangible and intangible assets acquired,including capitalized in-process research and development (IPR&D). Intangible assets acquired in a business combination that are used for in-processresearch and development activities are considered indefinite lived until the completion or abandonment of the associated research and development efforts.Upon reaching the end of the relevant research and development project, the Company will amortize the acquired in-process research and development overits estimated useful life or expense the acquired in-process research and development should the research and development project be unsuccessful with nofuture alternative use.Goodwill and IPR&D are not amortized, however, they are assessed for impairment using fair value measurement techniques on an annual basis ormore frequently if facts and circumstance warrant such a review. The goodwill or IPR&D are considered to be impaired if we determine that the carrying valueof the reporting unit or IPR&D exceeds its respective fair value. In accordance with our policy, we completed our most recent annual evaluation forimpairment of goodwill and IPR&D using the discounted cash flow valuation methodology based on discounted cash flows as of October 1, 2014 anddetermined that no impairment existed. 73Table of ContentsThe Company performs its goodwill impairment analysis at the reporting unit level, which aligns with the Company’s reporting structure andavailability of discrete financial information. Our evaluation included management estimates of cash flow projections based on internal future projections.Key assumptions from these projections included revenue growth and future gross and operating margin growth. The Company also makes key assumptionsrelated to its weighted cost of capital and terminal growth rates. The revenue and margin growth was based on increased sales of new and existing products aswe expect to maintain our investment in research and development. Additional assumed value creators included increased efficiencies from capital spending.The resulting cash flows were discounted using a weighted average cost of capital. Operating mechanisms and requirements to ensure that these growth andefficiency assumptions will ultimately be realized were also considered in our evaluation, including timing and probability of regulatory approvals for ourproducts to be commercialized. Our market capitalization at October 1, 2014 was also considered as a part of analysis. As a result, it was determined that noreporting unit of the Company was at risk of impairment when assessing the unit’s fair value compared to its carrying value. In addition, no indicators ofimpairments were noted through December 31, 2014 and consequently, no impairment charge has been recorded during the year.As of October 1, 2014 and October 1, 2013, at our annual evaluation date for impairment, the Company had two reporting units; the Progentixreporting unit and the remainder of the Company (the “primary reporting unit”). For the impairment assessment performed during 2012, we had threereporting units; Progentix reporting unit, Impulse Monitoring reporting unit, and the primary reporting unit. The Company determined that, consistent withcontinued integration of Impulse Monitoring into our core business, Impulse Monitoring was no longer a reporting unit since discrete financial informationfor Impulse Monitoring was no longer available which resulted in the combination of Impulse Monitoring reporting unit into our primary reporting unit forfuture goodwill impairment assessment. During 2012, when Impulse Monitoring was a reporting unit that provided a discrete financial information, we updated our discounted cash flowvaluation model for Impulse Monitoring and based on Management’s current estimates of revenues and expenses, related cash flows and the discount rateused in the model, the estimated fair value of the Impulse Monitoring reporting unit was less than its carrying value. Management’s estimates of revenues andrelated cash flows reflected the impacts of the significant coding changes for IOM services which took effect in 2013 and resulted in reduced reimbursementfor IOM services. During the year ended December 31, 2012, we recorded an impairment charge to Impulse Monitoring’s goodwill of $8.3 million. Duringthe year ended December 31, 2012, we recorded an impairment charge of $1.4 million, related to the IPR&D recorded for the technology acquired fromCervitech in 2009. The primary factor contributing to this impairment charge was the reduction in Management’s revenue estimate and the related decreaseto the estimated cash flows for this technology.Intangible assets with a finite life, such as acquired technology, customer relationships, manufacturing know-how, licensed technology, supplyagreements and certain trade names and trademarks, are amortized on a straight-line basis over their estimated useful life, ranging from 1 to 17 years.Intangible assets with a finite life are tested for impairment whenever events or circumstances indicate that the carrying amount may not be recoverable.In determining the useful lives of intangible assets, the Company considers the expected use of the assets and the effects of obsolescence, demand,competition, anticipated technological advances, changes in surgical techniques, market influences and other economic factors. For technology basedintangible assets, the Company considers the expected life cycles of products which incorporate the corresponding technology. Trademarks and trade namesthat are related to products are assigned lives consistent with the period in which the products bearing each brand are expected to be sold.During the year ended December 31, 2014, we recorded an impairment charge of $10.7 million related to developed technology acquired fromCervitech in 2009. The primary factor contributing to this impairment charge was the reduction in Management’s revenue estimate and the related decreaseto the estimated cash flows for this technology.See Note 2 to the Consolidated Financial Statements included in this Annual Report for further discussion on goodwill and intangible assets.Property and Equipment. Property and equipment are carried at cost less accumulated depreciation. Depreciation is computed using the straight-linemethod over the estimated useful lives of the assets, ranging from 2 to 20 years. Maintenance and repairs are expensed as incurred. The Company depreciatesleasehold improvements over their estimated useful lives or the term of the applicable lease, whichever is shorter.The Company reviews property, plant and equipment for impairment whenever events or changes in circumstances indicate that the carrying value ofan asset may not be recoverable. An impairment loss would be recognized when estimated future undiscounted cash flows relating to the asset are less than itscarrying amount. An impairment loss is measured as the amount by which the carrying amount of an asset exceeds its fair value. 74Table of ContentsIncome Taxes. A deferred tax asset or liability is determined based on the difference between the financial statement and tax basis of assets andliabilities as measured by the enacted tax rates which will be in effect when these differences reverse. The Company provides a valuation allowance againstnet deferred tax assets unless, based upon the available evidence, it is more likely than not that the deferred tax assets will be realized.See Note 9 to the Consolidated Financial Statements included in this Annual Report for further discussion on income taxes.Loss Contingencies. The Company is involved in a number of legal actions arising out of the normal course of our business. The outcomes of theselegal actions are not within the Company’s complete control and may not be known for prolonged periods of time. In some actions, the claimants seekdamages as well as other relief, including injunctions barring the sale of products that are the subject of the lawsuit, that could require significantexpenditures or result in lost revenues. In accordance with authoritative guidance, the Company discloses information regarding each material claim wherethe likelihood of a loss contingency is probable or reasonably possible. An estimated loss contingency is accrued in the Company’s financial statements if itis both probable that the liability has been incurred and the amount of the loss can be reasonably estimated. If a loss is reasonably possible and can bereasonably estimated, the estimated loss or range of loss is disclosed in the notes to the consolidated financial statements. In most cases, significant judgmentis required to estimate the amount and timing of a loss to be recorded.See Note 11 to the Consolidated Financial Statements included in this Annual Report for further discussion on legal proceedings.Comprehensive Income (Loss). Comprehensive income (loss) is defined as the change in equity during a period from transactions and other events andcircumstances from non-owner sources. Comprehensive income (loss) includes net of tax, unrealized gains or losses on the Company’s marketable securitiesand foreign currency translation adjustments. The cumulative translation adjustments included in accumulated other comprehensive loss were $9.5 millionand $3.3 million at December 31, 2014, and December 31, 2013, respectively, and a net cumulative gain of $0.7 million at December 31, 2012.Research and Development. Research and development costs are expensed as incurred. Product Shipment Costs. Product shipment costs are included in sales, marketing and administrative expense in the accompanying consolidatedstatements of operations and were $23.6 million, $21.7 million, and $17.6 million for the years ended December 31, 2014, 2013, and 2012, respectively. Themajority of the Company’s shipping costs are related to the loan of instrument sets, which are not sold as part of the Company’s core sales offering. Amountsbilled to customers for shipping and handling of products are reflected in revenues and are not significant for any period presented.Restructuring Charges. During the year ended December 31, 2014, as part of a company-wide efficiency effort, the Company reduced its footprint onthe east coast of the United States in order to match its current and projected business needs without adversely impacting its ability to deliver surgeoneducation and local customer fulfillment. More specifically, the Company exited a majority of the leased square footage at its New Jersey location anddecided to terminate the respective lease at December 2017 with the expectation of exiting earlier than the contract termination date. As a result of thereduction in space, the Company recorded restructuring and associated impairment charges of approximately $6.4 million, primarily associated with futurerental payments through December 31, 2017 and lease termination charges of $1.9 million, which was offset by estimated future sublease income. Theimpairment charges also included the net impact of a $0.1 million gain from writing-off deferred rent liabilities and leasehold improvements. As of December31, 2014, the total recorded liability associated with this early lease termination was $3.4 million. The charge is recorded in sales, marketing andadministrative expense in the Consolidated Statements of Operations. The current portion of the liability is recorded within accounts payable and accruedliabilities and the long-term portion is recorded within other long-term liabilities in the Consolidated Balance Sheets. Subsequent to year end, the Companymade the announcement it was fully exiting the New Jersey leasehold, to which the financial impacts will be recorded upon the cease use date.Stock-based Compensation. The estimated fair value of stock-based awards exchanged for shareowner (employee) and non-employee director servicesare expensed over the requisite service period. Awards issued to non-employees (excluding non-employee directors) are recorded at their fair value asdetermined in accordance with authoritative guidance, and are periodically revalued as the options vest and are recognized as expense over the relativeservice period. 75Table of ContentsFor purposes of calculating stock-based compensation, we estimate the fair value of stock options and shares issued under the Employee StockPurchase Plan using a Black-Scholes option-pricing model. The determination of the fair value of stock-based payment awards utilizing the Black-Scholesmodel is affected by our stock price and a number of assumptions, including expected volatility, expected term, risk-free interest rate and expected dividends.The expected volatility is based on the historical volatility of our common stock over the most recent period commensurate with the estimated expected termof the stock options. The expected term of the stock options is based on its historical data. The risk-free interest rate assumption is based on observed interestrates appropriate for the expected terms of the grants. The dividend yield assumption is based on our history and expectation of no dividend payouts.The fair value of restricted stock units granted is based on the market price of our common stock on the date of grant. The fair value of performance-based restricted stock units (PRSUs) that have pre-defined Company-specific performance criteria is determined based on the stock price at the date of grantadjusted with probability of achieving the specified performance criteria, as defined in the Performance Award agreements. Expense is recognized using theaccelerated method over the remaining recognition period based on these probabilities. Additionally, certain of our PRSUs are earned based on theachievement of pre-defined market conditions. The fair value of PRSUs with market conditions is estimated on the date of grant using a Monte Carlovaluation model and key assumptions are expected volatility and the risk free interest rate. We collectively refer to PRSUs with both Company-specificperformance criteria and pre-defined market conditions as Performance Awards.The Company is required to estimate at the grant date the value of awards that are anticipated to be forfeited prior to their vesting. TheCompany will adjust forfeiture rate estimates as necessary for awards with performance and service conditions through the vesting date so that fullcompensation cost is recognized only for awards that vest. The Company assesses the reasonableness of the estimated forfeiture rate at leastannually, with any change to be made on a cumulative basis in the period the estimated forfeiture rates change. The Company considered itshistorical experience of pre-vesting forfeitures on awards by employee (“shareowner”) homogenous group as the basis to arrive at its estimatedannual pre-vesting forfeiture rates.See Note 8 to the Consolidated Financial Statements included in this Annual Report for further discussion on stockholder equity and stock-basedcompensation. Net Income (Loss) Per Share. The Company computes basic net income (loss) per share using the weighted-average number of common sharesoutstanding during the period. Diluted net income (loss) assumes the conversion, exercise or issuance of all potential common stock equivalents, unless theeffect of inclusion would be anti-dilutive. For purposes of this calculation, common stock equivalents include the Company’s stock options, unvestedrestricted stock units (RSUs), including those with performance and market conditions, warrants, and the shares to be issued upon the conversion of theSenior Convertible Notes. No shares related to the assumed conversion of the Senior Convertible Notes were included in the diluted net income (loss)calculation for the years presented because the inclusion of such shares would have had an anti-dilutive effect. The shares to be issued upon exercise of alloutstanding warrants were excluded from the diluted net income (loss) calculation for all years presented because the inclusion of such shares would havehad an anti-dilutive effect. The contingently issuable shares are included in basic net income (loss) per share as of the date that all necessary conditions havebeen satisfied and are included in the denominator for dilutive calculation for the entire period if such shares would be issuable as of the end of the reportingperiod assuming the end of the reporting period was the end of the contingency period. 76Table of ContentsThe following table sets forth the computation of basic and diluted earnings (loss) per share (in thousands, except share data): Year Ended December 31, 2014 2013 2012 Numerator: Net (loss) income available to NuVasive, Inc.’s common stockholders $(16,720) $7,902 $3,144 Denominator for basic and diluted net (loss) income per share: Weighted average common shares outstanding for basic 46,715 44,461 43,328 Dilutive potential common stock outstanding: Stock options and ESPP — 416 177 Restricted stock units — 1,909 767 Weighted average common shares outstanding for diluted 46,715 46,786 44,272 Basic net (loss) income per share attributable to NuVasive, Inc. $(0.36) $0.18 $0.07 Diluted net (loss) income per share attributable to NuVasive, Inc. $(0.36) $0.17 $0.07 The following weighted outstanding common stock equivalents were not included in the calculation of net income (loss) per diluted share becausetheir effects were anti-dilutive (in thousands): Year Ended December 31, 2014 2013 2012 Stock Options, ESPP, and RSUs 8,902 5,015 6,592 Warrants 9,553 12,709 14,694 Senior Convertible Notes 9,553 9,890 11,214 Total 28,008 27,614 32,500 2. Balance Sheet DetailsProperty and Equipment, net. Property and equipment, net, consisted of the following (in thousands, except years): December 31, Useful Life 2014 2013 Instrument sets3 to 4 $189,774 $171,454 Machinery and equipment5 to 7 25,413 21,722 Computer equipment and software3 to 7 52,269 46,896 Leasehold improvements2 to 15 20,083 21,825 Furniture and fixtures3 to 7 7,282 7,510 Building and improvements10 to 20 7,507 7,371 Land- 541 541 302,869 277,319 Less: accumulated depreciation andamortization (174,304) (149,255) $128,565 $128,064 Our property and equipment mainly consisted of instrument sets, which we loan to surgeons and hospitals who purchase implants, biologics anddisposables for use in individual procedures, and computer equipment and software. 77Table of ContentsDepreciation expense was $52.3 million, $43.8 million, and $39.5 million for the years ended December 31, 2014, 2013 and 2012, respectively. AtDecember 31, 2014 and 2013, total assets recorded under capital leases of $1.5 million and $1.8 million, respectively, are included in the machinery andequipment balance. Depreciation of the assets under capital leases is included in depreciation expense. The Company depreciates leasehold improvementsover their estimated useful lives or the term of the applicable lease, whichever is shorter.Included in the depreciation expense recognized during the year ended December 31, 2014 was $4.2 million of accelerated depreciation as a result ofthe plan the Company committed to consolidate its offices located in San Diego, California into one corporate headquarters for efficiencies. This projectcommenced during the year ended December 31, 2014 and is expected to be completed by March 31, 2015. As a result, certain long-lived assets, primarilyleasehold improvements, will be abandoned and replaced during the respective construction period. In accordance with the authoritative guidance, theCompany has shortened the depreciable lives of impacted assets, which resulted in $4.2 million of accelerated depreciation, which is included in sales,marketing and administrative expenses, during the year ended December 31, 2014 that would have otherwise been recorded in future periods. There is noimpact to the Company’s Consolidated Statement of Operations over the life of the respective assets (see Note 1 to the Consolidated Financial Statementsincluded in this Annual Report for further discussion).Capitalized internal-use software costs include only those direct costs associated with the actual development or acquisition of computer software forinternal use, including costs associated with the design, coding, installation, and testing of the system. At December 31, 2014 and 2013, the Company had$17.3 million and $19.7 million in unamortized capitalized software costs, respectively. Amortization expense related to capitalized internal-use softwarecosts was $7.7 million, $5.5 million and $3.9 million for the years ended December 31, 2014, 2013 and 2012, respectively.Goodwill and Intangible Assets. Goodwill and intangible assets as of December 31, 2014 consisted of the following (in thousands, except years): Weighted- Average Amortization Period Gross Accumulated Intangible (in years) Amount Amortization Assets, net Intangible Assets Subject to Amortization: Developed technology 9 $79,008 $(27,760) $51,248 Manufacturing know-how and trade secrets 12 21,879 (11,640) 10,239 Trade name and trademarks 11 9,500 (4,264) 5,236 Customer relationships 8 43,153 (23,961) 19,192 Total intangible assets subject to amortization 10 $153,540 $(67,625) $85,915 Intangible Assets Not Subject to Amortization: In-process research and development 10,640 Goodwill 154,443 Total goodwill and intangible assets, net $250,998 78Table of ContentsGoodwill and intangible assets as of December 31, 2013 consisted of the following (in thousands, except years): Weighted- Average Amortization Period Gross Accumulated Intangible (in years) Amount Amortization Assets, net Intangible Assets Subject to Amortization: Developed technology 10 $62,328 $(21,359) $40,969 Manufacturing know-how and trade secrets 12 21,997 (9,890) 12,107 Trade name and trademarks 11 9,500 (3,317) 6,183 Customer relationships 8 43,871 (19,784) 24,087 Total intangible assets subject to amortization 10 $137,696 $(54,350) $83,346 Intangible Assets Not Subject to Amortization: In-process research and development 10,640 Goodwill 154,944 Total goodwill and intangible assets, net $248,930 Total expense related to the amortization of intangible assets was $13.6 million, $19.3 million and $12.4 million for the years ended December 31,2014, 2013 and 2012, respectively. Intangible assets acquired in a business combination that are used for in-process research and development activities areconsidered indefinite lived until the completion or abandonment of the associated research and development efforts. Upon reaching the end of the relevantresearch and development project, the Company will amortize the acquired in-process research and development over its estimated useful life or expense theacquired in-process research and development should the research and development project be unsuccessful with no future alternative use. During the years ended December 31, 2014 and 2012, the Company recorded impairment charges of $10.7 million and $1.4 million, respectively,related to the developed technology and IPR&D, respectively, acquired from Cervitech in 2009. In addition, during the year ended December 31, 2012, theCompany recorded an impairment charge to then one of our reporting units, Impulse Monitoring’s goodwill of $8.3 million. See Note 1 to the Consolidated Financial Statements included in this Annual Report for further discussion on impairment charges.Total future amortization expense related to intangible assets subject to amortization at December 31, 2014 is set forth in the table below (inthousands): 2015 $15,268 2016 14,809 2017 12,459 2018 11,432 2019 10,078 Thereafter through 2027 21,869 Total future amortization expense $85,915 The changes to goodwill are comprised of the following (in thousands): 2014 2013 Balance at January 1 $154,944 $154,106 Addition recorded in connection with acquisition — 764 Reduction recorded in connection with disposal of business (292) — Other (209) 74 Balance at December 31 $154,443 $154,944 79Table of ContentsAccounts Payable and Accrued Liabilities. Accounts payable and accrued liabilities consisted of the following (in thousands): December 31, 2014 2013 Accounts payable $13,648 $14,281 Accrued expenses 49,067 19,078 Royalties payable 51,377 38,967 Income taxes payable 12,740 212 Distributor commissions payable 8,329 7,319 Others 11,706 6,200 $146,867 $86,057 Accounts payable and accrued liabilities were mainly consisted of account payable, accrued expenses, royalties payable, and income taxespayable. Included in accrued expenses was $27.4 million of intangible assets the Company purchased during the year ended December 31, 2014 which werenot yet paid as of December 31, 2014. 3. Marketable SecuritiesMarketable securities consist of certificates of deposit, corporate notes, commercial paper, U.S. government treasury securities and securities ofgovernment-sponsored entities. The Company classifies all securities as available-for-sale, as the sale of such securities may be required prior to maturity toimplement management strategies. These securities are carried at fair value, with the unrealized gains and losses reported as a component of othercomprehensive income (loss) in stockholder’s equity until realized. A decline in the market value of any marketable security below cost that is determined tobe other-than-temporary will result in a revaluation of its carrying amount to fair value. The impairment is charged to earnings and a new cost basis for thesecurity is established. No such impairment charges were recorded for any period presented.Realized gains and losses from the sale of marketable securities, if any, are determined on a specific identification basis. Realized gains and losses anddeclines in value judged to be other-than-temporary are included in other income or expense on the consolidated statements of operations. Realized gainsand losses during the periods presented were immaterial. Premiums and discounts are amortized or accreted over the life of the related security as anadjustment to yield using the straight-line method and are included in interest income on the consolidated statements of operations. Interest and dividendson securities classified as available-for-sale are included in interest income on the consolidated statements of operations. 80Table of ContentsThe composition of marketable securities is as follows (in thousands, except years): ContractualMaturity(in Years) Amortized Cost GrossUnrealizedGains GrossUnrealizedLosses Fair Value December 31, 2014: Classified as current assets Certificates of deposit Less than 1 $282 $- $- $282 Corporate notes Less than 1 129,037 8 (105) 128,940 Commercial paper Less than 1 11,290 - - 11,290 U.S. government treasury securities Less than 1 1,500 1 - 1,501 Securities of government-sponsored entities Less than 1 78,333 12 (29) 78,316 Short-term marketable securities 220,442 21 (134) 220,329 Classified as non-current assets Corporate notes 1 to 2 14,082 - (13) 14,069 Securities of government-sponsored entities 1 to 2 28,996 - (23) 28,973 Long-term marketable securities 43,078 - (36) 43,042 Classified as restricted investments U.S. government treasury securities Less than 2 51,331 13 (13) 51,331 Securities of government-sponsored entities Less than 2 42,862 2 (54) 42,810 Restricted investments 94,193 15 (67) 94,141 Total marketable securities at December 31, 2014 $357,713 $36 $(237) $357,512 December 31, 2013: Classified as current assets Certificates of deposit Less than 1 $833 $- $- $833 Corporate notes Less than 1 71,611 23 (6) 71,628 Commercial paper Less than 1 19,973 - - 19,973 U.S. government treasury securities Less than 1 7,603 2 - 7,605 Securities of government-sponsored entities Less than 1 43,405 14 (9) 43,410 Short-term marketable securities 143,425 39 (15) 143,449 Classified as non-current assets Certificates of deposit 1 to 2 283 - - 283 Corporate notes 1 to 2 32,309 23 (14) 32,318 U.S. government treasury securities 1 to 2 1,500 1 - 1,501 Securities of government-sponsored entities 1 to 2 45,722 19 (14) 45,727 Long-term marketable securities 79,814 43 (28) 79,829 Classified as restricted investments U.S. government treasury securities Less than 2 43,274 16 (6) 43,284 Securities of government-sponsored entities Less than 2 29,125 4 (16) 29,113 Restricted investments 72,399 20 (22) 72,397 Total marketable securities at December 31, 2013 $295,638 $102 $(65) $295,675 As of December 31, 2014, the Company had no investments that were in a significant unrealized loss position. The Company reviews its investmentsto identify and evaluate investments that have an indication of possible other-than-temporary impairment. Factors considered in determining whether a lossis other-than-temporary include the length of time and extent to which fair value has been less than the cost basis, the financial condition and near-termprospects of the investee, and the Company’s intent and ability to hold the investment for a period of time sufficient to allow for any anticipated recovery inmarket value. The Company maintains an investment portfolio of various holdings, types and maturities. The Company places its cash investments ininstruments that meet high credit quality standards, as specified in its investment policy guidelines. These guidelines also limit the amount of credit exposureto any one issue, issuer or type of instrument.Foreign Currency and Derivative Financial InstrumentsThe Company translates the financial statements of its foreign subsidiaries using end-of-period exchange rates for assets and liabilities and averageexchange rates during each reporting period for results of operations. 81Table of ContentsSome of the Company’s reporting entities conduct a portion of their business in currencies other than the entity’s functional currency. Thesetransactions give rise to receivables and payables that are denominated in currencies other than the entity’s functional currency. The value of thesereceivables and payables is subject to changes in currency exchange rates from the point at which the transactions are originated until the settlement in cash.Both realized and unrealized gains and losses in the value of these receivables and payables are included in the determination of net income. Net currencyexchange gains (losses) recognized on business transactions were $(2.6) million net with hedging transactions, $0.7 million and $0.8 million for the yearsended December 31, 2014, 2013 and 2012, respectively, and are included in other income (expense) in the Consolidated Statements of Operations.To manage foreign currency exposure risks, the Company uses derivatives for activities in entities that have short term intercompany receivables andpayables denominated in a currency other than the entity’s functional currency. Realized and unrealized gains or losses on the value of financial contractsentered into to hedge the exchange rate exposure of these receivables and payables are also included in the determination of net income as they have notbeen designated for hedge accounting under ASC Topic 815, Derivatives and Hedging. These contracts, which settle monthly, effectively fix the exchangerate at which these specific receivables and payables will be settled in, so that gains or losses on the forward contracts offset the gains or losses from changesin the value of the underlying receivables and payables. During the year ended December 31, 2014, a gain of $0.7 million was recognized in other incomedue to the change in the fair value of the derivative instruments, and the fair value of the hedge contracts we held was immaterial on our ConsolidatedBalance Sheet as of December 31, 2014. As of December 31, 2014 a notional principal amount of $26.0 million in foreign currency forward contracts wasoutstanding to hedge currency risk relative to our foreign receivables and payables.The Company’s currency exposures vary, but are primarily concentrated in the pound sterling, the euro, the Australian dollar and the yen. TheCompany will continuously monitor the costs and the impact of foreign currency risks upon the financial results as part of the Company’s risk managementprogram. The Company does not use derivative financial instruments for speculation or trading purposes or for activities other than risk management. We donot require and are not required to pledge collateral for these financial instruments or we do not carry any master netting arrangements to mitigate the creditrisk.The following table summarizes the fair values of derivative instruments at December 31, 2014 and 2013: Asset Derivatives Liability Derivatives Fair Value Fair Value Balance Sheet December 31, December 31, Balance Sheet December 31, December 31, (in thousands) Location 2014 2013 Location 2014 2013 Derivatives instruments not designated as cash flow hedges Forward exchange contracts Other currentassets $— $— Other currentliabilities * $— Total derivatives $— $— $ * $— *De minimus amount recognized in the hedge relationship. The following table summarizes the effect of derivative instruments on the Consolidated Statements of Operations for the years endedDecember 31, 2014 and 2013: Year ended December 31, 2014 Year ended December 31, 2013 Location of Amount of Location of Amount of (Gain)/Loss (Gain)/Loss (Gain)/Loss (Gain)/Loss Recognized in Recognized in Recognized in Recognized in (in thousands) Income Income Income Income Derivatives instruments not designated as cash flow hedges Forward exchange contracts Other (income)expense $(730) Other (income)expense $— Total derivatives $(730) $— 4. Fair Value MeasurementsThe Company measures certain assets and liabilities in accordance with authoritative guidance which requires fair value measurements be classifiedand disclosed in one of the following three categories:Level 1: Quoted prices (unadjusted) in active markets that are accessible at the measurement date for assets or liabilities.Level 2: Observable prices that are based on inputs not quoted on active markets, but corroborated by market data. 82Table of ContentsLevel 3: Unobservable inputs are used when little or no market data is available.Assets and liabilities are classified based on the lowest level of input that is significant to the fair value measurements. The Company reviews the fairvalue hierarchy classification on a quarterly basis. Changes in the ability to observe valuation inputs may result in a reclassification of levels for certainassets or liabilities within the fair value hierarchy. The Company did not have any transfers of assets and liabilities between the Levels of the fair valuemeasurement hierarchy during the years presented.The fair values of the Company’s assets and liabilities, which are measured at fair value on a recurring basis, were determined using the followinginputs (in thousands): Quoted Price in Significant Other Significant Active Market Observable Inputs Unobservable Total (Level 1) (Level 2) Inputs (Level 3) December 31, 2014: Cash Equivalents, Marketable Securities and Restricted Investments: Money market funds $39,963 $39,963 $— $— Certificates of deposit 282 282 — — Corporate notes 143,009 — 143,009 — Commercial paper 11,290 — 11,290 — U.S. government treasury securities 52,831 52,831 — — Securities of government-sponsored entities 150,101 — 150,101 — Total cash equivalents, marketable securities and restricted investments $397,476 $93,076 $304,400 $— Contingent Consideration: Acquisition-related liabilities, current $(644) $— $— $(644)Total contingent consideration $(644) $— $— $(644)December 31, 2013: Cash Equivalents, Marketable Securities and Restricted Investments: Money market funds $72,514 $72,514 $— $— Certificates of deposit 1,116 1,116 — — Corporate notes 103,946 — 103,946 — Commercial paper 19,973 — 19,973 — U.S. government treasury securities 52,390 52,390 — — Securities of government-sponsored entities 118,250 — 118,250 — Total cash equivalents, marketable securities and restricted investments $368,189 $126,020 $242,169 $— Contingent Consideration: Acquisition-related liabilities, current $(616) $— $— $(616)Acquisition-related liabilities, non-current (596) — — (596)Total contingent consideration $(1,212) $— $— $(1,212) Carrying value of the financial instruments measured and classified within Level 1 was based on quoted prices.To manage foreign currency exposure risks, the Company uses derivatives for activities in entities that have short term intercompany receivables andpayables denominated in a currency other than the entity’s functional currency. The fair value is based on a quoted market price (Level 1). During the yearended December 31, 2014, a gain of $0.7 million was recognized in other income due to the change in the fair value of the derivative instruments, and the fairvalue of the hedge contracts we held was immaterial on our Consolidated Balance Sheet as of December 31, 2014.See Note 3 to the Consolidated Financial Statements included in this Annual Report for further discussion on our hedge transactions.The types of instruments that trade in markets that are not considered to be active, but are valued based on quoted market prices, broker or dealerquotations, or alternative pricing sources with reasonable levels of price transparency are generally classified within Level 2 of the fair value hierarchy. 83Table of ContentsCertain contingent consideration liabilities are classified within Level 3 of the fair value hierarchy because they use unobservable inputs. For thoseliabilities, fair value is determined using a probability-weighted discounted cash flow model, the significant inputs which are not observable in the market.The fair value, based on a quoted market price (Level 1), of the Company’s outstanding Senior Convertible Notes due 2017 at December 31, 2014 andDecember 31, 2013 was approximately $516.1 million and $439.3 million, respectively. The carrying value of the Company’s Senior Convertible Notes isdiscussed in Note 6, Senior Convertible Notes. The carrying values of our capital lease obligations approximated their estimated fair value as ofDecember 31, 2014 and 2013.Contingent Consideration LiabilityIn connection with an immaterial business combination completed in 2012, the Company agreed to pay the seller an amount, not toexceed €2.0 million in aggregate purchase price, in the event two specified revenue-based milestones are achieved. The first milestone wasachieved and paid during the year ended December 31, 2014. The second milestone was measured and paid in mid February 2015 in the amountthat was accrued as of December 31, 2014. The fair value of the contingent consideration was determined using a discounted cash flow model, thesignificant inputs of which are not observable in the market. The key assumptions in applying this approach are the revenue projections, the interest rate andthe probabilities assigned to the milestones being achieved. Based on these assumptions, the estimated fair value of the contingent consideration was $0.6million and $1.2 million at December 31, 2014 and 2013, respectively, and was included in accrued liabilities for current portion and other long-termliabilities for non-current portion in the Consolidated Balance Sheet. Changes in fair value are recorded in the statements of operations as sales, marketingand administrative expenses. The Company paid approximately $0.6 million during the year ended December 31, 2014 related to this contingentconsideration arrangement.As of December 31, 2014, the Company has obligations under certain consultancy arrangements to pay up to approximately $23.2 million in theaggregate in the event that specified revenue-based milestones are achieved prior to 2024. Any such payment will be made in a combination of cash and theCompany’s common shares as provided in the agreements. Any payments in satisfaction of theses contingent obligations are considered a cost of goods soldand are recognized as and if milestones are achieved. During 2014, the Company paid $6.2 million in aggregate – $3.0 million in cash and $3.2 million incommon shares - in connection with these agreements. There was no accrual as of December 31, 2014 or 2013, related to these payments.The following table sets forth the changes in the estimated fair value of the Company’s liabilities measured on a recurring basis using significantunobservable inputs (Level 3) (in thousands): 2014 2013 Fair value measurement at January 1 $1,212 $1,074 Change in fair value measurement included in operating expenses 40 138 Contingent consideration paid or settled (608) — Fair value measurement at December 31 $644 $1,212 Non-financial assets and liabilities measured on a nonrecurring basisCertain non-financial assets and liabilities are measured at fair value, usually with Level 3 inputs including discounted cash flow method or costmethod, on a nonrecurring basis in accordance with authoritative guidance. These include items such as nonfinancial assets and liabilities initially measuredat fair value in a business combination and non-financial long-lived assets measured at fair value for an impairment assessment. In general, non-financialassets, including goodwill, intangible assets and property and equipment, are measured at fair value when there is an indication of impairment and arerecorded at fair value only when any impairment is recognized.During the years ended December 31, 2014 and 2012, the Company recorded impairment charges of $10.7 million and $1.4 million, respectively,related to the developed technology and IPR&D, respectively, acquired from Cervitech in 2009. Additionally, during the year ended December 31, 2012, theCompany recorded an impairment charge to then one of its reporting units, Impulse Monitoring’s goodwill of $8.3 million.Based on management’s assessment, during the year ended December 31, 2014, the Company recognized $2.2 million in leasehold improvementwrite-offs associated with exiting a majority of the leased square footage at its New Jersey location. 84Table of ContentsSee Note 1 to the Consolidated Financial Statements included in this Annual Report for further discussion on impairment analysis and leaseholdrelated charges. 5. Business Combinations The Company has completed acquisitions that were not considered individually or collectively material to the overall Consolidated FinancialStatements and/or the results of the Company's operations. These acquisitions have been included in the Consolidated Financial Statements from therespective dates of the acquisitions. The Company recognizes the assets acquired, liabilities assumed, and any non-controlling interest at fair value at thedate of acquisition. Certain acquisitions contain contingent consideration arrangements that require the Company to assess the acquisition date fair value ofthe contingent consideration liabilities, which is recorded as part of the purchase consideration of the acquisition. The Company continuously assesses andadjusts the fair value of the contingent consideration liabilities, if necessary, until the settlement or expiration of the contingency occurs. Contingent Consideration Liabilities As a result of contingent consideration arrangements associated with certain asset and/or business acquisitions, the Company may have (orat times following such transactions, may have had) future payment obligations based on certain technological or operational milestones. Forthose contingent arrangements entered in as a result of business combinations, the Company records these obligations at fair value at the time ofacquisition with subsequent fair value adjustments to the contingent consideration reflected in the line items of the Consolidated Statement ofOperations commensurate with the nature of the contingent consideration. At December 31, 2014, the estimated fair value of existing contingentconsideration agreements, individually or collectively, are not considered material to the Company's Consolidated Financial Statements (see Note 4and 7 to the Consolidated Financial Statements included in this Annual Report for further discussion). Investment in Progentix Orthobiology, B.V.In 2009, the Company completed the purchase of forty percent (40%) of the capital stock of Progentix, a company organized under the laws of theNetherlands, from existing shareholders (the Progentix Shareholders) pursuant to a Preferred Stock Purchase Agreement for $10.0 million in cash (the InitialInvestment). As of December 31, 2014, NuVasive loaned Progentix cumulatively $5.3 million at an interest at a rate of 6% per year. NuVasive is notobligated to provide additional funding. Concurrently with the Preferred Stock Purchase Agreement, NuVasive, Progentix and the Progentix Shareholders entered into an Option PurchaseAgreement, as amended (the “Option Agreement”), whereby NuVasive was obligated under certain circumstances, and had the option under othercircumstances, to purchase the remaining sixty percent (60%) of capital stock of Progentix (the “Remaining Shares”) from its shareholders for an amount upto $35.0 million, subject to certain reductions. The Option Agreement expired unexercised on June 13, 2013. Also, concurrently with the Preferred StockPurchase Agreement, NuVasive and Progentix entered into a Distribution Agreement, as amended, whereby Progentix appointed NuVasive as its exclusivedistributor for certain Progentix products. The Distribution Agreement is in effect for a term of ten years unless terminated earlier in accordance with its terms.In accordance with authoritative guidance, the Company has determined that Progentix is a variable interest entity, (or “VIE”) as it does not have theability to finance its activities without additional subordinated financial support and its equity investors will not absorb their proportionate share of expectedlosses and will be limited in the receipt of the potential residual returns of Progentix. Additionally, pursuant to this guidance, NuVasive is considered itsprimary beneficiary as NuVasive has both the power to direct the economically significant activities of Progentix and the obligation to absorb losses of, orthe right to receive benefits from, Progentix. Accordingly, the financial position and results of operations of Progentix have been included in the Company’sconsolidated financial statements from the date of the Initial Investment. The liabilities recognized as a result of consolidating Progentix do not representadditional claims on the Company’s general assets. The creditors of Progentix have claims only on the assets of Progentix, which are not material, and theassets of Progentix are not available to NuVasive.The equity interests in Progentix not owned by the Company, which includes shares of both common and preferred stock, are reported as non-controlling interests on the consolidated balance sheet of the Company. The preferred stock represents 18% of the non-controlling equity interests andprovides for a cumulative 8% dividend, if and when declared by Progentix’s Board of Directors. As the rights of the preferred stock are substantially the sameas those of the common stock, the preferred stock is classified as non-controlling interest and shares in the allocation of the losses incurred by Progentix.Losses incurred by Progentix are charged to the Company and to the non-controlling interest holders based on their ownership percentage. The OptionAgreement that was entered into between NuVasive, Progentix and the Progentix Shareholders were not considered to be freestanding financial instrumentsduring 85Table of Contentsthe Option Period as defined by authoritative guidance. Therefore, during the Option Period, the Remaining Shares and the Option Agreement wereaccounted for as a combined unit on the consolidated financial statements as a redeemable non-controlling interest that was initially recorded at fair valueand classified as mezzanine equity. Upon the expiration of the Option Agreement on June 13, 2013, the non-controlling interest was no longer redeemableand therefore, pursuant to the authoritative guidance, the non-controlling interest was reclassified out of mezzanine equity to its own component of totalequity within the Company’s consolidated balance sheet.Total assets and liabilities of Progentix included in the accompanying consolidated balance sheet are as follows (in thousands): December 31, 2014 2013 Total current assets $839 $580 Identifiable intangible assets, net 13,935 14,403 Goodwill 12,654 12,654 Other long-term assets 1 7 Accounts payable & accrued expenses 542 403 Deferred tax liabilities, net 2,770 2,770 Non-controlling interests 8,310 9,086 The following is a reconciliation of equity attributable to the non-controlling interests (in thousands): Year Ended December 31, 2014 2013 Non-controlling interests at beginning of period $9,086 $10,003 Less: Net loss attributable to the non-controlling interests prior to reclassification from mezzanine to equity — 514 Less: Net loss attributable to the non-controlling interests subsequent to reclassification from mezzanine to equity 776 403 Non-controlling interests at end of period $8,310 $9,086 Impulse Monitoring Inc. and Physician PracticesThe Company maintains contractual relationships with several physician practices ("PCs") which were inherited through the 2011 acquisitionof Impulse Monitoring Inc. Under the respective contracts' terms, PCs provide the physician oversight services associated with IOM services. TheCompany provides management services to the PCs including all non-medical services, management reporting, billing and collections of allcharges for medical services provided as well as administrative support. The PCs pay the Company a monthly management fee for theseservices. In accordance with authoritative guidance, the Company has determined that the PCs are variable interest entities and the Company hascontrolling financial interests in the PCs as it has both the power to direct the economically significant activities of the PCs, and the obligation toabsorb losses of, or the right to receive benefits from, the PCs. Therefore, the accompanying Consolidated Financial Statements include theaccounts of the PCs from the date of acquisition. During the periods presented, the result of PCs was immaterial to our financials. The creditorsof the PCs have claims only on the assets of the PCs, which are not material, and the assets of the PCs are not available to the Company. Business Consolidation Costs The Company incurs various costs related to business combination and integration activities. These activities include restructuring and integratingacquired entities and existing operations through business consolidation activities. Types of costs include severance, relocation, consulting, and other costsdirectly related to the activity. The Company recorded such expenses of $1.4 million during the year ended December 31, 2014 in sales, marketing, andadministrative expense. The expense related to these activities was minimal during the years ended 2013 and 2012. 6. Senior Convertible NotesThe carrying values of the Company’s Senior Convertible Notes are as follows (in thousands): 86Table of Contents December 31, 2014 2013 2.75% Senior Convertible Notes due 2017: Principal amount $402,500 $402,500 Unamortized debt discount (41,754) (56,440)Total Senior Convertible Notes $360,746 $346,060 Senior Convertible Notes due 2017. In June 2011, the Company issued $402.5 million principal amount of Senior Convertible Notes with a statedinterest rate of 2.75% and a maturity date of July 1, 2017 (the "2017 Notes"). The net proceeds from the offering, after deducting initial purchasers' discountsand costs directly related to the offering, were approximately $359.2 million. The 2017 Notes may be settled in cash, stock, or a combination thereof, solelyat the Company's discretion. It is the Company's current intent and policy to settle all conversions through combination settlement, which involves satisfyingthe principal amount outstanding with cash and any note conversion value over the principal amount in shares of the Company's common stock. The initialconversion rate of the 2017 Notes is 23.7344 shares per $1,000 principal amount, which is equivalent to a conversion price of approximately $42.13 pershare, subject to adjustments. The Company also entered into transactions for convertible note hedge (the "2017 Hedge") and warrants (the "2017 Warrants")in concurrent to the issuance of the 2017 Notes. The cash conversion feature of the 2017 Notes (the “Embedded Conversion Derivative”) required bifurcation from the Notes and was initiallyaccounted for as a derivative liability and debt discount of $88.9 million upon issuance of the Notes without authorization of issuing additional commonstocks for the conversion. Upon obtaining stockholder approval for the additional authorized shares of the Company’s common stock, the derivativeliability was reclassified to stockholders’ equity, resulted in recognizing cumulatively $39.5 million in other income for change in fair value measurementand $49.4 million in additional paid-in-capital during 2011. The debt discount of $88.9 million is recognized as interest expense using an effective interestrate of 8.0% over the term of the Notes. The interest expense recognized on the 2017 Notes during the year ended December 31, 2014 includes $11.1 millionand $14.7 million for the contractual coupon interest and the accretion of the debt discount, respectively. The interest expense recognized on the 2017 Notesduring the year ended December 31, 2013 includes $11.1 million and $13.7 million for the contractual coupon interest and the accretion of the debtdiscount, respectively. Interest on the 2017 Notes began accruing upon issuance and is payable semi-annually. Prior to January 1, 2017, holders may convert their 2017 Notes only under the following conditions: (a) during any calendar quarter beginningOctober 1, 2011, if the reported sale price of the Company's common stock for at least 20 days out of 30 consecutive trading days ending on the last tradingday of the immediately preceding calendar quarter is greater than 130% of the conversion price on each applicable trading day; (b) during the five businessday period in which the trading price of the 2017 Notes falls below 98% of the product of (i) the last reported sale price of the Company's common stock and(ii) the conversion rate on that date; and (c) upon the occurrence of specified corporate events, as defined in the 2017 Notes. From January 1, 2017 and untilthe close of business on the second scheduled trading day immediately preceding July 1, 2017, holders may convert their 2017 Notes at any time (regardlessof the foregoing circumstances). The Company may not redeem the 2017 Notes prior to maturity. Other than restrictions relating to certain fundamentalchanges and consolidations, mergers or asset sales and customary anti-dilution adjustments, the 2017 Notes do not contain any financial covenants and donot restrict the Company from paying dividends or issuing or repurchasing any of its other securities. 2017 Hedge. In connection with the offering of the 2017 Notes, the Company entered into the hedge transaction with the initial purchasers and/or theiraffiliates (the "2017 Counterparties") entitling the Company to purchase up to 9,553,096 shares of the Company's common stock at an initial stock price of$42.13 per share, each of which is subject to adjustment. The cost of the 2017 Hedge was $80.1 million and accounted for as derivative assets upon issuanceof the Notes. Upon approval of stockholders on issuance of additional authorized shares, the derivative asset was reclassified to stockholders' equity, resultedin recognizing cumulatively $37.1 million in other expense for the change in fair value measurement and $43.0 million in additional paid-in-capital during2011. The 2017 Hedge will expire on July 1, 2017. The 2017 Hedge is expected to reduce the potential equity dilution upon conversion of the 2017 Notes ifthe daily volume-weighted average price per share of the Company's common stock exceeds the strike price of the 2017 Hedge. 2017 Warrants. The Company sold warrants to the 2017 Counterparties to acquire up to 477,654 shares of the Company's Series A ParticipatingPreferred Stock at an initial strike price of $988.51 per share, subject to adjustment. Each share of Series A Participating Preferred Stock is convertible into 20shares of the Company's common stock, or up to 9,553,080 common shares in total. The 2017 Warrants will expire on various dates from September 2017through January 2018 and may be settled in cash or net shares. It is the Company's current intent and policy to settle all conversions in shares of theCompany’s common stock. The Company received $47.9 million in cash proceeds from the sale of the 2017 Warrants, which was recorded in additional paid-in-capital. The 87Table of Contents2017 Warrants could have a dilutive effect on the Company's earnings per share to the extent that the price of the Company's common stock during a givenmeasurement period exceeds the strike price of the 2017 Warrants. 7. CommitmentsLeasesThe Company leases office facilities and equipment under various operating and capital lease agreements. The initial terms of these leases range from1 year to 15 years and generally provide for periodic rent increases and renewal options. Certain leases require the Company to pay taxes, insurance andmaintenance. In connection with certain operating leases, the Company has restricted cash of totaling $5.6 million as of December 31, 2014 a securitydeposit.Rent expense is recognized on a straight-line basis over the term of the lease. Accordingly, rent expense recognized in excess of rent paid is reflectedas a liability in the accompanying consolidated balance sheets. Rent expense, including costs directly associated with the facility leases, was approximately$11.5 million, $12.0 million, and $10.8 million for the years ended December 31, 2014, 2013, and 2012, respectively.During the year ended December 31, 2014, the Company exited a majority of the leased square footage at its New Jersey location and decided toterminate the respective lease at December 2017 with the expectation of exiting earlier than the contract termination date. As a result of the reduction inspace, the Company recorded restructuring and associated impairment charges including $5.8 million in future rental payments through December 31, 2017.The charge is recorded in sales, marketing and administrative expense in the Consolidated Statements of Operations (see Note 1 to the ConsolidatedFinancial Statements included in this Annual Report for further discussion on the restructuring charges associated with exiting the New Jersey location). The Company’s future minimum annual lease payments under capital and operating leases, including payments for costs directly associated with thefacility leases, for years ending after December 31, 2014 are as follows (in thousands): Capital Operating Leases Leases 2015 $557 $9,046 2016 538 9,068 2017 145 8,737 2018 9 6,210 2019 — 6,174 Thereafter — 23,291 Total minimum lease payments $1,249 $62,526 Less amount representing interest (77) Present value of obligations under capital leases 1,172 Less current portion (495) Long-term capital lease obligations $677 Licensing and Purchasing Agreements The Company is contingently obligated to make additional payments of up to $16.6 million in cash if specified future events occur or conditions aremet as provided in certain consulting, purchase and/or product develop agreements. Not all of the respective agreements specify milestone paymenttimelines. The Company has also entered into certain consulting arrangements that require payment of up to 264,000 shares (the equivalent value ofapproximately $12.5 million based on the closing price of our stock as of December 31, 2014) in the Company’s common stock. These agreements expire onvarious dates through 2024. Executive Employment Agreements The Company has employment contracts with key executives that provide for the continuation of salary if terminated for reasons other than cause, asdefined in those agreements. At December 31, 2014, future employment contract commitments for such key executives were approximately $23.0 million. Incertain circumstances, the employment agreements call for the acceleration of equity vesting. Those figures are not reflected in the above information. 88Table of Contents8. Stockholders’ EquityCommon Stock. There were 120,000,000 shares of common stock authorized at December 31, 2014 and 2013.Preferred Stock. There are 5,000,000 shares of preferred stock authorized and none issued or outstanding at December 31, 2014 and 2013.On June 28, 2011, in connection with the issuance of the 2017 Warrants, the Company amended its Restated Certificate of Incorporation to designate477,654 shares of the Company’s authorized preferred stock, par value $0.001 per share, as Series A Participating Preferred Stock (the Series A PreferredStock). The Series A Preferred Stock will automatically convert into shares of the Company’s common stock. The holders of Series A Preferred Stock(collectively, the Preferred Holders) are entitled to receive dividends when and if declared by the Board of Directors. The preferred dividends are payable inpreference and in priority to any dividends on the Company’s common stock. Shares of Series A Preferred Stock are convertible into 20 shares of commonstock, subject to certain antidilution adjustments. Preferred Holders vote on an equivalent basis with common stockholders on an as-converted basis. ThePreferred Holders are entitled to receive liquidation preferences at the rate of $648.20 per share. Liquidation payments to the Preferred Holders have priorityand are made in preference to any payments to the holders of common stock.Stock Repurchase. The company’s employee equity incentive plans allow for “net share settlement” of certain stock awards. This net share settlementis accounted for with the cost of any award shares that are net settled being included in treasury stock and reported as a reduction in total equity at the time ofsettlement. In connection with the net share settlement for tax withholding, we have funded - and anticipate to continue to fund - a significant amount of cashin satisfaction of certain shareowner tax obligations for settled equity awards.Equity Incentive PlansIn April 2004, the Board of Directors approved the 2004 Amended and Restated Equity Incentive Plan, as amended, (the "2004 EIP") under which7 million shares of the Company’s common stock were authorized for future issuance, and reserved for purchase upon exercise of options granted. In addition,the 2004 EIP provided for automatic annual increases in the number of shares reserved for issuance thereunder equal to the lesser of (i) 4% of the Company’soutstanding shares on the last business day in December of the calendar year immediately preceding; (ii) 4,000,000 shares; or (iii) a number of sharesdetermined by the Board of Directors.The 2004 EIP provided for the grant of incentive and non-statutory stock options, restricted stock units (RSUs) and rights to purchase stock toemployees, directors and consultants of the Company (in addition to stock appreciation rights, restricted stock units, performance awards, and deferred stockawards). The 2004 EIP provided that incentive stock options will be granted only to employees and are subject to certain limitations as to fair value during acalendar year. Under the 2004 EIP, the exercise price of incentive stock options must equal at least the fair value on the date of grant and the exercise price ofnon-statutory stock options and the issuance price of common stock may be no less than 85% of the fair value on the date of grant or issuance. The optionsare exercisable for a period of up to ten years after the date of grant and generally vest 25% one year from date of grant and ratably each month thereafter for aperiod of 36 months. No options were issued under the 2004 EIP after 2011. The 2004 EIP also provided for the issuance of restricted stock units (RSUs) to be granted to officers subject to time- and/or performance-based vestingrequirements which such RSUs vest annually at 33% per year beginning one year from date of grant (presuming that any applicable performance criteria ismet). The remaining RSUs were subject to time-based vesting requirements and generally vest annually at 25% per year beginning one year from date ofgrant. In addition, the award agreements under the 2004 EIP provide for the acceleration of 50% of the unvested equity awards of all shareowners upon achange in control and the vesting of the remaining unvested equity awards for those shareowners that are involuntarily terminated within a year of the changein control.Pursuant to its terms, effective as of February 20, 2014, no further awards may be granted under the 2004 EIP; however, that plan continues to governall awards previously issued under it (many of which remain outstanding). In March 2014, the Compensation Committee (the "Compensation Committee") ofthe Board of Directors of the Company adopted the 2014 Equity Incentive Plan of NuVasive, Inc. (the "2014 EIP"), which was approved by the Company'sstockholders at its 2014 Annual Meeting of Stockholders and provides the Company with the ability to grant various types of equity awards to its workforce.(including, without limitation, restricted stock units, restricted stock awards, performance awards, and deferred stock awards). The 2014 EIP also provides forthe issuance of RSUs to be granted to officers subject to time- and/or performance-based vesting requirements which such RSUs generally vest annually at25% per year beginning one year from date of grant (presuming that any applicable performance criteria is met). In addition, the award agreements under the2014 EIP generally provide for the acceleration of 50% of the unvested equity awards of all shareowners upon a change in control and the vesting of theremaining unvested equity awards for those shareowners that are involuntarily terminated within a year of the change in control. 89Table of ContentsEach of the 2004 EIP and the 2014 EIP allow for “net share settlement” of certain equity awards whereby, in lieu of (i) making cash payments insatisfaction of the exercise price owed respective to non-qualified stock option awards, or (ii) open market selling award shares to generate cash proceeds foruse in satisfaction of statutory tax obligations respective to an award’s settlement or exercise, the company offsets the award shares being settled in arespective transaction by the number of shares of company stock with a value equal to the respective obligation, and, in the case of taxes, making a cashpayment to the respective taxing authority on behalf of the shareowner using company cash. The net share settlement is accounted for with the cost of anyaward shares that are net settled being included in treasury stock and reported as a reduction in total equity at the time of settlement.Additionally, the NuVasive, Inc. 2004 Amended and Restated Employee Stock Purchase Plan (the ESPP), provides eligible employees with a means ofacquiring equity in the Company through accumulated payroll deductions and at a discounted purchase price.The Company estimates the fair value of stock options and shares issued to employees under the ESPP using a Black-Scholes option-pricing model onthe date of grant. The Black-Scholes option-pricing model incorporates various and highly sensitive assumptions including expected volatility, expectedterm and risk-free interest rates. The expected volatility is based on the historical volatility of the Company’s common stock over the most recent periodcommensurate with the estimated expected term of the Company’s stock options and ESPP which is derived from historical experience. The risk-free interestrate for periods within the contractual life of the option is based on the U.S. Treasury yield in effect at the time of grant. The Company has never declared orpaid dividends and has no plans to do so in the foreseeable future. The fair value of RSUs and Performance-Based Restricted Stock Units (PRSU) is based onthe stock price on the date of grant. The fair value of the performance based restricted stock units that are earned based on the achievement of pre-definedmarket conditions for total stockholder return (“TSR PRSU”) is estimated on the date of grant using a Monte Carlo valuation model. The key assumptions inapplying this model are an expected volatility and a risk free interest rate. The fair value of equity instruments that are expected to vest are recognized andamortized on an accelerated basis over the requisite service period.The compensation cost that has been included in the statement of operations for our stock-based compensation plans was as follows (in thousands): Year Ended December 31, 2014 2013 2012 Sales, marketing and administrative expense $31,514 $31,425 $24,096 Research and development expense 1,841 1,649 2,138 Cost of goods sold 332 166 78 Stock-based compensation expense before taxes 33,687 33,240 26,312 Related income tax benefits (13,475) (13,296) (10,525)Stock-based compensation expense, net of taxes $20,212 $19,944 $15,787 As of December 31, 2014, there was $18.5 million and $4.8 million of unrecognized compensation expense for RSUs and Performance Awards,respectively, which is expected to be recognized over a weighted-average period of approximately 1.7 years and 1.5 years, respectively. In addition, as ofDecember 31, 2014, there was $1.1 million of unrecognized compensation expense for shares expected to be issued under the ESPP which is expected to berecognized through April 2016. The unamortized expense for options was immaterial as of December 31, 2014.The benefits of tax deductions in excess of recognized compensation cost is required to be reported as a financing cash flow. Excess tax benefits of$11.9 million, $13.6 million, and $3.0 million were reported as financing cash flows for the years ended December 31, 2014, 2013, and 2012 respectively.Stock Options. The aggregate intrinsic value of outstanding stock options at December 31, 2014 is based on the Company’s closing stock price onDecember 31, 2014 of $47.16. The Company received $17.5 million, $3.4 million and $0.5 million in proceeds from the exercise of stock options during theyears ended December 31, 2014, 2013 and 2012, respectively. The total intrinsic value of options exercised was $17.6 million, $2.0 million, and $0.4 millionduring the years ended December 31, 2014, 2013 and 2012, respectively. The total fair value of options that vested during the year ended December 31,2014, 2013 and 2012 was $3.5 million, $6.8 million, and $15.1 million, respectively. The Company did not grant any stock options during the years endedpresented.Following is a summary of stock option activity for the year ended December 31, 2014 under all stock plans (in thousands, except years and pershare amounts): 90Table of Contents Weighted-Average Remaining Weighted Contractual Aggregate Avg. Exercise Term Intrinsic Shares Price (Years) Value Outstanding at December 31, 2013 6,362 $30.75 4.71 $24,996 Exercised (1,030) 23.54 Cancelled (46) 35.25 Outstanding at December 31, 2014 5,286 32.11 3.88 $79,594 Exercisable at December 31, 2014 5,261 $32.14 3.87 $79,047 Vested or expected to vest at December 31, 2014 5,286 $32.11 3.88 $79,594 Restricted Stock Units. Time-based restricted stock units (RSUs) represent a right to receive shares of common stock at a future date determined inaccordance with the terms and conditions of a participant’s award agreement (issued under either the 2004 EIP or 2014 EIP). No exercise price or othermonetary payment are required for receipt of RSUs or the shares issued in settlement of the respective awards (provided that tax withholding obligationsnonetheless apply); instead, consideration is furnished in the form of the participant’s services to the Company. Time-based RSUs have graded vesting termsof up to four years. Total compensation cost for these awards is generally based on the fair value of the award on the date of grant.The Company is required to estimate at the grant date the value of awards that are anticipated to be forfeited prior to their vesting. This estimatedforfeiture rate is subject to revision in subsequent periods on a cumulative basis in the period the estimated forfeiture rates change. The Company consideredits historical experience of pre-vesting forfeitures on RSUs by employee (“shareowner”) homogenous group as the basis to arrive at its estimated annual pre-vesting forfeiture rate of 0% to 7% per year as of December 31, 2014.The total fair value of RSUs that vested during the year ended December 31, 2014, 2013 and 2012 was $27.5 million, $10.4 million and $5.6 million,respectively.Following is a summary of RSU activity for the year ended December 31, 2014 (in thousands, except per share amounts): Weighted Average Number of Grant Date Shares Fair Value Nonvested at December 31, 2013 2,304 $19.77 Granted 753 36.62 Vested (773) 21.36 Forfeited (218) 23.07 Nonvested at December 31, 2014 2,066 $24.99 Performance-Based Restricted Stock Units. During the first quarter of 2012, the Compensation Committee of the Board of Directors (theCompensation Committee) granted PRSUs to certain senior executives that were ultimately earned based on the achievement of Compensation Committee-established, pre-defined company-specific performance criteria (Performance Conditions) for the year ended December 31, 2012 (the 2012 PRSUs). Eachrecipient was eligible to receive between 0% and 250% of the target number of shares of company common stock subject to the applicable award, with thefinal multiplier being based on the company’s actual performance in 2012 against the Performance Conditions. Based upon the company’s actualperformance against the Performance Conditions, approximately 117,000 shares of common stock vested on each of March 1, 2013 and March 1, 2014 forsuch 2012 PRSUs and an additional 117,000 shares will vest on March 1, 2015 (subject to continuous service to the Company through the vesting date) (ineach case, in the aggregate for all award recipients). The associated expense for these 2012 PRSUs was measured by the probability of the achievement onthe pre-defined performance matric, and then adjusted to the actual achievement upon completion of the performance criteria. The associated expense isbeing amortized over the three-year vesting period from the date of grant.During the first quarter of 2013, the Compensation Committee granted TSR PRSUs to certain senior executives that were earned based on thecompany’s achievement of Compensation Committee-established, pre-defined market conditions (Market Conditions) for the year ended December 31, 2013(the 2013 PRSUs). The TSR PRSUs vest in two equal installments on February 1, 2014 and February 1, 2015 so long as the recipient provides continuedservice to the company through the vesting date. Each recipient was eligible to receive between 0% and 350% of the target number of shares of companycommon stock subject to the applicable award, with the final multiplier being based on the company’s actual performance in 2013 against the MarketConditions. Based upon the company’s actual performance against the Market Conditions, approximately 470,000 shares of common stock vested onFebruary 1, 91Table of Contents2014 and an additional 470,000 shares vested on February 1, 2015 (subject to continuous service to the Company through the vesting date) (in each case, inthe aggregate for all award recipients). The expense was based on the Market Conditions and measured on the date of grant using a Monte Carlo model andthe associated expense is amortized over the two-year vesting period from the date of grant.During the first quarter of 2014, the Compensation Committee granted PRSUs with performance criteria measured by the Company’s TSR and totalrevenue growth over the two-year performance period spanning calendar years 2014 and 2015, with each performance metric being weighted equally anddetermined independently (the 2014 PRSUs). The Company’s two-year TSR is measured as the change in the Company’s stock price between the openingstock price for 2014 and December 31, 2015, with the latter price being measured as the 15 trading-day trailing average of the Company’s stock price as ofDecember 31, 2015 (without adjusting for dividends). The target TSR is the median TSR of the companies comprising the Dow Jones Medical Devices Index.Should the Company’s TSR over such two-year period be in excess of the 90th percentile of the index, the eligible executives will earn a number of shares ofCompany common stock equal to 250% of the target amount of the 2014 PRSUs being awarded for this goal. Conversely, no shares would be awarded if theCompany’s two-year TSR is below the 30th percentile of the index; provided, however, that, if the Company’s TSR during the two-year performance period ismore than 5%, then, notwithstanding the Company’s percentile ranking, the minimum multiplier for this performance metric would be 25%. Revenue growthperformance is measured as total revenue growth against the target revenue growth as determined by the Compensation Committee, measured over the two-year performance period spanning fiscal years 2014 and 2015. Should the Company achieve 185.7% of the target revenue growth goal over such two-yearperiod, eligible executives will earn a number of shares of Company common stock equal to 250% of the target amount of the 2014 PRSUs being awarded forthis goal. Conversely, no shares would be awarded upon achievement of less than 28.6% of the target revenue growth goal. The number of shares achievedwith respect to the 2014 PRSUs will be determined in or around January 2016, upon the Compensation Committee’s determination of the Company’s two-year TSR and total revenue growth over the two year performance period as compared to the respective targets. Following such determination date, half ofany achieved 2014 PRSUs shares will vest promptly, and the remaining half will vest on the one-year anniversary of such determination date (e.g. in 2017),subject, in all cases, to continuous service to the Company through each of the vesting dates and certain, limited vesting acceleration criteria (i.e., in theevent of a change of control). The fair value of the 2014 PRSUs based on the TSR performance metric is measured on the date of grant using a Monte Carlo model and the associatedexpense is amortized over the three-year period from the date of grant. The fair value of the PRSUs based on the revenue growth performance metric ismeasured on the date of grant, considering a probability of achieving the specific goals, and expense is amortized over the three-year vesting period. TheCompany re-evaluates the probability of achieving the specific goals each reporting period and adjusts the related expense accordingly. The Companyconsidered its historical experience of pre-vesting forfeitures on PRSUs and determined to apply no forfeiture rate as of December 31, 2014 due to minimalforfeiture activity in its history in PRSU recipients. The total fair value of performance awards vested during the year ended December 31, 2014 and 2013 was $21.6 million and $2.3 million,respectively. Following is a summary of PRSU activity for the year ended December 31, 2014 (in thousands, except per share amounts): Maximum Number Shares of Shares Eligibleto be Issued Average GrantDate Fair Value Outstanding at December 31, 2013 503 1,175 $18.51 Awarded at target 153 382 36.39 Achieved in excess of target 672 — 19.24 Vested (588) (588) 18.52 Forfeited (13) (33) 36.39 Outstanding at December 31, 2014 727 936 $21.96 Employee Stock Purchase Plan. Under the terms of the ESPP, employees can elect to have up to 15% of their annual compensation, up to a maximumof $21,250 per year withheld to purchase shares of NuVasive common stock at a discount. The purchase price of the common stock is equal to 85% of thelower of the fair market value per share of the common stock on the commencement date of the two-year or six-month offering period (depending on thepurchase period enrolled) or the end of each semi-annual purchase period. In the years ended December 31, 2014, 2013 and 2012, 268,000, 417,000, and369,000 shares, respectively, were purchased under the ESPP. 92Table of ContentsThe weighted average assumptions used to estimate the fair value of stock options granted and stock purchase rights under the ESPP are as follows: Year Ended December 31, 2014 2013 2012 ESPP Volatility 46% 55% 57%Expected term (years) 1.3 1.5 1.6 Risk free interest rate 0.2% 0.2% 0.2%Expected dividend yield —% —% —% Common Stock Reserved for Future Issuance. The following table summarizes common shares reserved for issuance at December 31,2014 on exercise or conversion of (in thousands): Common stock options: Issued and outstanding 5,286 Available for future grant 2,516 Available for issuance under the ESPP 1,758 Issued and outstanding RSUs and PRSUs 3,063 2017 Notes 12,419 Senior Convertible Note warrants 19,106 Total shares reserved for future issuance 44,148 9. Income TaxesThe income (loss) before income taxes by region is summarized as follows (in thousands): Year Ended December 31, 2014 2013 2012 United States $11,462 $8,818 $10,723 Foreign (22,672) 950 533 Total (loss) income before income taxes $(11,210) $9,768 $11,256 The components of income tax expense (benefit) consist of the following (in thousands): Year Ended December 31, 2014 2013 2012 Current income tax expense: Federal $32,387 $10,484 $941 State 3,359 2,718 3,235 Foreign 2,259 922 113 Total current 38,005 14,124 4,289 Deferred income tax benefit (expense): Federal (28,102) (8,060) 6,551 State (2,281) (905) (1,588)Foreign (1,336) (2,376) (438)Total deferred (31,719) (11,341) 4,525 Total income tax expense from continuing operations $6,286 $2,783 $8,814 93Table of ContentsFor the year ended December 31, 2014, the total income tax expense differs from the statutory federal income tax rate (35%) mainly due to thenegative impact from our globalization initiative project and non-deductible expenses primarily relating to executive compensation stock, offset by generalbusiness and domestic manufacturing credits and discrete benefits relating to disqualifying dispositions of qualified stock grants. The globalizationinitiative which started during 2013 and became effective in January 2014 involved establishing new international operations and entering into newintercompany transfer pricing arrangements, including the licensing of intangibles. As part of the initiative the Company expects a negative impact on thetax rate in the implementation years with longer term benefits as international operations expand.For the year ended December 31, 2013, the total income tax expense differs from the statutory federal income tax rate (35%) due to the negativeimpact of non-deductible expenses primarily relating to stock based compensation, offset by general business credits which also included the credits for 2012that were retroactively reinstated.For the year ended December 31, 2012, the total income tax expense differs from the statutory federal income tax rate (35%) due to the negativeimpact of state taxes and non-deductible expenses primarily relating to goodwill impairment and stock based compensation, offset by the change invaluation allowance.These differences are the result of the following items (in thousands): Year Ended December 31, 2014 2013 2012 Provision at statutory rate $(3,923) $3,419 $3,940 Foreign provision in excess of federal statutory rate (199) 205 37 State income tax (benefit) expense, net of federal benefit 827 (222) 2,189 Globalization initiative 9,244 — — Stock compensation expense (benefit) (677) 887 1,561 Non-deductible meals & entertainment 521 343 655 Research and experimental credits (1,459) (1,668) Domestic manufacturing deduction (739) — — Executive compensation 2,105 165 — Impairment charges — — 2,905 Other (207) 50 (320)Change in valuation allowance 793 (396) (2,153)Total income tax (benefit) expense $6,286 $2,783 $8,814 Deferred income taxes reflect the net tax effect of temporary differences between the carrying amount of assets and liabilities for financial reportingpurposes and the amounts used for income tax purposes. Significant components of the Company’s deferred tax assets and liabilities are as follows (inthousands): December 31, 2014 2013 Deferred Tax Assets: Net operating loss carry-forwards $6,638 $6,970 Stock based compensation 36,104 37,204 General business credit carry-forwards 4,336 3,215 Litigation and related accrual 66,307 49,779 Other 14,624 12,311 Gross deferred tax assets 128,009 109,479 Valuation allowance (11,026) (9,175)Net deferred tax assets $116,983 $100,304 Deferred Tax Liabilities: Capitalized assets $(6,507) $(16,194)Original issue discount (1,629) (2,276)Acquired intangibles (293) (4,829)Deferred tax liabilities (8,429) (23,299)Consolidated net deferred tax assets 108,554 77,005 Add: Deferred tax liability, net, attributable to non-controlling interests 1,681 1,681 Net deferred tax assets $110,235 $78,686 94Table of ContentsIn assessing the realizability of deferred tax assets, the Company considered whether it is more likely than not that some portion or all of the deferredtax assets will be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods inwhich those temporary differences become deductible. Based on all available evidence, the Company has concluded that it is more likely than not that it willbe able to realize the benefit of the federal deferred tax assets in the future.At December 31, 2014, the Company has federal net operating loss carryforwards of $11.2 million that begin to expire in 2017. In addition, theCompany has California and foreign net operating loss carryforwards of approximately $3.3 million and $8.6 million, respectively. The California andforeign net operating loss carryforwards begin to expire in 2016 and 2018, respectively.At December 31, 2014, the Company has California R&D credit carryforwards of approximately $8.8 million that can be carried forward indefinitely.IRC §382 limits the utilization of tax carryforwards that arise prior to certain cumulative changes in a corporation’s ownership. During 2012, theCompany completed a formal IRC §382 study with respect to potential ownership changes and additional limitations were not identified. Previouslimitations due to §382 have been reflected in the deferred tax assets at December 31, 2014.In accordance with authoritative guidance, the impact of an uncertain income tax position on the income tax return must be recognized at the largestamount that is more-likely-than-not to be sustained upon audit by the relevant taxing authority. An uncertain income tax position will not be recognized if ithas less than a 50% likelihood of being sustained.A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows (in thousands): Year Ended December 31, 2014 2013 2012 Unrecognized tax benefit at the beginning of the year $4,504 $4,399 $4,279 Additions from tax positions taken in the current year 2,574 13 100 Additions from tax positions taken in prior years 5,294 92 20 Unrecognized tax benefit at the end of the year $12,372 $4,504 $4,399 At December 31, 2014, 2013 and 2012, $7.2 million, $3.2 million and $3.2 million, respectively, of the Company’s total unrecognized tax benefits, ifrecognized, would affect the effective income tax rate. The Company does not anticipate there will be a significant change in unrecognized tax benefitswithin the next 12 months.The Company’s policy is to recognize interest and penalties related to income tax matters in income tax expense. As the unrecognized tax benefitsrelate to un-utilized deferred tax assets and because the Company has generated net operating losses since inception for both federal and state income taxpurposes through 2009, no additional tax liability, penalties or interest have been recognized for balance sheet or statement of operations purposes as of andfor the periods ended December 31, 2014 and 2013.The Company is subject to taxation in the U.S. and various foreign and state jurisdictions. All of the Company’s tax years are subject to examinationdue to the carry forward of un-utilized net operating losses and R&D credits.The Company does not record U.S. income taxes on the undistributed earnings of its foreign subsidiaries based upon the Company’s intention topermanently reinvest undistributed earnings to ensure sufficient working capital and further expansion of existing operations outside the United States. Theundistributed earnings of the foreign subsidiaries as of December 31, 2014 are immaterial. In the event the Company is required to repatriate funds fromoutside of the United States, such repatriation would be subject to local laws, customs, and tax consequences. 10. Business Segment, Product and Geographic InformationThe Company operates in one segment based upon the Company’s organizational structure, the way in which the operations are managed andevaluated by the chief operating decision maker (“CODM”) and the lack of availability of discrete financial information. The Company’s CODM reviewsrevenue at the product line offering level, and manufacturing, operating income and expenses, and net income at the Company wide level to allocateresources and assess the Company’s overall performance. The Company shares common, centralized support functions, including finance, human resources,legal, information technology, and corporate marketing, all of which report directly to the CODM. Accordingly, decisions regarding the Company’s overalloperating performance and allocation of Company resources are assessed on a consolidated basis. We believe it is appropriate to operate as one reportingsegment. The Company has disclosed the revenues for each of its product line offerings to allow the reader of the financial statements the ability to gain sometransparency into the operations of the Company. 95Table of ContentsThe Company operates under three distinct product lines for revenue; Spine Surgery Products, Biologics, and Monitoring Service. The Company’sSpine Surgery Products line offerings, which include thoracolumbar product offerings, cervical product offerings and disposables, are primarily used toenable access to the spine and to perform restorative and fusion procedures in a minimally disruptive fashion. The Company’s Biologics product lineofferings includes allograft (donated human tissue), FormaGraft® (a collagen synthetic product), Osteocel® Plus and Osteocel® Pro (each an allograft cellularmatrix containing viable mesenchymal stem cells, or MSCs), and AttraX® (a synthetic bone graft material), all of which are used to aid the spinal fusion orbone healing process. The Company’s Monitoring Service offering includes IOM services.Revenue by product line offerings was as follows: Year Ended December 31, (in thousands) 2014 2013 2012 Spine Surgery Products $590,471 $530,370 $471,186 Biologics 129,570 115,633 110,179 Monitoring Service 42,374 39,170 38,890 Total Revenue $762,415 $685,173 $620,255 Revenue and property and equipment, net, by geographic area were as follows: Revenue Property and Equipment, Net Year Ended December 31, December 31, (in thousands) 2014 2013 2012 2014 2013 United States $667,850 $620,363 $575,255 $105,022 $109,458 International (excludes Puerto Rico) 94,565 64,810 45,000 23,543 18,606 Total $762,415 $685,173 $620,255 $128,565 $128,064 11. ContingenciesThe Company is subject to potential liabilities under government regulations and various claims and legal actions that are pending or may be assertedfrom time-to-time. These matters arise in the ordinary course and conduct of the Company's business and include, for example, commercial, intellectualproperty, environmental, securities and employment matters. The Company intends to continue to defend itself vigorously in such matters. Furthermore, theCompany regularly assesses contingencies to determine the degree of probability and range of possible loss for potential accrual in its financial statements.An estimated loss contingency is accrued in the Company's financial statements if it is probable that a liability has been incurred and the amount ofthe loss can be reasonably estimated. Based on the Company's assessment, it has adequately accrued an amount for contingent liabilities currently inexistence. The Company does not accrue amounts for liabilities that it does not believe are probable or that it considers immaterial to its overall financialposition. Litigation is inherently unpredictable, and unfavorable resolutions could occur. As a result, assessing contingencies is highly subjective andrequires judgment about future events. The amount of ultimate loss may exceed the Company's current accruals, and it is possible that its cash flows or resultsof operations could be materially affected in any particular period by the unfavorable resolution of one or more of these contingencies.Legal ProceedingsMedtronic Sofamor Danek USA, Inc. LitigationIn August 2008, Warsaw Orthopedic, Inc., Medtronic Sofamor Danek USA, Inc. and other Medtronic related entities (collectively, "Medtronic") filed apatent infringement lawsuit against the Company in the United States District Court for the Southern District of California (the "Medtronic Litigation"),alleging that certain of the Company's products or methods, including the XLIF® procedure, infringe, or contribute to the infringement of, twelve U.S. patentsassigned or licensed to Medtronic. Three of the patents were later withdrawn by Medtronic, leaving nine purportedly infringed patents. The Companybrought counterclaims against Medtronic alleging infringement of certain of the Company's patents. 96Table of ContentsThe case has been administratively broken into several phases. The first phase of the case included three Medtronic patents and one the Companypatent. Trial on the first phase of the case concluded on September 20, 2011 and a jury delivered an unfavorable verdict against the Company with respect tothe three Medtronic patents and a favorable verdict with respect to the one NuVasive patent at hand. The jury awarded monetary damages of approximately$101.2 million to Medtronic, which includes lost profits and back royalties (the "2011 verdict"). Medtronic's subsequent motion for a permanent injunctionwas denied by the District Court on January 26, 2012. On March 19, 2012, the District Court issued an order granting prejudgment interest with respect to thepatent infringements determined in the 2011 verdict, and, on June 11, 2013, the District Court ruled on the respective ongoing royalty rates (the "June 2013ruling"). On August 20, 2013, the Company and Medtronic filed their respective notices of appeal of such decisions, and the appeal is now proceeding beforethe U.S. Court of Appeals for the Federal Circuit. In addition, on March 19, 2012, in connection with these proceedings, the Company entered into an escrowarrangement and transferred $113.3 million of cash into a restricted escrow account to secure the amount of judgment, plus prejudgment interest, duringpendency of the appeal. These funds are included in restricted cash and investments on the Company's December 31, 2014 consolidated balance sheet.In accordance with the authoritative guidance on the evaluation of loss contingencies, during the year ended December 31, 2011, the Companyrecorded an accrual of $101.2 million for the 2011 verdict. In addition, on sales subsequent to the 2011 verdict and through March 31, 2013, the Companyaccrued royalties at the royalty rates stated in the 2011 verdict, and, upon receiving the June 2013 ruling, the Company began accruing ongoing royalties onsales at the royalty rates stated in the June 2013 ruling, and recorded a charge of approximately $7.9 million to account for the difference between using theroyalty rates stated in the 2011 verdict and those in the June 2013 ruling on sales through March 31, 2013. As a result of the June 2013 ruling, the Companyhas agreed to escrow funds to secure accrued royalties, estimated at $29.4 million to date, as well as future ongoing royalties. The Company is also accruingpost-judgment interest. With respect to the prejudgment interest award, the Company, based on its own assessment, as well as that of outside counsel,believes a reversal of the prejudgment interest award on appeal is probable, and, therefore - in accordance with authoritative guidance on the evaluation ofloss contingencies - has not recorded an accrual for this amount, which is estimated to approximate $13.0 million. Additional damages (including interest)may still be awarded, and, as of December 31, 2014, the Company cannot estimate a range of additional potential loss. With respect to the favorable verdict delivered regarding the one NuVasive patent litigated to verdict, the jury awarded the Company monetarydamages of approximately $0.7 million for reasonable royalty damages. In accordance with the authoritative guidance on the evaluation of gaincontingencies, this amount has not been recorded at December 31, 2014. Additionally, the June 2013 ruling determined the ongoing royalty rate to be paidto the Company by Medtronic for its post-verdict sales of the one NuVasive patent. Consistent with the treatment afforded the $0.7 million damage award, noamount has been recorded for royalty revenue as of December 31, 2014.The second phase of the case involved one Medtronic cervical plate patent. On April 25, 2013, the Company and Medtronic entered into a settlementagreement fully resolving the second phase of the case. The settlement also removes from the case the cervical plate patent that was part of the first phase. Aspart of the settlement, the Company received a broad license to practice (i) the Medtronic patent that was the sole subject of the second phase of thelitigation, (ii) the Medtronic patent that was part of the first phase of the litigation, and (iii) each of the Medtronic patent families that collectively representthe vast majority of Medtronic's patent rights related to cervical plate technology. In exchange for these license rights, the Company made a one-timepayment to Medtronic of $7.5 million, which amount will be fully offset against any damage award ultimately determined to be owed by the Company inconnection with a final resolution of the first phase of the litigation. In addition, Medtronic will receive a royalty on certain cervical plate products sold bythe Company, including the Helix® and Gradient® lines of products. As a result of this settlement, all current patent disputes between the parties related tocervical plate technology have been resolved. Accordingly, the Company's accrual for the case for the year ended December 31, 2014 was reduced to $93.7million (down $7.5 million from the original accrual made and booked since September 2011 as a result of a $7.5 million payment made in 2013). 97Table of ContentsIn August 2012, Medtronic filed additional patent claims in the U.S. District Court for the Northern District of Indiana alleging that various NuVasivespinal implants (including its CoRoent® XL family of spinal implants) infringe Medtronic's U.S. Patent No. 8,021,430, that NuVasive's Osteocel® Plus bonegraft product infringes Medtronic's U.S. Patent No. 5,676,146, (‘146 Patent) and that the Company's XLIF® procedure and use of MaXcess IV retractor duringthe XLIF procedure infringe methodology claims of Medtronic's U.S. Patent No. 8,251,997. The case, which is referred to herein as the third phase of theMedtronic litigation, was later transferred to the Southern District of California, and, on March 7, 2013, NuVasive counterclaimed alleging infringement byMedtronic of the Company's U.S. Patent Nos. 8,000,782 (systems and related methods for performing surgical procedures), 8,005,535 (systems and relatedmethods for performing surgical procedures), 8,016,767 (a surgical access system including a tissue distraction assembly and a tissue retraction assembly),8,192,356 (a system for accessing a surgical target site and related methods, involving an initial distraction system, among other things), 8,187,334 (spinalfusion implant), 8,361,156 (spinal fusion implant), D652,922 (dilator design), and D666,294 (dilator design). On July 25, 2013, Medtronic amended itscomplaint to add a charge of infringement of its U.S. Patent No. 8,444,696. The District Court has stayed litigation of a number of Medtronic and NuVasivepatents currently subject to reexamination or review proceedings conducted by the Patent Office. Summary judgment for the remaining patents, Medtronic’s‘146 Patent and the Company’s ‘922 Patent is set for February 2015. No trial date has been set for the ‘146 Patent or ‘922 Patent. At December 31, 2014, theprobable outcome of this litigation cannot be determined, nor can the Company estimate a range of potential loss. In accordance with the authoritativeguidance on the evaluation of loss contingencies, the Company has not recorded an accrual related to this litigation.Trademark Infringement LitigationOn September 25, 2009, Neurovision Medical Products, Inc. (NMP) filed suit against the Company in the U.S. District Court for the Central District ofCalifornia (Case No. 2:09-cv-06988-R-JEM) alleging trademark infringement and unfair competition. NMP sought cancellation of NuVasive's "NeuroVision"trademark registrations, injunctive relief and damages based on NMP's common law use of the "NeuroVision" mark. The matter was tried in October 2010 andan unfavorable jury verdict was delivered against the Company. The verdict awarded damages to NMP of $60.0 million, which was upheld in a January 2011judgment ordered by the District Court. NuVasive appealed the judgment, and during pendency of the appeal, NuVasive was required to escrow fundstotaling $62.5 million. In September 2012, the Court of Appeals reversed and vacated the District Court judgment and ordered the case back to the DistrictCourt for a new trial before a different judge. As a result, the full $62.5 million was released from escrow and returned to the Company. Retrial of the matterbegan on March 25, 2014, and on April 3, 2014, a jury returned a verdict in favor of NMP on its claims against the Company in the amount of $30.0 million. The Court affirmed the jury’s verdict, and on September 4, 2014, the Company filed a notice of appeal. The Court entered judgment and ordered a permanentinjunction on September 24, 2014, enjoining the Company's future use of the NeuroVision trademark to market or promote its products. The Court alsoentered an order canceling the Company's NeuroVision trademark registrations, but that order is stayed pending the appeal process. On December 2, 2014, theCourt denied NMP’s motion for attorneys’ fees, costs, and prejudgment interest, and NMP filed a notice of appeal on December 17, 2014. The appeals wereconsolidated on February 2, 2015, and resolution of the appeals may take up to two years. During pendency of the appeal, NuVasive has agreed to escrowfunds totaling $32.5 million to secure the amount of judgment, plus interest, attorney’s fees and costs. At December 31, 2014 jury verdict represents aprobable loss that can reasonably be determined. Accordingly, in accordance with the authoritative guidance on the evaluation of loss contingencies, theCompany has recorded a $30.0 million liability related to this litigation.Securities LitigationOn August 28, 2013, a purported securities class action lawsuit was filed in the United States District Court for the Southern District of Californianaming the Company and certain of its current and former executive officers for allegedly making false and materially misleading statements regarding theCompany's business and financial results, specifically relating to the purported improper submission of false claims to Medicare and Medicaid. Thecomplaint asserts a putative class period stemming from October 22, 2008 to July 30, 2013. The complaint alleges violations of Sections 10(b) and 20(a) ofthe Securities Exchange Act of 1934, as amended, and Rule 10b-5 promulgated thereunder and seeks unspecified monetary relief, interest, and attorneys' fees.On February 13, 2014, the lead plaintiff ("Plaintiff") filed an Amended Class Action Complaint for Violations of the Federal Securities Laws. In March 2014,the Company filed a motion to dismiss the Amended Class Action Complaint for Violations of the Federal Securities Laws. On August 19, 2014, the Courtgranted the Company's motion to dismiss and ordered Plaintiff to amend its complaint. Plaintiff filed a Second Amended Complaint on September 8, 2014.The Company once again moved to dismiss the complaint on September 22, 2014 and that motion was granted on December 9, 2014. On December 23, 2014Plaintiff filed a Third Amended Complaint. The Company filed a motion to dismiss the Third Amended Complaint on January 9, 2015. While theCompany’s motion was pending, Plaintiff sought leave to file a Fourth Amended Complaint. The Court took the hearing on NuVasive’s motion to dismissthe Third Amended Complaint off calendar and Plaintiff’s motion to file an amended complaint is pending. At December 31, 2014, the probable outcome ofthis litigation cannot be determined, nor can the Company estimate a range of potential loss. In accordance with authoritative guidance on the evaluation ofloss contingencies, the Company has not recorded an accrual related to this litigation. 98Table of Contents12. Regulatory MatterIn mid-2013, the Company received a federal administrative subpoena from the Office of the Inspector General of the U.S. Department of Health andHuman Services ("OIG") in connection with an investigation into possible false or otherwise improper claims submitted to Medicare and Medicaid. Thesubpoena seeks discovery of documents for the period January 2007 through April 2013. The Company is working with the OIG to understand the scope ofthe subpoena and to provide the requested documents. The Company has, and intends to, fully cooperate with the OIG's request. At December 31, 2014, theCompany is unable to determine the potential outcome and/or financial impact, if any, that will result from this investigation. 13. Quarterly Data (unaudited)The following quarterly financial data, in the opinion of management, reflects all adjustments, consisting of normal recurring adjustments necessary,for a fair presentation of results for the periods presented (in thousands, except per share amounts): Year Ended December 31, 2014 FirstQuarter (1) SecondQuarter (2) ThirdQuarter FourthQuarter Total revenues $177,496 $190,677 $189,918 $204,324 Gross profit 134,202 145,841 142,199 157,815 Consolidated net income (loss) (18,533) (4,270) (1,987) 7,292 Net income (loss) attributable to NuVasive, Inc. (18,276) (4,088) (1,830) 7,473 Basic net income (loss) per common share attributable to NuVasive, Inc. (0.40) (0.09) (0.04) 0.16 Diluted net income (loss) per common share attributable to NuVasive, Inc. (0.40) (0.09) (0.04) 0.15 Year Ended December 31, 2013 FirstQuarter SecondQuarter (3) ThirdQuarter FourthQuarter Total revenues $159,504 $165,698 $169,156 $190,815 Gross profit 120,408 116,954 125,865 141,462 Consolidated net income (loss) 596 (6,728) 7,280 5,837 Net income (loss) attributable to NuVasive, Inc. 851 (6,469) 7,511 6,009 Basic net income (loss) per common share attributable to NuVasive, Inc. 0.02 (0.15) 0.17 0.13 Diluted net income (loss) per common share attributable to NuVasive, Inc. 0.02 (0.15) 0.16 0.13 (1)Consolidated financial results include a one-time litigation liability charge of $30.0 million representing the reasonably estimated probable lossrelated to an unfavorable jury verdict.(2)Consolidated financial results include a one-time intangible assets impairment charge of $10.7 million related to the developed technology acquiredfrom Cervitech in 2009.(3)Consolidated financial results include a one-time royalty expense charge of $7.9 million, accounting for the difference in using the Medtronic royaltyrates stated in the September 2011 verdict and those in the June 2013 ruling on sales through March 31, 2013. 99Table of ContentsNuVasive, Inc.Schedule II: Valuation Accounts(In thousands) Balance atBeginning of Period AdditionsCharged toExpense (1) Deductions orOthers (2) Balance atEnd of Period Inventory Reserve Year ended December 31, 2014 $21,874 $11,425 $10,721 $22,578 Year ended December 31, 2013 $16,856 $10,003 $4,985 $21,874 Year ended December 31, 2012 $11,739 $9,324 $4,207 $16,856 (1)Amount represents excess and obsolete reserve recorded to cost of sales. (2)Excess and obsolete inventory write-off against reserve or reversal of reserve formerly established. 100Table of Contents ExhibitNumber Description 3.1 Restated Certificate of Incorporation (incorporated by reference to our Quarterly Report on Form 10-Q filedwith the Commission on August 13, 2004) 3.2 Certificate of Amendment to the Restated Certificate of Incorporation (incorporated by reference to ourCurrent Report on Form 8-K filed with the Commission on September 28, 2011) 3.3 Restated Bylaws (incorporated by reference to our Current Report on Form 8-K filed with the Commission onJanuary 6, 2012) 3.4 Amendment No. 1 to the Restated Bylaws (incorporated by reference to our Current Report on Form 8-K filedwith the Commission on May 19, 2014) 4.1 Specimen Common Stock Certificate (incorporated by reference to our Annual Report on Form 10-K filedwith the Commission on March 16, 2006) 4.2 Certificate of Designations of Series A Participating Preferred Stock filed with the Delaware Secretary of Stateon June 28, 2011 (incorporated by reference to our Current Report on Form 8-K filed with the Commission onJune 29, 2011) 4.3 Indenture dated June 28, 2011 between the Company and the Trustee (incorporated by reference to ourCurrent Report on Form 8-K filed with the Commission on June 29, 2011) 4.4 Form of 2.75% Convertible Senior Note due 2017 (incorporated by reference to our Current Report onForm 8-K filed with the Commission on June 29, 2011) 10.1# 2004 Amended and Restated Equity Incentive Plan (incorporated by reference to our Quarterly Report onForm 10-Q filed with the Commission on July 26, 2012) 10.2# Amendment No. 1 to the 2004 Amended and Restated Equity Incentive Plan (incorporated by reference toour Annual Report on Form 10-K filed with the Commission on March 3, 2014) 10.3# Form of Stock Option Award Notice under the 2004 Equity Incentive Plan (incorporated by reference toAmendment No. 1 to our Registration Statement on Form S-1 filed with the Commission on April 8, 2004) 10.4# Form of Option Exercise and Stock Purchase Agreement under the 2004 Equity Incentive Plan (incorporatedby reference to Amendment No. 1 to our Registration Statement on Form S-1 filed with the Commission onApril 8, 2004) 10.5# Form of Restricted Stock Unit Award Agreement under the 2004 Equity Incentive Plan (incorporated byreference to our Annual Report on Form 10-K filed with the Commission on February 26, 2010) 10.6# Form of Restricted Stock Grant Notice and Restricted Stock Agreement under the 2004 Amended andRestated Equity Incentive Plan (incorporated by reference to Amendment No.1 to our Registration Statementon Form S-1 filed with the Commission on April 8, 2004) 10.7# NuVasive, Inc. 2004 Amended and Restated Employee Stock Purchase Plan (incorporated by reference to ourQuarterly Report on Form 10-Q filed with the Commission on October 30, 2014) 10.8# 2014 Equity Incentive Plan (incorporated by reference to Exhibit A to our Definitive Proxy Statement filedwith the Commission on March 27, 2014)10.9# NuVasive, Inc. 2014 Executive Incentive Compensation Plan (incorporated by reference to Exhibit B to ourDefinitive Proxy Statement filed with the Commission on March 27, 2014) 10.10# Form of Indemnification Agreement between the Company and its directors and certain executives thereof(incorporated by reference to our Current Report on Form 8-K filed with the Commission on May 19, 2014) 10.11# NuVasive, Inc. Executive Severance Plan (incorporated by reference to our Current Report on Form 8-K filedwith the Commission on May 19, 2014) 10.12# Form of Change in Control Agreement between the Company and certain executives thereof (incorporated byreference to our Current Report on Form 8-K filed with the Commission on May 19, 2014) 10.13# Form of Compensation Letter Agreement dated March 4, 2011 between the Company and Keith C. Valentine(incorporated by reference to our Quarterly Report on Form 10-Q filed with the Commission on May 6, 2011) 101Table of ContentsExhibitNumber Description 10.14# Separation Letter Agreement dated December 13, 2013 between the Company and Craig Hunsaker(incorporated by reference to our Annual Report on Form 10-K filed with the Commission on March 3, 2014) 10.15# Transition Services Agreement dated April 29, 2014 between the Company and Michael J. Lambert(incorporated by reference to our Current Report on Form 8-K filed with the Commission on April 29, 2014) 10.16# Non-Employee Director Cash Compensation Plan (incorporated by reference to our Annual Report on Form10-K filed with the Commission on March 3, 2014) 10.17 Lease Agreement for Sorrento Summit dated November 6, 2007 between the Company and HCPI/Sorrento,LLC. (incorporated by reference to our Quarterly Report on Form 10-Q filed with the Commission onNovember 8, 2007) 10.18 Confirmation for base call option transaction dated June 22, 2011, between the Company and Bank ofAmerica, N.A. (incorporated by reference to our Current Report on Form 8-K filed with the Commission onJune 29, 2011) 10.19 Confirmation for additional call option transaction dated June 24, 2011, between the Company and Bank ofAmerica, N.A. (incorporated by reference to our Current Report on Form 8-K filed with the Commission onJune 29, 2011) 10.20 Confirmation for base call option transaction dated June 22, 2011, between the Company and Goldman,Sachs & Co. (incorporated by reference to our Current Report on Form 8-K filed with the Commission onJune 29, 2011) 10.21 Confirmation for additional call option transaction, dated June 24, 2011, between the Company andGoldman, Sachs & Co. (incorporated by reference to our Current Report on Form 8-K filed with theCommission on June 29, 2011) 10.22 Confirmation for base warrant transaction, dated June 22, 2011, between the Company and Bank of America,N.A. (incorporated by reference to our Current Report on Form 8-K filed with the Commission on June 29,2011) 10.23 Confirmation for additional warrant transaction, dated June 24, 2011, between the Company and Bank ofAmerica, N.A. (incorporated by reference to our Current Report on Form 8-K filed with the Commission onJune 29, 2011) 10.24 Confirmation for base warrant transaction, dated June 22, 2011, between the Company and Goldman, Sachs& Co. (incorporated by reference to our Current Report on Form 8-K filed with the Commission on June 29,2011) 10.25 Confirmation for additional warrant transaction, dated June 24, 2011, between the Company and Goldman,Sachs & Co. (incorporated by reference to our Current Report on Form 8-K filed with the Commission onJune 29, 2011) 10.26 Preferred Stock Purchase Agreement, dated January 13, 2009, among the Company, Progentix Orthobiology,B.V. and the sellers listed on Schedule A thereto (incorporated by reference to our Annual Report onForm 10-K filed with the Commission on February 26, 2010) 10.27† Option Purchase Agreement, dated January 13, 2009, among the Company, Progentix Orthobiology, B.V.and the sellers listed on Schedule A thereto (incorporated by reference to our Annual Report on Form 10-Kfiled with the Commission on February 26, 2010) 10.28† Exclusive Distribution Agreement, dated January 13, 2009, between the Company and ProgentixOrthobiology, B.V. (incorporated by reference to our Quarterly Report on Form 10-Q filed with theCommission on May 8, 2009) 10.29† Settlement and License Agreement, dated April 25, 2013, among the Company, Medtronic Sofamor DanekUSA, Inc., Warsaw Orthopedic, Inc., Medtronic Puerto Rico Operations Co. and Medtronic Sofamor DanekDeggendorf, GmbH (incorporated by reference to our Quarterly Report on Form 10-Q filed with theCommission on July 30, 2013) 21.1 List of subsidiaries of the Company 23.1 Consent of Independent Registered Public Accounting Firm 31.1 Certification of Chief Executive Officer pursuant to Rule 13a-14(a) and 15d-14(a) of the Securities ExchangeAct of 1934, as amended 31.2 Certification of Chief Financial Officer pursuant to Rule 13a-14(a) and 15d-14(a) of the Securities ExchangeAct of 1934, as amended 32.1* Certifications of the Chief Executive Officer and Chief Financial Officer pursuant to Rule 13a-14(b) of theSecurities Exchange Act of 1934, as amended, and 18 U.S.C. section 1350 101 XBRL Instance Document 102Table of ContentsExhibitNumber Description 101 XBRL Taxonomy Extension Schema Document 101 XBRL Taxonomy Calculation Linkbase Document 101 XBRL Taxonomy Label Linkbase Document 101 XBRL Taxonomy Presentation Linkbase Document 101 XBRL Taxonomy Definition Linkbase Document†Certain confidential information contained in this exhibit was omitted by means of redacting a portion of the text and replacing it with an asterisk. Wehave filed separately with the Commission an unredacted copy of the exhibit.#Indicates management contract or compensatory plan.*These certifications are being furnished solely to accompany this annual report pursuant to 18 U.S.C. Section 1350, and are not being filed forpurposes of Section 18 of the Securities Exchange Act of 1934 and are not to be incorporated by reference into any filing of NuVasive, Inc., whethermade before or after the date hereof, regardless of any general incorporation language in such filing. 103Exhibit 21.1 Subsidiaries of NuVasive, Inc. The following is a list of subsidiaries of the Company as of December 31, 2014, omitting subsidiaries which, considered in the aggregate, would notconstitute a significant subsidiary as defined by Rule 1-02(w) of Regulation S-X. Name Jurisdiction of Incorporation Impulse Monitoring, Inc. DelawareNuVasive Ireland IrelandNuVasive (AUS/NZ) Pty. Ltd. AustraliaNuVasive Germany, GmbH GermanyNuVasive PR, Inc. Puerto RicoCervitech, Inc. DelawareNuVasive International Technology IrelandNuVasive Netherlands B.V. NetherlandsNuVasive Japan K.K. JapanNuVasive UK Limited United Kingdom Exhibit 23.1 CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM We consent to the incorporation by reference in the following Registration Statements: (1) Registration Statement (Form S-3 Nos. 333-127634, 333-127842, 333-138047, and 333-140432) of NuVasive, Inc., (2) Registration Statement (Form S-8 No. 333-116546) pertaining to the 1998 Stock Option/Stock Issuance Plan, 2004 Equity Incentive Plan, and 2004Employee Stock Purchase Plan of NuVasive, Inc., (3) Registration Statement (Form S-8 Nos. 333-149478, 333-172465, 333-186896 and 333-193705) pertaining to the 2004 Equity Incentive Plan, asamended and restated, and 2004 Employee Stock Purchase Plan of NuVasive, Inc., and (4) Registration Statement (Form S-8 No. 333-196141) pertaining to the 2014 Equity Incentive Plan of NuVasive, Inc. of our reports dated February 24, 2015, with respect to the consolidated financial statements and schedule of NuVasive, Inc. and to the effectiveness ofinternal control over financial reporting of NuVasive, Inc. included in this Annual Report (Form 10-K) for the year ended December 31, 2014. /s/ ERNST & YOUNG LLP San Diego, CaliforniaFebruary 24, 2015 Exhibit 31.1I, Alexis V. Lukianov, certify that:1.I have reviewed this Annual Report on Form 10-K of NuVasive, Inc.;2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make thestatements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by thisreport;3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects thefinancial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;4.The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined inExchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f))for the registrant and have:a)Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, toensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within thoseentities, particularly during the period in which this report is being prepared;b)Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under oursupervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements forexternal purposes in accordance with generally accepted accounting principles;c)Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about theeffectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; andd)Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recentfiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely tomaterially affect, the registrant’s internal control over financial reporting; and5.The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to theregistrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):a)All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonablylikely to adversely affect the registrant’s ability to record, process, summarize and report financial information; andb)Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal controlover financial reporting. Date: February 24, 2015 /s/ Alexis V. LukianovAlexis V. LukianovChairman and Chief Executive Officer Exhibit 31.2I, Quentin S. Blackford, certify that:1.I have reviewed this Annual Report on Form 10-K of NuVasive, Inc.;2.Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make thestatements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by thisreport;3.Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects thefinancial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;4.The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined inExchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f))for the registrant and have:a)Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, toensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within thoseentities, particularly during the period in which this report is being prepared;b)Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under oursupervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements forexternal purposes in accordance with generally accepted accounting principles;c)Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about theeffectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; andd)Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recentfiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely tomaterially affect, the registrant’s internal control over financial reporting; and5.The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to theregistrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):a)All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonablylikely to adversely affect the registrant’s ability to record, process, summarize and report financial information; andb)Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal controlover financial reporting. Date: February 24, 2015 /s/ Quentin S. BlackfordQuentin S. BlackfordExecutive Vice President and Chief Financial Officer Exhibit 32.1CERTIFICATIONS OF CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICERPURSUANT TO 18 U.S.C. SECTION 1350, AS ADOPTED PURSUANT TOSECTION 906 OF THE SARBANES-OXLEY ACT OF 2002In connection with the Annual Report of NuVasive, Inc. (the Company) on Form 10-K for the year ended December 31, 2014, as filed with the Securities andExchange Commission on the date hereof (the Annual Report), I, Alexis V. Lukianov, Chairman and Chief Executive Officer of the Company, certify,pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that to my knowledge:1. The Annual Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and2. The information contained in the Annual Report fairly presents, in all material respects, the financial condition and results of operations of theCompany.Date: February 24, 2015 /s/ Alexis V. LukianovAlexis V. LukianovChairman and Chief Executive Officer In connection with the Annual Report, I, Quentin S. Blackford, Executive Vice President and Chief Financial Officer of the Company, certify, pursuant to 18U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that to my knowledge:1. The Annual Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and2. The information contained in the Annual Report fairly presents, in all material respects, the financial condition and results of operations of theCompany.Date: February 24, 2015 /s/ Quentin S. BlackfordQuentin S. BlackfordExecutive Vice President and Chief Financial Officer

Continue reading text version or see original annual report in PDF format above