HOLO Portal was just acquired for $0.9M. What just happened?

Augmedics may have just grabbed the deal of the century.

A quick background and three thoughts.


Surgalign spent $125M to acquire HOLO ($42M in cash and shares paid at closing, plus potential future milestone payments of up to $83 million). Then Surgalign spent 2 years getting HOLO to commercialization. I am going to guess that Surgalign had about $100M total invested in HOLO. Augmedics just bought HOLO assets for $900,000.

The HOLO Portal

HOLO Portal combines artificial intelligence and augmented reality guidance in spine surgery. It received FDA clearance for lumbar spine procedures in January 2022.  HOLO is the only FDA cleared AI/AR technology in the world. The first procedure using Holo Portal was completed in May at Carmel-based Indiana Spine Hospital.

HOLO uses “real” AI (unlike fake AI claims from other companies). HOLO has a large dataset of lumbar anatomies that feed the neural net to 1) determine if a pixel is bone or not bone 2) categorize one of 7 anatomies of a VB (3 figure out the optimal pedicle orientation. This is real Machine Learning application.

For what its worth, HOLO Portal™ Surgical Guidance System was awarded the 2022 Best New Technology Award from Orthopedics This Week.

Note to the orthopedics industry – There is no correlation between awards and success.

Thought #1 – Shame on Surgalign.

The Surgalign failure should be taught to all early stage leaders in orthopedics. The Surgalign CEO and Board gambled and drove a great asset into a dumpster fire sale with over-leveraged financial strategies. Surgalign reached a max market cap of $180M in May 2019. That same year, Surgalign posted $117M in gross sales of spine hardware. In 2020, they wanted to pivot from hardware to software. They leveraged their favorable financial situation (at the top of the market) to acquire HOLO. Then in 2022, Surgalign doubled-down on their gamble and acquired another digital asset, Inteneural Networsk for $100M while the Surgalign stock was plummeting. Crazy! Surgalign filed for Chapter 11 bankruptcy on June 19, 2023.

On July 31, 2023, the spine hardware assets of the company were sold off for $5.9M total through the bankruptcy process to Xtant before HOLO was sold off for $0.9M to Augmedics.

Thought #2 – Missed opportunity for others?

People LOVE HOLO. Surgalign employees exhibited great loyalty because they loved the technology. Surgeons loved the HOLO technology.

Most people in the industry thought that the HOLO asset would sell for at least $2-5M. It’s should be worth at least $10M.


  • Why didn’t a few of the Surgalign employees who know and love the HOLO potential put in a bid for $1M or more?
  • Why didn’t a venture group swoop in and buy this asset then sell it 12 months later for 10X?
  • Where were the big spine companies… Medtronic, Globus, DePuy-Synthes, Stryker or Nuvasive ?

Thought #3 – What’s next for HOLO?

What will Augmedics do with the HOLO Portal?

Augmedics Xvision system requires a headset, while the HOLO systems uses a transparent screen (with goggles that will be eliminated in the next version) over the surgical site. HOLO can be used in the future for any surgery, while Augmedics is specific to pedicle screw placement. Different hardware and different software – HOLO and Xvision . No obvious integration pathway forward.

My guess is that Augmedics will leverage their new HOLO Portal assets to weave a new story to prep for an IPO in 2024.

Time will tell.

Send me your thoughts – tiger@tigerbuford.com

Read articles about Augmedics here – https://orthostreams.com/?s=augmedics

Listen to my interview with Augmedics CEO/Founder back in 2018 here – https://www.youtube.com/watch?v=5QYNfpaXWME

The Augmedics press release

Augmedics Strengthens AR/AI Portfolio With Planned Acquisition of Surgalign Digital Health Assets (press release)

Augmedics, a pioneer in augmented reality (AR) surgical navigation, today announced it has been named the successful bidder for the digital health assets of Surgalign and Holo Surgical following a competitive auction process. The news comes a month following Augmedics’ $82.5 million raise to accelerate the adoption of augmented reality spine surgery and further strengthens the company’s AR and AI portfolio with intellectual property and other digital health assets.

“We are pleased to further expand our strong technical and intellectual property position in the field of augmented reality surgery with this planned acquisition”Tweet this

“We are pleased to further expand our strong technical and intellectual property position in the field of augmented reality surgery with this planned acquisition,” said Augmedics President & CEO Kevin Hykes. “Augmedics shares Surgalign’s passion for developing cutting-edge technology in the name of improved surgical outcomes. We look forward to leveraging these assets to further evolve the xvision platform.”

The sale will close pending approval by the Bankruptcy Court at a hearing set for August 8, 2023.

About Augmedics

Augmedics pioneers cutting-edge augmented reality technologies to improve surgical outcomes. The company’s revolutionary xvision Spine System® allows surgeons to see patients’ anatomy as if they have “x-ray vision” and accurately navigate instruments and implants during spine procedures. The first-of-its-kind, FDA-cleared xvision has been used to treat over 4,000 patients and implant more than 20,000 pedicle screws across 21 US states. xvision has consistently demonstrated 97-100% accuracy of pedicle screw placement across multiple patient studies.

Augmedics has received numerous honors, including being named a 2021 Index Awards Finalist, a Fast Company World Changing Ideas Awards 2021 Finalist, and one of Time Magazine’s Best Inventions of 2020. It was recently featured in The Economist documentary How will businesses use the metaverse?

To learn more or schedule an xvision demo, visit augmedics.com.


Alexa Bourdage

The Surgalign’s press release

Surgalign Holdings, Inc., (OTC: SRGAQ) (“Surgalign” or the “Company”), a global medical technology company focused on elevating the standard of care by driving the evolution of digital health, today announced that following a competitive court-supervised marketing and sale process, including a competitive auction, the Company has selected Xtant Medical Holdings, Inc. (“Xtant”) as the successful bidder for its hardware and biologics assets and Augmedics, Inc. as the successful bidder for its digital health assets (“Augmedics” and together with Xtant, the “Successful Bidders”). The sale and marketing process, including the auction, was conducted in accordance with bidding procedures approved by the United States Bankruptcy Court for the Southern District of Texas, Houston Division, where the Company’s chapter 11 cases are currently pending. The Official Committee of Unsecured Creditors participated in the auction as a consultation party.

Xtant’s bid for the hardware and biologics assets consists of a cash purchase price of $5 million and the assumption of certain liabilities, as set forth in the asset purchase agreement. In addition, Augmedics’s bid for the digital health assets consists of a cash purchase price of $900,000 and the assumption of certain liabilities, as set forth in the asset purchase agreement. Both of the Successful Bidders’ bids maximize the value and minimize the remaining duration of the Company’s chapter 11 proceedings by providing a clear path forward for the Company to consummate a chapter 11 plan and return value to its stakeholders.

Terry Rich, President and Chief Executive Officer of Surgalign, stated, “We are pleased to have concluded the sale process and believe with Xtant and Augmedics, our technology and its potential will live on. I cannot thank our customers and partners enough for their support through this process. Further, I want to acknowledge the entire Surgalign team for their unwavering commitment throughout the years, and for their ongoing passion to develop the best solutions to help drive better patient outcomes.”

The applicable asset purchase agreements between the Successful Bidders and the Company will be presented for approval to the Bankruptcy Court at the sale hearing set for August 8, 2023. The Successful Bidders and the Company will work to close the transactions promptly following approval of the sales by the Bankruptcy Court.

Additional information about Surgalign’s chapter 11 proceedings is available through the Company’s claims agent Kroll Restructuring Administration LLC (“Kroll”). Interested parties can view documents by visiting https://restructuring.ra.kroll.com/surgalign, or by calling the toll-free hotline at +1 (833) 939-6015 or for calls originating outside the U.S., by calling +1 (646) 440-4843. Inquiries can also be sent directly to Kroll at surgaligninfo@ra.kroll.com.

White & Case LLP is serving as the Company’s legal counsel, Alvarez & Marsal Securities, LLC is serving as investment banker, and Alvarez & Marsal North America, LLC is serving as financial advisor to the Company.

About Surgalign Holdings, Inc.
Surgalign Holdings, Inc. is a global medical technology company committed to the promise of digital health to drive transformation across the surgical landscape. Uniquely aligned and resourced to advance the standard of care, the company is building technologies physicians and other health providers will look to for what is truly possible for their patients. Surgalign is focused on developing solutions that predictably deliver superior clinical and economic outcomes. Surgalign markets products throughout the United States and in approximately 40 countries worldwide through an expanding network of top independent distributors. Surgalign is headquartered in Deerfield, IL, with commercial, innovation and design centers in San Diego, CA, Warsaw and Poznan, Poland, and Wurmlingen, Germany. Learn more at www.surgalign.com and connect on LinkedIn and Twitter.

Investor and Media Relations Contact:
Glenn Wiener
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