The existence and further duration of the COVID-19 pandemic may also further exacerbate certain risks as described in "Part II- Item 1A - Risk Factors" below.

Factors Affecting Results of Operations and Key Performance Indicators

Increase surgeon activity and training

We made significant progress in the number of covered lives for minimally invasive sacroiliac fusion in the U.S.

Components of Results of Operations

Cost of Goods Sold, Gross Profit, and Gross Margin

Interest income is primarily related to our investments of excess cash in money market funds and marketable securities.

Interest expense is primarily related to borrowings, amortization of debt issuance costs and accretion of final fees on the Solar and SVB Term Loan.

Other income (expense), net consists primarily of net foreign exchange gains and losses on foreign transactions.

We derive the majority of our revenue from sales to customers in the U.S. Revenue by geography is based on billing address of the customer. The table below summarizes our revenue by geography:

Comparison of the Three Months Ended March 31, 2022 and 2021

Revenue, Cost of Goods Sold, Gross Profit, and Gross Margin:

Research and Development Expenses. The increase in research and development expenses for the three months ended March 31, 2022 compared to the three months ended March 31, 2021 was primarily due to an increase of $0.4 million in employee related costs and stock-based compensation driven by increased headcount and an increase of $0.2 million due to increased clinical study, research and development activities and facilities costs.

Interest and Other Income (Expense), Net:

Total interest and other expense, net $ (542) $ (667) $ 125

Interest Income. The increase in interest income for the three months ended March 31, 2022 as compared to the three months ended March 31, 2021 was mainly due to higher interest earned on our investments in marketable securities, primarily as a result of higher interest rates.

In May 29, 2020, we entered into a term loan with Solar Capital Partners ("Solar"). Pursuant to the Loan and Security Agreement, Solar provided an aggregate principal amount of $40.0 million term loan (the "Solar Term Loan"). We paid in full and terminated the Solar Term Loan in August 2021.

This compared to $48.4 million of contractual obligations as of December 31, 2021 .

Cash Used in Operating Activities

Cash Provided by Financing Activities

Critical Accounting Policies, Significant Judgments, and Use of Estimates

We have no off-balance sheet arrangements that have, or are reasonably likely to have, a current or future effect on our financial condition, results of operations, liquidity, capital expenditures or capital resources that is material to investors.

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