Document:

exv10w20

Exhibit 10.20

December 10, 2008

Dear Mr. Lukianov,

     This amendment (this “Amendment”) to the letter agreement between NuVasive and you dated
August 5, 2008 (the “Original Agreement”, together with this Amendment, the “Agreement”) confirms
the material compensation terms of your continued employment with NuVasive. Except as otherwise
defined herein, defined terms used herein have the meanings set forth in the Appendix of Defined
Terms attached to the Original Agreement. The terms of the Original Agreement are modified as
follows:

	 	1.	 	A performance bonus, if any, that is payable to you shall be paid no later than
March 15th of the year following the calendar year in which it is earned.
	 
	 	2.	 	The definition of Severance Benefit is amended and restated in its entirety by
the following:

     “‘Severance Benefit’ upon any termination of your employment (whether voluntary or
involuntary) at any time, severance is equal to 200% of Compensation. Such amount shall be due and
payable immediately upon any such termination and upon the condition that you execute NuVasive’s
standard form of release of claims and that such release of claims becomes effective in accordance
with its terms on or prior to the 45th day following such termination.”

     No other amendments to the Original Agreement are contemplated by this Amendment and all
remaining terms set forth in the Original Agreement shall remain in full force and effect. We look
forward to your continued success with NuVasive.

	 	 	 	 	 
	 	Truly Yours,

NUVASIVE, INC.

 	 
	 	/s/ Eileen M. Moore
 	 
	 	Eileen M. More 	 
	 	 	 
	 

I have read and accept the terms of this letter.

	 	 	 
	/s/ Alexis V. Lukianov
 

Alexis V. Lukianovexv10w21

Exhibit 10.21

December 10, 2008

Dear Mr. Valentine,

     This amendment (this “Amendment”) to the letter agreement between NuVasive and you dated
August 5, 2008 (the “Original Agreement”, together with this Amendment, the “Agreement”) confirms
the material compensation terms of your continued employment with NuVasive. Except as otherwise
defined herein, defined terms used herein have the meanings set forth in the Appendix of Defined
Terms attached to the Original Agreement. The terms of the Original Agreement are modified as
follows:

	 	1.	 	A performance bonus, if any, that is payable to you shall be paid no later than
March 15th of the year following the calendar year in which it is earned.
	 
	 	2.	 	The definition of Severance Benefit is amended and restated in its entirety by
the following:

     “‘Severance Benefit’ is equal to the following: (1) upon an Involuntary Termination prior to a
Change of Control, Severance Benefit is equal to 100% of Compensation; (2) upon an Involuntary
Termination within 12 months following a Change of Control, Severance Benefit is equal to 150% of
Compensation; or (3) upon an Involuntary Termination more than 12 months following a Change of
Control, Severance Benefit is equal to 100% of Compensation. Such amount shall be due and payable
immediately upon any such termination and upon the condition that you execute NuVasive’s standard
form of release of claims and that such release of claims becomes effective in accordance with its
terms on or prior to the 45th day following such termination.”

     No other amendments to the Original Agreement are contemplated by this Amendment and all
remaining terms set forth in the Original Agreement shall remain in full force and effect. We look
forward to your continued success with NuVasive.

Truly Yours,

	 	 	 	 	 
	NUVASIVE, INC.
	 	 	 	 
	 
	 	 	 	 
	/s/ Alexis V. Lukianov
 

Alexis V. Lukianov

	 	/s/ Eileen M. More
 

Eileen M. More
	 	 

I have read and accept the terms of this letter.

	 	 	 
	/s/ Keith C. Valentine
 

Keith C. Valentineexv10w22

Exhibit 10.22

December 10, 2008

Dear Mr. O’Boyle,

     This amendment (this “Amendment”) to the letter agreement between NuVasive and you dated
August 5, 2008 (the “Original Agreement”, together with this Amendment, the “Agreement”) confirms
the material compensation terms of your continued employment with NuVasive. Except as otherwise
defined herein, defined terms used herein have the meanings set forth in the Appendix of Defined
Terms attached to the Original Agreement. The terms of the Original Agreement are modified as
follows:

	 	1.	 	A performance bonus, if any, that is payable to you shall be paid no later than
March 15th of the year following the calendar year in which it is earned.
	 
	 	2.	 	The definition of Severance Benefit is amended and restated in its entirety by
the following:

     “‘Severance Benefit’ is equal to the following: (1) upon an Involuntary Termination prior to a
Change of Control, Severance Benefit is equal to 100% of Compensation; (2) upon an Involuntary
Termination within 12 months following a Change of Control, Severance Benefit is equal to 150% of
Compensation; or (3) upon an Involuntary Termination more than 12 months following a Change of
Control, Severance Benefit is equal to 100% of Compensation. Such amount shall be due and payable
immediately upon any such termination and upon the condition that you execute NuVasive’s standard
form of release of claims and that such release of claims becomes effective in accordance with its
terms on or prior to the 45th day following such termination.”

     No other amendments to the Original Agreement are contemplated by this Amendment and all
remaining terms set forth in the Original Agreement shall remain in full force and effect. We look
forward to your continued success with NuVasive.

Truly Yours,

	 	 	 	 	 
	NUVASIVE, INC.
	 	 	 	 
	 
	 	 	 	 
	/s/ Alexis V. Lukianov
 

Alexis V. Lukianov

	 	/s/ Eileen M. More
 

Eileen M. More
	 	 

I have read and accept the terms of this letter.

	 	 	 
	/s/ Kevin O’Boyle
 

Kevin O’Boyleexv10w23

Exhibit 10.23

December 10, 2008

Dear Mr. Miles,

     This amendment (this “Amendment”) to the letter agreement between NuVasive and you dated
August 5, 2008 (the “Original Agreement”, together with this Amendment, the “Agreement”) confirms
the material compensation terms of your continued employment with NuVasive. Except as otherwise
defined herein, defined terms used herein have the meanings set forth in the Appendix of Defined
Terms attached to the Original Agreement. The terms of the Original Agreement are modified as
follows:

	 	1.	 	A performance bonus, if any, that is payable to you shall be paid no later than
March 15th of the year following the calendar year in which it is earned.
	 
	 	2.	 	The definition of Severance Benefit is amended and restated in its entirety by
the following:

     “‘Severance Benefit’ is equal to the following: (1) upon an Involuntary Termination prior to a
Change of Control, Severance Benefit is equal to 100% of Compensation; (2) upon an Involuntary
Termination within 12 months following a Change of Control, Severance Benefit is equal to 150% of
Compensation; or (3) upon an Involuntary Termination more than 12 months following a Change of
Control, Severance Benefit is equal to 100% of Compensation. Such amount shall be due and
payable immediately upon any such termination and upon the condition that you execute
NuVasive’s standard form of release of claims and that such release of claims becomes effective in
accordance with its terms on or prior to the 45th day following such termination.”

     No other amendments to the Original Agreement are contemplated by this Amendment and all
remaining terms set forth in the Original Agreement shall remain in full force and effect. We look
forward to your continued success with NuVasive.

Truly Yours,

	 	 	 	 	 
	NUVASIVE, INC.
	 	 	 	 
	 
	 	 	 	 
	/s/ Alexis V. Lukianov
 

Alexis V. Lukianov

	 	/s/ Eileen M. More
 

Eileen M. More
	 	 

I have read and accept the terms of this letter.

	 	 	 
	/s/ Patrick Miles
 

Patrick Milesexv10w24

Exhibit 10.24

December 10, 2008

Dear Mr. Rydin,

     This amendment (this “Amendment”) to the letter agreement between NuVasive and you dated
August 5, 2008 (the “Original Agreement”, together with this Amendment, the “Agreement”) confirms
the material compensation terms of your continued employment with NuVasive. Except as otherwise
defined herein, defined terms used herein have the meanings set forth in the Appendix of Defined
Terms attached to the Original Agreement. The terms of the Original Agreement are modified as
follows:

	 	1.	 	A performance bonus, if any, that is payable to you shall be paid no later than
March 15th of the year following the calendar year in which it is earned.
	 
	 	2.	 	The definition of Severance Benefit is amended and restated in its entirety by
the following:

     “‘Severance Benefit’ upon an Involuntary Termination at any time, severance is equal to 100%
of Compensation. Such amount shall be due and payable immediately upon any such termination and
upon the condition that you execute NuVasive’s standard form of release of claims and that such
release of claims becomes effective in accordance with its terms on or prior to the 45th day
following such termination.”

     No other amendments to the Original Agreement are contemplated by this Amendment and all
remaining terms set forth in the Original Agreement shall remain in full force and effect. We look
forward to your continued success with NuVasive.

Truly Yours,

	 	 	 	 	 
	NUVASIVE, INC.
	 	 	 	 
	 
	 	 	 	 
	/s/ Alexis V. Lukianov
 

Alexis V. Lukianov

	 	/s/ Eileen M. More
 

Eileen M. More
	 	 

I have read and accept the terms of this letter.

	 	 	 
	/s/ Jeffrey Rydin
 

Jeffrey Rydinexv10w25

Exhibit 10.25

December 10, 2008

Dear Mr. Hannon,

     This amendment (this “Amendment”) to the letter agreement between NuVasive and you dated
August 5, 2008 (the “Original Agreement”, together with this Amendment, the “Agreement”) confirms
the material compensation terms of your continued employment with NuVasive. Except as otherwise
defined herein, defined terms used herein have the meanings set forth in the Appendix of Defined
Terms attached to the Original Agreement. The terms of the Original Agreement are modified as
follows:

	 	1.	 	A performance bonus, if any, that is payable to you shall be paid no later than
March 15th of the year following the calendar year in which it is earned.
	 
	 	2.	 	The definition of Severance Benefit is amended and restated in its entirety by
the following:

     “‘Severance Benefit’ upon an Involuntary Termination at any time, severance is equal to 100%
of Compensation. Such amount shall be due and payable immediately upon any such termination and
upon the condition that you execute NuVasive’s standard form of release of claims and that such
release of claims becomes effective in accordance with its terms on or prior to the 45th day
following such termination.”

     No other amendments to the Original Agreement are contemplated by this Amendment and all
remaining terms set forth in the Original Agreement shall remain in full force and effect. We look
forward to your continued success with NuVasive.

Truly Yours,

	 	 	 	 	 
	NUVASIVE, INC.
	 	 	 	 
	 
	 	 	 	 
	/s/ Alexis V. Lukianov
 

Alexis V. Lukianov

	 	/s/ Eileen M. More
 

Eileen M. More
	 	 

I have read and accept the terms of this letter.

	 	 	 
	/s/ Jason Hannon
 

Jason Hannon

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