Alphatec (ATEC) 10-Q 4 Aug 15 2015 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2015	Aug. 03, 2015
Document And Entity Information [Abstract]
Entity Registrant Name	Alphatec Holdings, Inc.
Entity Central Index Key	1,350,653
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Document Type	10-Q
Trading Symbol	ATEC
Document Period End Date	Jun. 30, 2015
Document Fiscal Year Focus	2,015
Document Fiscal Period Focus	Q2
Amendment Flag	false
Entity Common Stock, Shares Outstanding		100,107,871

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($) $ in Thousands	Jun. 30, 2015	Dec. 31, 2014
Current assets:
Cash	$ 8,898	$ 19,735
Restricted cash	4,400	4,400
Accounts receivable, net	38,857	40,440
Inventories, net	41,237	41,747
Prepaid expenses and other current assets	4,203	5,466
Deferred income tax assets	2,479	1,324
Total current assets	100,074	113,112
Property and equipment, net	23,834	26,040
Goodwill	163,752	171,333
Intangibles, net	24,885	30,259
Other assets	1,627	4,179
Total assets	314,172	344,923
Current liabilities:
Accounts payable	10,422	10,130
Accrued expenses	28,147	35,393
Deferred revenue	1,001	1,300
Common stock warrant liabilities	6,985	8,702
Current portion of long-term debt	6,753	8,076
Total current liabilities	53,308	63,601
Long-term debt, less current portion	69,784	74,597
Other long-term liabilities	30,599	32,220
Deferred income tax liabilities	3,291	1,948
Redeemable preferred stock, $0.0001 par value; 20,000 authorized at June 30, 2015 and December 31, 2014; 3,319 shares issued and outstanding at both June 30, 2015 and December 31, 2014	23,603	23,603
Stockholders’ equity:
Common stock, $0.0001 par value; 200,000 authorized at June 30, 2015 and December 31, 2014; 100,107 and 99,856 shares issued and outstanding at June 30, 2015 and December 31, 2014, respectively	10	10
Treasury stock, at cost, 19 shares, at both June 30, 2015 and December 31, 2014	(97)	(97)
Additional paid-in capital	416,720	413,921
Shareholder note receivable	(5,000)	(5,000)
Accumulated other comprehensive loss	(20,974)	(11,316)
Accumulated deficit	(257,072)	(248,564)
Total stockholders’ equity	133,587	148,954
Total liabilities and stockholders’ equity	$ 314,172	$ 344,923

CONDENSED CONSOLIDATED BALANCE3

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Jun. 30, 2015	Dec. 31, 2014
Statement of Financial Position [Abstract]
Redeemable preferred stock, par value	$ 0.0001	$ 0.0001
Redeemable preferred stock, shares authorized	20,000,000	20,000,000
Redeemable preferred stock, shares issued	3,319,000	3,319,000
Redeemable preferred stock, shares outstanding	3,319,000	3,319,000
Common stock, par value	$ 0.0001	$ 0.0001
Common stock, shares authorized	200,000,000	200,000,000
Common stock, shares issued	100,107,000	99,856,000
Common stock, shares outstanding	100,107,000	99,856,000
Treasury stock, shares	19,000	19,000

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014	Jun. 30, 2015	Jun. 30, 2014
Income Statement [Abstract]
Revenues	$ 46,633	$ 53,167	$ 95,280	$ 102,340
Cost of revenues	18,745	16,600	34,080	32,033
Amortization of acquired intangible assets	361	447	730	893
Gross profit	27,527	36,120	60,470	69,414
Operating expenses:
Research and development	3,912	4,534	7,763	8,715
Sales and marketing	16,644	19,837	34,839	37,896
General and administrative	9,241	9,241	18,379	23,463
Amortization of acquired intangible assets	669	757	1,346	1,515
Restructuring expenses	(112)	(90)	(172)	686
Total operating expenses	30,354	34,279	62,155	72,275
Operating income (loss)	(2,827)	1,841	(1,685)	(2,861)
Other income (expense):
Interest income	12	3	19	6
Interest expense	(3,040)	(3,747)	(6,411)	(5,435)
Other income (expense), net	2,161	(685)	724	(302)
Total other income (expense)	(867)	(4,429)	(5,668)	(5,731)
Pretax net loss	(3,694)	(2,588)	(7,353)	(8,592)
Income tax provision	253	307	1,155	976
Net loss	$ (3,947)	$ (2,895)	$ (8,508)	$ (9,568)
Net loss per basic and diluted share (in dollars per share)	$ (0.04)	$ (0.03)	$ (0.09)	$ (0.10)
Shares used in calculating basic and diluted net loss per share (in shares)	99,258	96,922	99,187	96,860

CONDENSED CONSOLIDATED STATEME5

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014	Jun. 30, 2015	Jun. 30, 2014
Statement of Comprehensive Income [Abstract]
Net loss	$ (3,947)	$ (2,895)	$ (8,508)	$ (9,568)
Foreign currency translation adjustments	1,539	(901)	(9,658)	(722)
Comprehensive loss	$ (2,408)	$ (3,796)	$ (18,166)	$ (10,290)

CONDENSED CONSOLIDATED STATEME6

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014
Operating activities:
Net loss	$ (8,508)	$ (9,568)
Adjustments to reconcile net loss to net cash provided by (used in) by operating activities:
Depreciation and amortization	9,587	9,555
Stock-based compensation	2,518	2,139
Interest expense related to amortization of debt discount and debt issuance costs	2,494	2,356
Provision for doubtful accounts	231	227
Provision for excess and obsolete inventory	1,574	1,338
Deferred income tax expense	366	354
Other non-cash items	587	1,498
Changes in operating assets and liabilities:
Restricted cash	2,200	(2,001)
Accounts receivable	866	(2,674)
Inventories	(1,316)	(1,825)
Prepaid expenses and other current assets	1,075	2,640
Other assets	84	(167)
Accounts payable	1,657	2,145
Accrued expenses and other	(9,783)	(31,260)
Deferred revenues	(234)	193
Net cash provided by (used in) operating activities	3,398	(25,050)
Investing activities:
Purchases of property and equipment	(7,256)	(4,875)
Cash received from sale of assets	0	300
Net cash used in investing activities	(7,256)	(4,575)
Financing activities:
Borrowings under lines of credit	73,463	79,101
Repayments under lines of credit	(76,086)	(72,757)
Principal payments on capital lease obligations	(384)	(455)
Proceeds from notes payable	0	24,500
Principal payments on notes payable	(4,351)	(2,901)
Net cash (used in) provided by financing activities	(7,358)	27,488
Effect of exchange rate changes on cash	379	(225)
Net decrease in cash	(10,837)	(2,362)
Cash at beginning of period	19,735	21,345
Cash at end of period	8,898	18,983
Supplemental disclosure of cash flow information:
Cash paid for interest	3,727	2,637
Cash paid for income taxes	362	293
Purchases of property and equipment in accounts payable	400	2,470
Non-cash debt discount	0	500
Initial fair value of warrant liability	0	10,368
Purchase of property and equipment through capital lease	$ 0	$ 759

The Company and Basis of Presen

The Company and Basis of Presentation	6 Months Ended
	Jun. 30, 2015
Accounting Policies [Abstract]
The Company and Basis of Presentation	T he Company and Basis of Presentation The Company Alphatec Holdings, Inc. (“Alphatec”, “Alphatec Holdings” or the “Company”), through its wholly owned subsidiary, Alphatec Spine, Inc. and its subsidiaries (“Alphatec Spine”), designs, develops, manufactures and markets products for the surgical treatment of spine disorders. In addition to its U.S. operations, the Company also markets its products in over 50 international markets through the distribution channels of Alphatec Spine and its affiliate, Scient’x S.A.S., and its subsidiaries (“Scient’x”), via a direct sales force in Italy and the United Kingdom and via independent distributors in the rest of Europe, the Middle East and Africa. In South America and Latin America, the Company conducts its operations through its Brazilian subsidiary, Cibramed Productos Medicos. In Asia, the Company markets its products through its subsidiary, Alphatec Pacific, Inc. and its subsidiaries (“Alphatec Pacific”), via a direct sales force and independent distributors, and through distributors in other parts of Asia and Australia. Basis of Presentation The accompanying condensed consolidated balance sheet as of December 31, 2014 , which has been derived from audited financial statements, and the unaudited interim condensed consolidated financial statements have been prepared by the Company in accordance with U.S. generally accepted accounting principles (“GAAP”) and the rules and regulations of the Securities and Exchange Commission (“SEC”) related to a quarterly report on Form 10-Q. Certain information and note disclosures normally included in annual audited financial statements prepared in accordance with GAAP have been condensed or omitted pursuant to those rules and regulations, although the Company believes that the disclosures made in this quarterly report on Form 10-Q are adequate to make the information not misleading. The interim unaudited condensed consolidated financial statements reflect all adjustments which, in the opinion of management, are necessary for a fair statement of the financial position and results of operations for the periods presented. All such adjustments are of a normal and recurring nature. These unaudited condensed consolidated financial statements should be read in conjunction with the Company’s audited financial statements for the year ended December 31, 2014 , which are included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2014 that was filed with the SEC on February 26, 2015 . Operating results for the three and six months ended June 30, 2015 are not necessarily indicative of the results that may be expected for the year ending December 31, 2015 , or any other future periods. The accompanying condensed consolidated financial statements have been prepared assuming that the Company will continue as a going concern. A going concern basis of accounting contemplates the recovery of the Company’s assets and the satisfaction of its liabilities in the normal course of business. Based on the Company’s annual operating plan, management believes that its cash as of June 30, 2015 of $8.9 million combined with anticipated cash flow from operations through June 30, 2016 and other working capital, excluding common stock warrant liabilities, of $44.9 million at June 30, 2015 and the Company's available borrowings under the credit facilities with MidCap Financial, LLC ("MidCap") will be sufficient to fund its cash requirements through at least June 30, 2016 . The Company’s amended and restated credit facility (the “Amended Credit Facility”) with MidCap contains financial covenants consisting of a monthly fixed charge coverage ratio, a senior leverage ratio and a total leverage ratio (see Note 5). Based on the Company’s current operating plan, the Company believes that it will be in compliance with the financial covenants of the Amended Credit Facility at least through June 30, 2016 . However, there is no assurance that the Company will be able to do so. If the Company is not able to achieve its planned revenue or incurs costs in excess of its forecasts, it may be required to substantially reduce discretionary spending and it could be in default of the Amended Credit Facility. There can be no assurance that the Company could obtain a waiver of such default from MidCap, that the Amended Credit Facility could be successfully renegotiated or that the Company could modify its operations to maintain liquidity. If the Company is unable to obtain any required waiver or amendments, MidCap would have the right to exercise remedies specified in the Amended Credit Facility, including accelerating the repayment of debt obligations. The Company may be forced to seek additional financing, which may include additional debt and/or equity financing or funding through other third party agreements. There can be no assurances that additional financing would be available on acceptable terms or available at all. Furthermore, any equity financing may result in dilution to existing stockholders and any debt financing may involve agreements that include covenants limiting or restricting the Company's ability to take specific actions, such as incurring debt, making capital expenditures or declaring dividends.

Summary of Significant Accounti

Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2015
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies The Company’s significant accounting policies are described in Note 2 to its audited consolidated financial statements for the year ended December 31, 2014 , which are included in the Company’s Annual Report on Form 10-K that was filed with the SEC on February 26, 2015 . Except as discussed below, these accounting policies have not significantly changed during the six months ended June 30, 2015 . Fair Value Measurements The carrying amount of financial instruments consisting of cash, restricted cash, trade accounts receivable, prepaid expenses and other current assets, accounts payable, accrued expenses, accrued compensation and current portion of long-term debt included in the Company’s consolidated financial statements are reasonable estimates of fair value due to their short maturities. Based on the borrowing rates currently available to the Company for loans with similar terms, management believes the fair value of long-term debt approximates its carrying value. Authoritative guidance establishes a three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value as follows: Level 1: Observable inputs such as quoted prices in active markets; Level 2: Inputs, other than the quoted prices in active markets, that are observable either directly or indirectly; and Level 3: Unobservable inputs in which there is little or no market data, which require the reporting entity to develop its own assumptions. The Company does not maintain any financial instruments that are considered to be Level 1 or Level 2 instruments as of June 30, 2015 or December 31, 2014 . The Company classifies its common stock warrant liabilities within Level 3 of the fair value hierarchy because they are valued using valuation models with significant unobservable inputs. The following table provides a reconciliation of liabilities measured at fair value using significant unobservable inputs (Level 3) for the six months ended June 30, 2015 (in thousands): Common Stock Warrant Liabilities Balance at December 31, 2014 $ 8,702 Changes in fair value (1,717 ) Balance at June 30, 2015 $ 6,985 Common stock warrant liabilities are measured at fair value using the Black-Scholes option pricing valuation model. The assumptions used in the Black-Scholes option pricing valuation model for the common stock warrant liabilities were: (a) a risk-free interest rate based on the rates for U.S. Treasury zero-coupon bonds with maturities similar to those of the remaining contractual term of the warrants; (b) an assumed dividend yield of zero based on the Company’s expectation that it will not pay dividends in the foreseeable future; (c) an expected term based on the remaining contractual term of the warrants; and (d) an expected volatility based upon the Company's historical volatility over the remaining contractual term of the warrants. The significant unobservable input used in measuring the fair value of the common stock warrant liabilities associated with the Deerfield Facility Agreement (defined below) is the expected volatility. Significant increases in volatility would result in a higher fair value measurement. Recent Accounting Pronouncements In May 2014, the Financial Accounting Standards Board ("FASB") issued new accounting guidance related to revenue recognition. This new standard will replace all current U.S. GAAP guidance on this topic and eliminate all industry-specific guidance. The new revenue recognition standard provides a unified model to determine when and how revenue is recognized. The core principle is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. On July 9, 2015, the FASB voted to defer the effective date by one year to December 15, 2017 for annual reporting periods beginning after that date. The FASB also permitted early adoption of the standard, but not before the original effective date of December 15, 2016. The Company is currently evaluating the impact, if any, the adoption of this standard will have on its financial statements. In August 2014, the FASB issued guidance related to disclosures of uncertainties about an entity’s ability to continue as a going concern. The guidance requires management to evaluate whether there are conditions and events that raise substantial doubt about the entity’s ability to continue as a going concern within one year after the financial statements are issued. Management will be required to make this evaluation for both annual and interim reporting periods and will have to make certain disclosures if it concludes that substantial doubt exists or when its plans alleviate substantial doubt about the entity’s ability to continue as a going concern. Substantial doubt exists when relevant conditions and events, considered in the aggregate, indicate that it is probable that the entity will be unable to meet its obligations as they become due within one year after the date that the financial statements are issued. The guidance is effective for annual periods ending after December 15, 2016 and for interim reporting periods within annual periods beginning after December 15, 2016, with early adoption permitted. The Company is currently evaluating the impact of this guidance and expects to adopt the standard for the annual reporting period ending December 31, 2016. In April 2015, the FASB issued guidance that amends existing guidance to require the presentation of debt issuance costs in the balance sheet as a deduction from the carrying amount of the related debt liability instead of a deferred charge. The guidance will not change the amortization of debt issuance costs, which will continue to follow the existing accounting guidance. The guidance is effective for annual reporting periods beginning after December 15, 2015, but early adoption is permitted. The Company is currently evaluating the impact of adopting this new accounting standard on its financial statements.

Select Balance Sheet Details

Select Balance Sheet Details	6 Months Ended
	Jun. 30, 2015
Balance Sheet Related Disclosures [Abstract]
Select Balance Sheet Details	Select Balance Sheet Details Accounts Receivable, net Accounts receivable, net consist of the following (in thousands): June 30, 2015 December 31, 2014 Accounts receivable $ 39,668 $ 41,233 Allowance for doubtful accounts (811 ) (793 ) Accounts receivable, net $ 38,857 $ 40,440 Inventories, net Inventories, net consist of the following (in thousands): June 30, 2015 December 31, 2014 Gross Reserve for excess and obsolete Net Gross Reserve for excess and obsolete Net Raw materials $ 5,467 $ — $ 5,467 $ 5,020 $ — $ 5,020 Work-in-process 994 — 994 1,032 — 1,032 Finished goods 54,524 (19,748 ) 34,776 57,020 (21,325 ) 35,695 Inventories $ 60,985 $ (19,748 ) $ 41,237 $ 63,072 $ (21,325 ) $ 41,747 Property and Equipment, net Property and equipment, net consist of the following (in thousands except as indicated): Useful lives (in years) June 30, 2015 December 31, 2014 Surgical instruments 4 $ 62,690 $ 62,872 Machinery and equipment 7 15,486 15,382 Computer equipment 3 3,260 3,180 Office furniture and equipment 5 3,759 3,789 Leasehold improvements various 3,844 3,841 Building 39 64 65 Land n/a 9 9 Construction in progress n/a 982 1,320 90,094 90,458 Less accumulated depreciation and amortization (66,260 ) (64,418 ) Property and equipment, net $ 23,834 $ 26,040 Total depreciation expense was $2.8 million and $3.1 million for the three months ended June 30, 2015 and 2014 , respectively. Total depreciation expense was $5.6 million and $6.4 million for the six months ended June 30, 2015 and 2014 , respectively. At June 30, 2015 , assets recorded under capital leases of $3.2 million were included in the machinery and equipment balance and zero were included in the construction in progress balance. At December 31, 2014 , assets recorded under capital leases of $3.2 million were included in the machinery and equipment balance and $0.6 million were included in the construction in progress balance. Amortization of assets under capital leases was included in depreciation expense. Intangible Assets, net Intangible assets, net consist of the following (in thousands except for useful lives): Useful lives (in years) June 30, 2015 December 31, 2014 Developed product technology 3-8 $ 21,805 $ 22,526 Distribution rights 3 2,048 2,095 Intellectual property 5 1,004 1,004 License agreements 1-7 16,716 16,716 Core technology 10 4,174 4,554 Trademarks and trade names 3-9 3,322 3,559 Customer-related 12-15 19,405 20,493 Distribution network 10-12 4,027 4,027 Physician education programs 10 2,568 2,802 Supply agreement 10 225 225 75,294 78,001 Less accumulated amortization (50,409 ) (47,742 ) Intangible assets, net $ 24,885 $ 30,259 Total amortization expense was $2.6 million and $1.6 million for the three months ended June 30, 2015 and 2014 , respectively. Total amortization expense was $4.0 million and $3.2 million for the six months ended June 30, 2015 and 2014 , respectively. On June 19, 2015 the Company entered into an exclusive distribution agreement with a third party to market a biologic product that would replace its existing NEXoss Synthetic Bone Graft (See Note 4). The Company expensed $0.3 million as an impairment charge in cost of goods sold in the three and six months ended June 30, 2015 for the write-off of an intangible asset related to this product. Additionally, due to a revised marketing strategy for the Company's Epicage interbody fusion device, the Company evaluated the related intangible asset for impairment in June 2015. As a result of this impairment analysis the Company expensed $0.9 million as an impairment charge in cost of goods sold in the three and six months ended June 30, 2015 for the write-off of an intangible asset related to this product. Future amortization expense related to intangible assets as of June 30, 2015 is as follows (in thousands): Year Ending December 31, Remainder of 2015 $ 2,324 2016 4,323 2017 4,316 2018 2,900 2019 2,713 Thereafter 8,309 $ 24,885 Accrued Expenses Accrued expenses consist of the following (in thousands): June 30, 2015 December 31, 2014 Legal $ 552 $ 967 Accounting 1,000 1,262 Severance 100 318 Restructuring 193 531 Sales milestones 127 107 Accrued taxes 678 1,344 Deferred rent 573 785 Royalties 1,896 2,129 Commissions 4,387 6,152 Payroll and related 6,033 8,291 Litigation settlements 5,399 7,393 Accrued interest 968 946 Other 6,241 5,168 Total accrued expenses $ 28,147 $ 35,393 Goodwill The changes in the carrying amount of goodwill from December 31, 2014 through June 30, 2015 are as follows (in thousands): Balance at December 31, 2014 $ 171,333 Effect of foreign exchange rate on goodwill (7,581 ) Balance at June 30, 2015 $ 163,752

License and Consulting Agreemen

License and Consulting Agreements	6 Months Ended
	Jun. 30, 2015
Contractors [Abstract]
License and Consulting Agreements	License and Consulting Agreements The Company’s license and consulting agreements are described in Note 5 to its audited consolidated financial statements for the year ended December 31, 2014 , which are included in its Annual Report on Form 10-K which was filed with the SEC on February 26, 2015. License Agreement In June 2015 the Company entered into an exclusive distribution agreement with a third party supplier pursuant to which the Company acquired exclusive worldwide distribution rights to market a synthetic biologic product under the Company's own brand name (the "Biologic Supply Agreement"). The Biologic Supply Agreement requires the Company to make minimum payments to the third party supplier for the Company's worldwide distribution rights under the agreement to remain exclusive.

Debt

Debt	6 Months Ended
	Jun. 30, 2015
Debt Disclosure [Abstract]
Debt	Debt MidCap Facility Agreement On August 30, 2013, the Company entered into the Amended Credit Facility with MidCap. The Amended Credit Facility amended and restated the prior credit facility that the Company had with MidCap (the "Prior Credit Facility"). Pursuant to the Amended Credit Facility, the Company increased the borrowing limit from $50 million to $73 million . The Company also extended the maturity to August 2016 . As of June 30, 2015 , the Amended Credit Facility consisted of a $33 million term loan, $28 million of which was drawn at closing and the remaining $5 million of which was drawn in April 2014, and a revolving line of credit with a maximum borrowing base of $40 million , of which $29.2 million was outstanding under the revolving line of credit at June 30, 2015 . The Company used the term loan proceeds of $28 million drawn at closing to repay a portion of the outstanding balance on the prior revolving line of credit. The Company borrowed an additional $5 million term loan under the Amended Credit Facility in July 2015 (see Note 14). The term loan interest rate is priced at the London Interbank Offered Rate ("LIBOR") plus 8.0% , subject to a 9.5% floor, and the revolving line of credit interest rate remains priced at LIBOR plus 6.0% , reset monthly. At June 30, 2015 , the revolving line of credit carried an interest rate of 6.2% and the term loan carries an interest rate of 9.5% . The borrowing base is determined, from time to time, based on the value of domestic eligible accounts receivable and domestic eligible inventory. As collateral for the Amended Credit Facility, the Company granted MidCap a security interest in substantially all of its assets, including all accounts receivable and all securities evidencing its interests in its subsidiaries. In addition to monthly payments of interest, monthly repayments of $0.5 million are due through maturity, with the remaining principal due upon maturity. In connection with the execution of the Amended Credit Facility, the Company incurred an additional $0.4 million in costs that were capitalized as debt issuance costs. At June 30, 2015 , $0.3 million remains as unamortized debt issuance costs related to the prior and Amended Credit Facility within the unaudited consolidated balance sheet, which will be amortized over the remaining term of the Amended Credit Facility. The Amended Credit Facility includes traditional lending and reporting covenants including a fixed charge coverage ratio, a senior leverage ratio and a total leverage ratio to be maintained by the Company. The Amended Credit Facility also includes several potential events of default, such as payment default and insolvency conditions, which could cause interest to be charged at a rate which is up to five percentage points above the rate effective immediately before the event of default or result in MidCap’s right to declare all outstanding obligations immediately due and payable. In February 2013, the Company and MidCap entered into a first amendment to the Credit Facility (the "First Amendment to the Credit Facility”). The First Amendment to the Credit Facility allowed the Company to exclude payments related to an acquisition and a settlement agreement from calculation of the fixed charge coverage ratio and the senior leverage ratio. In conjunction with the First Amendment to the Credit Facility, the Company paid MidCap a fee of $0.1 million . On August 30, 2013, the Company entered into the Amended Credit Agreement with MidCap. On March 17, 2014, the Company entered into a first amendment to the Amended Credit Facility with MidCap (the "First Amendment to the Amended Credit Facility"). Under the First Amendment to the Amended Credit Facility, MidCap gave the Company its consent to enter into the Facility Agreement (defined below) and make settlement payments in connection with the Orthotec litigation. The First Amendment to the Amended Credit Facility also added a total leverage ratio financial covenant. The Company was in compliance with all of the covenants of the Amended Credit Facility as of June 30, 2015 . Deerfield Facility Agreement On March 17, 2014, the Company entered into a facility agreement (the “Facility Agreement”) with Deerfield Private Design Fund II, L.P., Deerfield Private Design International II, L.P. Deerfield Special Situations Fund, L.P. and Deerfield Special Situations International Master Fund, L.P. (collectively "Deerfield"), pursuant to which Deerfield agreed to loan the Company up to $50 million , subject to the terms and conditions set forth in the Facility Agreement. Under the terms of the Facility Agreement, the Company had the option, but was not required, upon certain conditions to draw the entire amount available under the Facility Agreement, at any time until January 30, 2015 (the “Draw Period”), provided that the initial draw be used for a portion of the payments made in connection with the Orthotec settlement described in Note 7 below. The Company has agreed to pay Deerfield, upon each disbursement of funds under the Facility Agreement, a transaction fee equal to 2.5% of the principal amount of the funds disbursed. Amounts borrowed under the Facility Agreement bear interest at a rate of 8.75% per annum and are payable on the third, fourth and fifth anniversary date of the first amount borrowed under the Facility Agreement, with the final payment due on March 20, 2019. The Facility Agreement also contains various representations and warranties, and affirmative and negative covenants, customary for financings of this type, including restrictions on the ability of the Company and its subsidiaries to incur additional indebtedness or liens on its assets, except as permitted under the Facility Agreement. As security for the Company's repayment of its obligations under the Facility Agreement, the Company granted to Deerfield a security interest in substantially all of the Company's property and interests in property, which is subordinated to the security interest granted under the Amended Credit Facility. In connection with the execution of the Facility Agreement on March 17, 2014, the Company issued to Deerfield warrants to purchase an aggregate of 6,250,000 shares of the Company’s common stock, which are immediately exercisable and have an exercise price equal to $1.39 per share (the “Initial Warrants”). Additionally, the Company agreed that each disbursement borrowing under the Facility Agreement be accompanied by the issuance to Deerfield of warrants to purchase up to 10,000,000 shares of the Company’s common stock, in proportion to the amount of draw compared to the total $50 million facility (the "Draw Warrants"). On March 20, 2014, the Company made an initial draw of $20 million under the Facility Agreement and received net proceeds of $19.5 million to fund the portion of the settlement payment obligations that were due in 2014 to Orthotec, LLC. The $0.5 million transaction fee is recorded as a debt discount and is being amortized over the term of the draw, which ends March 20, 2019. In connection with this borrowing, the Company issued Draw Warrants to purchase 4,000,000 shares of common stock at an exercise price of $1.39 per share, which were valued at $4.7 million and recorded as a debt discount and is being amortized over the term of the $20 million draw. Additionally, $2.3 million of the value of the Initial Warrants was reclassified as a debt discount and is being amortized through interest expense over the term of the debt using the effective interest method. On November 21, 2014, the Company made a second draw of $6.0 million under the Facility Agreement and received net proceeds of $5.9 million to fund a portion of the Orthotec settlement payments due through 2016. The $0.2 million transaction fee was recorded as a debt discount and is being amortized over the remaining term of the draw, which ends March 20, 2019. In connection with this second draw, the Company issued Draw Warrants to purchase 1,200,000 shares of common stock at an exercise price of $1.39 per share, which were valued at $0.9 million and were recorded as a debt discount and is being amortized over the term of the debt using the effective interest method. Additionally, $0.2 million of the value of the Initial Warrants was reclassified as a debt discount and is being amortized through interest expense over the term of the debt using the effective interest method. As of June 30, 2015, Orthotec settlement payments of $20.8 million have been made, leaving remaining proceeds from the funds borrowed under the Facility Agreement of $4.6 million , of which $4.4 million was classified as short-term restricted cash and $0.2 million was classified as long-term restricted cash under other assets, as their use is limited under the terms of the Facility Agreement for the payments of amounts due under the Orthotec litigation settlement agreement. Additionally, a payment of $1.1 million was made on July 1, 2015. The amounts borrowed under the Facility Agreement, which total $26.0 million in principal as of June 30, 2015 , are due in three equal annual payments beginning March 20, 2017. As of June 30, 2015 , the outstanding Initial Warrants and Draw Warrants to purchase an aggregate of 11,450,000 shares of common stock were revalued to their fair value with a charge to other income (expense) of $1.7 million for the six months ended June 30, 2015 . The warrant liability of $7.0 million is recorded as common stock warrant liabilities within current liabilities on the condensed consolidated balance sheet as of June 30, 2015 . At June 30, 2015 , the outstanding warrants were valued using the Black-Scholes option pricing model. This is a Level 3 measurement using the following assumptions: June 30, 2015 Risk-free interest rate 1.5 % Dividend yield — % Expected volatility 51 % Expected life (years) 4.8 Principal payments on debt are as follows as of June 30, 2015 (in thousands): Year Ending December 31, Remainder of 2015 $ 3,134 2016 52,299 2017 8,667 2018 8,667 2019 8,667 Thereafter — Total 81,434 Add: capital lease principal payments 1,401 Less: debt discount (6,298 ) Total 76,537 Less: current portion of long-term debt (6,753 ) Long-term debt, net of current portion $ 69,784

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2015
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Leases The Company leases certain equipment under capital leases which expire on various dates through June 2017 . The leases bear interest at rates ranging from 6.6% to 9.6% per annum, are generally due in monthly principal and interest installments and are collateralized by the related equipment. The Company also leases its buildings and certain equipment and vehicles under operating leases which expire on various dates through January 2019 . Future minimum annual lease payments under such leases are as follows as of June 30, 2015 (in thousands): Year Ending December 31, Operating Capital Remainder of 2015 $ 1,758 $ 403 2016 2,276 787 2017 796 347 2018 252 — 2019 128 — $ 5,210 1,537 Less: amount representing interest (136 ) Present value of minimum lease payments 1,401 Current portion of capital leases (710 ) Capital leases, less current portion $ 691 Rent expense under operating leases for the three months ended June 30, 2015 and 2014 was $0.7 million and $0.8 million , respectively. Rent expense under operating leases for the six months ended June 30, 2015 and 2014 was $1.5 million and $1.8 million , respectively. Litigation On August 10, 2010, a purported securities class action complaint was filed in the United States District Court for the Southern District of California on behalf of all persons who purchased the Company's common stock between December 19, 2009 and August 5, 2010 against the Company and certain of its directors and officers alleging violations of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), and Rule 10b-5 promulgated thereunder. On February 17, 2011, an amended complaint was filed against the Company and certain of its directors and officers adding alleged violations of the Securities Act of 1933, as amended (the "Securities Act"). HealthpointCapital, Jefferies & Company, Inc., Canaccord Adams, Inc., Cowen and Company, Inc., and Lazard Capital Markets LLC are also defendants in this action. The complaint alleged that the defendants made false or misleading statements and failed to disclose material facts about the Company’s business, financial condition, operations and prospects, particularly relating to the Scient’x transaction and the Company's financial guidance following the closing of the acquisition. The complaint sought unspecified monetary damages, attorneys’ fees, and other unspecified relief. The Company filed a motion to dismiss the amended complaint on April 18, 2011. The district court granted the motion to dismiss with leave to amend on March 22, 2012. On April 19, 2012, the lead plaintiff filed a Second Amended Complaint alleging violations of Sections 10(b) and 20(a) of the Exchange Act and violations of Section 11, 12(a)(2), and 15 of the Securities Act against the same named defendants. On May 3, 2012, the Company filed a motion to dismiss the Second Amended Complaint. The district court granted that motion without leave to amend and entered final judgment in the Company's favor on March 28, 2013. On April 17, 2013, the lead plaintiff filed a notice of appeal to the United States Court of Appeals for the Ninth Circuit. The appellate court heard oral argument on May 5, 2015. On June 5, 2015, the Ninth Circuit affirmed the district court’s decision in all respects and ordered dismissal of the case. The mandate issued on June 30, 2015. In addition to the matter described above, the Company is and may become involved in various other legal proceedings arising from its business activities. While management believes the ultimate disposition of the above matter that ha s been settled will not have a material adverse impact on the Company’s consolidated results of operations, cash flows or financial position, litigation is inherently unpredictable, and depending on the nature and timing of these proceedings, an unfavorable resolution could materially affect the Company’s future consolidated results of operations, cash flows or financial position in a particular period. The Company assesses contingencies to determine the degree of probability and range of possible loss for potential accrual or disclosure in our consolidated financial statements. An estimated loss contingency is accrued in the Company’s consolidated financial statements if it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. Because litigation is inherently unpredictable and unfavorable resolutions could occur, assessing contingencies is highly subjective and requires judgments about future events. When evaluating contingencies, the Company may be unable to provide a meaningful estimate due to a number of factors, including the procedural status of the matter in question, the presence of complex or novel legal theories, and/or the ongoing discovery and development of information important to the matters. In addition, damage amounts claimed in litigation against us may be unsupported, exaggerated or unrelated to reasonably possible outcomes, and as such are not meaningful indicators of the Company’s potential liability. Royalties The Company has entered into various intellectual property agreements requiring the payment of royalties based on the sale of products that utilize such intellectual property. These royalties primarily relate to products sold by Alphatec Spine and are calculated either as a percentage of net sales or in one instance on a per-unit sold basis. Royalties are included on the accompanying condensed consolidated statement of operations as a component of cost of revenues.

Orthotec Settlement

Orthotec Settlement	6 Months Ended
	Jun. 30, 2015
Commitments and Contingencies Disclosure [Abstract]
Orthotec Settlement	Orthotec Settlement On March 15, 2014, the Company, Orthotec, LLC and certain other parties, including certain directors and affiliate of the Company, entered into a binding term sheet (the "Binding Term Sheet") to resolve the Orthotec, LLC v. Surgiview, S.A.S, et al. matter in the Superior Court of California, Los Angeles County and related litigation matters (the "Orthotec Settlement"). Pursuant to the terms contained in the Binding Term Sheet, the Company agreed to pay Orthotec, LLC $49 million in cash, including initial cash payments totaling $1.75 million , which the Company previously paid in March 2014, and an additional lump sum payment of $15.75 million , which the Company previously paid in April 2014. The Company agreed to pay the remaining $31.5 million in 28 quarterly installments of $1.1 million and then one additional quarterly installment of $0.7 million , commencing October 1, 2014. As of June 30, 2015, the Company has made installment payments in the aggregate of $19.7 million . The Company has the right to prepay the amounts due without penalty. In addition, the unpaid balance of the amounts due accrues interest at the rate of 7% per year beginning May 15, 2014 until the amounts due are paid in full. The accrued but unpaid interest will be paid in quarterly installments of $1.1 million (or the full amount of the accrued but unpaid interest if less than $1.1 million ) following the full payment of the $31.5 million in quarterly installments described above. No interest will accrue on the accrued interest. The Binding Term Sheet provided for mutual releases of all claims in the Orthotec, LLC v. Surgiview, S.A.S, et al. matter in the Superior Court of California, Los Angeles County and all other related litigation matters involving the Company and its directors and affiliates. On September 26, 2014, the Company entered into a Settlement and Release Agreement, dated as of August 13, 2014, by and among the Company and its direct subsidiaries, including Alphatec Spine, Inc., Alphatec Holdings International C.V., Scient'x S.A.S. and Surgiview S.A.S.; HealthpointCapital, LLC, HealthpointCapital Partners, L.P., HealthpointCapital Partners II, L.P., John H. Foster and Mortimer Berkowitz III; and Orthotec, LLC and Patrick Bertranou, (the "Settlement Agreement"). The Settlement Agreement contains substantially the same business terms as the Binding Term Sheet set forth above, and supersedes the Binding Term Sheet.

Net Loss Per Share

Net Loss Per Share	6 Months Ended
	Jun. 30, 2015
Earnings Per Share [Abstract]
Net Loss Per Share	Net Loss Per Share Basic earnings per share (“EPS”) is calculated by dividing the net income or loss available to common stockholders by the weighted average number of common shares outstanding for the period, without consideration for common stock equivalents. Diluted EPS is computed by dividing the net income available to common stockholders by the weighted average number of common shares outstanding for the period and the weighted average number of dilutive common stock equivalents outstanding for the period determined using the treasury-stock method. For purposes of this calculation, common stock subject to repurchase by the Company, options and warrants are considered to be common stock equivalents and are only included in the calculation of diluted earnings per share when their effect is dilutive (in thousands, except per share data): Three Months Ended Six Months Ended 2015 2014 2015 2014 Numerator: Net loss for basic earnings per share $ (3,947 ) $ (2,895 ) $ (8,508 ) $ (9,568 ) Decrease in fair value of warrants — — — — Diluted net loss applicable to common stockholders $ (3,947 ) $ (2,895 ) $ (8,508 ) $ (9,568 ) Denominator: Weighted average common shares outstanding 100,162 97,832 100,054 97,730 Weighted average unvested common shares subject to repurchase (904 ) (910 ) (867 ) (870 ) Weighted average common shares outstanding—basic 99,258 96,922 99,187 96,860 Effect of dilutive securities: Conversion of preferred stock — — — — Options — — — — Warrants — — — — Weighted average common shares outstanding—diluted 99,258 96,922 99,187 96,860 Net loss per basic and diluted share $ (0.04 ) $ (0.03 ) $ (0.09 ) $ (0.10 ) The anti-dilutive securities not included in diluted net loss per share were as follows (in thousands): Three Months Ended Six Months Ended 2015 2014 2015 2014 Options to purchase common stock 6,954 7,270 7,135 7,320 Unvested restricted share awards 904 910 867 870 Warrants to purchase common stock 11,544 10,844 11,544 10,844 Total 19,402 19,024 19,546 19,034

Stock Benefit Plans and Stock-B

Stock Benefit Plans and Stock-Based Compensation	6 Months Ended
	Jun. 30, 2015
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock Benefit Plans and Stock-Based Compensation	Stock Benefit Plans and Stock-Based Compensation In February 2015, the Company granted 1,854,000 performance-based restricted stock units ("PSUs") to certain employees under its 2005 Employee, Director and Consultant Stock Plan (the "2005 Plan"). The PSUs vest based upon the Company's achievement of certain performance goals over the period from January 1, 2015 through December 31, 2017. The number of PSUs that may vest varies between 0% - 200% based on the achievement of such goals. The PSUs were valued at $1.35 per share based on the closing price of the Company's common stock on the date of grant. For purposes of measuring compensation expense, the amount of PSUs ultimately expected to vest is estimated at each reporting date based on management’s expectations regarding the relevant performance criteria. The recognition of compensation expense associated with PSUs requires judgment in assessing the probability of meeting the performance goals, as well as defined criteria for assessing achievement of the performance-related goals. The awards are deemed probable of vesting as of June 30, 2015.

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2015
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes To calculate its interim tax provision, at the end of each interim period the Company estimates the annual effective tax rate and applies that to its ordinary quarterly earnings. In addition, the effect of changes in enacted tax laws or rates or tax status is recognized in the interim period in which the change occurs. The computation of the annual estimated effective tax rate at each interim period requires certain estimates and significant judgment including, but not limited to, the expected operating income for the year, projections of the proportion of income earned and taxed in foreign jurisdictions, permanent and temporary differences between book and tax amounts, and the likelihood of recovering deferred tax assets generated in the current year. The accounting estimates used to compute the provision for income taxes may change as new events occur, additional information is obtained or as the tax environment changes. The Company recognizes interest and penalties related to uncertain tax positions as a component of the income tax provision. The Company’s unrecognized tax benefits decreased less than $0.2 million during the six months ended June 30, 2015 . The decrease in unrecognized tax benefits during the six months ended June 30, 2015 was primarily related to foreign currency fluctuations and changes in prior year uncertain tax positions within the Company's foreign subsidiaries, partially offset by an increase related to state research credits and uncertain tax positions within the Company’s foreign subsidiaries. The unrecognized tax benefits at June 30, 2015 and December 31, 2014 were $8.7 million and $8.9 million , respectively. With the facts and circumstances currently available to the Company, it is reasonably possible that the amount that could reverse over the next 12 months is insignificant. Additionally, the French restructuring (see Note 12) may result in limitations on the Company’s ability to utilize its French net operating loss carryforwards to offset future taxable income. The income tax provision consists primarily of income tax provisions related to state income taxes, the tax effect of changes in deferred tax liabilities associated with tax deductible goodwill and operations in other foreign jurisdictions where the Company operates. The Company is not currently under examination by the Internal Revenue Service, or by any foreign, state or local tax authorities.

Segment and Geographical Inform

Segment and Geographical Information	6 Months Ended
	Jun. 30, 2015
Segment Reporting [Abstract]
Segment and Geographical Information	Segment and Geographical Information Operating segments are defined as components of an enterprise for which separate financial information is available and evaluated regularly by the chief operating decision maker, or decision-making group, in deciding how to allocate resources and in assessing performance. The Company has one operating and one reportable business segment. During the three and six months ended June 30, 2015 and 2014 , the Company operated in two geographic regions, the U.S. and International, which consists of locations outside of the U.S. In the International geographic region, sales in Japan for the three and six months ended June 30, 2015 totaled $7.9 million and $15.4 million , respectively, which represented greater than 10 percent of the Company’s consolidated revenues for such periods. In the International geographic region, sales in Japan for the three and six months ended June 30, 2014 totaled $7.7 million and $15.4 million , respectively, which represented greater than 10 percent of the Company’s consolidated revenues for such periods. Revenues attributed to the geographic location of the customer were as follows (in thousands): Three Months Ended Six Months Ended June 30, June 30, 2015 2014 2015 2014 United States $ 27,247 $ 34,518 $ 57,714 $ 66,568 International 19,386 18,649 37,566 35,772 Total consolidated revenues $ 46,633 $ 53,167 $ 95,280 $ 102,340 Total assets by region were as follows (in thousands): June 30, December 31, United States $ 181,578 $ 200,978 International 132,594 143,945 Total consolidated assets $ 314,172 $ 344,923

Restructuring

Restructuring	6 Months Ended
	Jun. 30, 2015
Restructuring and Related Activities [Abstract]
Restructuring	Restructuring On September 16, 2013, the Company announced that Scient'x began a process to significantly restructure its business operations in France in an effort to improve operating efficiencies and rationalize its cost structure. The restructuring included a reduction in Scient'x's workforce and closing of the manufacturing facilities in France. The Company has recorded total costs of $10.3 million to date associated with this restructuring, which includes employee severance, social plan benefits and related taxes, facility closing costs, manufacturing transfer costs, and contract termination costs, in accordance with ASC Topic 420, Accounting for Costs Associated with Exit or Disposal Activities, and ASC Topic 712 , Non Retirement Postemployment Benefits. The Company has substantially completed the activities associated with the restructuring as of June 30, 2015 , and substantially all of the costs portion have been paid.

Related Party Transactions

Related Party Transactions	6 Months Ended
	Jun. 30, 2015
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions For the six months ended June 30, 2015 and 2014 , the Company incurred expenses of less than $0.1 million and for the six months ended June 30, 2015, the Company had a liability of $0.2 million payable to HealthpointCapital, LLC for travel and administrative expenses. The Company has entered into indemnification agreements with certain of its directors which are named defendants in the New York Orthotec matter (see Note 7 – Orthotec Settlement). The indemnification agreements require the Company to indemnify these individuals to the fullest extent permitted by applicable law and to advance expenses incurred by them in connection with any proceeding against them with respect to which they may be entitled to indemnification by the Company. For the six months ended June 30, 2015 and 2014 , the Company incurred legal expenses of zero and less than $0.1 million , respectively, in connection with the Company’s indemnification obligations to two former directors of Scient'x in the New York Orthotec matter.

Subsequent Events

Subsequent Events	6 Months Ended
	Jun. 30, 2015
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events On July 6, 2015, the Company announced a restructuring of its manufacturing operations in California in an effort to improve its cost structure. The restructuring includes a reduction in workforce and closing the California manufacturing facility. The restructuring will take place over the next year and the Company estimates that it will incur termination benefits, accelerated depreciation and facility closing and other restructuring costs of up to $4 million . On July 10, 2015, the Company entered into a Second Amendment to the Amended Credit Facility with MidCap (the "Second Amendment") to increase the term loan commitment from $33 million to $38 million . The Company borrowed the additional $5 million on July 10, 2015, which is the third term loan tranche under the Amended Credit Facility (the"Third Term Loan Tranche"). Until January 1, 2016, only interest payments are due for the Third Term Loan Tranche. Thereafter, the Company will pay an amount equal to $0.5 million on the first day of each calendar month as an amortization payment in respect of all tranches of the term loan. The Company agreed to pay MidCap, a commitment fee equal to 1.0% of the principal amount of the funds disbursed in the Third Term Loan Tranche. On July 10, 2015, the Company entered into a First Amendment to the Facility Agreement (the “Facility Agreement First Amendment”), with Deerfield. The Facility Agreement First Amendment permitted, among other things, the Company to enter into and borrow the additional $5 million term loan under the Second Amendment to the Amended Credit Facility.

Summary of Significant Accoun21

Summary of Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2015
Accounting Policies [Abstract]
Fair Value Measurements	Fair Value Measurements The carrying amount of financial instruments consisting of cash, restricted cash, trade accounts receivable, prepaid expenses and other current assets, accounts payable, accrued expenses, accrued compensation and current portion of long-term debt included in the Company’s consolidated financial statements are reasonable estimates of fair value due to their short maturities. Based on the borrowing rates currently available to the Company for loans with similar terms, management believes the fair value of long-term debt approximates its carrying value. Authoritative guidance establishes a three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value as follows: Level 1: Observable inputs such as quoted prices in active markets; Level 2: Inputs, other than the quoted prices in active markets, that are observable either directly or indirectly; and Level 3: Unobservable inputs in which there is little or no market data, which require the reporting entity to develop its own assumptions. The Company does not maintain any financial instruments that are considered to be Level 1 or Level 2 instruments as of June 30, 2015 or December 31, 2014 . The Company classifies its common stock warrant liabilities within Level 3 of the fair value hierarchy because they are valued using valuation models with significant unobservable inputs.
Warrants to Purchase Common Stock	Common stock warrant liabilities are measured at fair value using the Black-Scholes option pricing valuation model. The assumptions used in the Black-Scholes option pricing valuation model for the common stock warrant liabilities were: (a) a risk-free interest rate based on the rates for U.S. Treasury zero-coupon bonds with maturities similar to those of the remaining contractual term of the warrants; (b) an assumed dividend yield of zero based on the Company’s expectation that it will not pay dividends in the foreseeable future; (c) an expected term based on the remaining contractual term of the warrants; and (d) an expected volatility based upon the Company's historical volatility over the remaining contractual term of the warrants. The significant unobservable input used in measuring the fair value of the common stock warrant liabilities associated with the Deerfield Facility Agreement (defined below) is the expected volatility. Significant increases in volatility would result in a higher fair value measurement.
Recent Accounting Pronouncements	Recent Accounting Pronouncements In May 2014, the Financial Accounting Standards Board ("FASB") issued new accounting guidance related to revenue recognition. This new standard will replace all current U.S. GAAP guidance on this topic and eliminate all industry-specific guidance. The new revenue recognition standard provides a unified model to determine when and how revenue is recognized. The core principle is that a company should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. On July 9, 2015, the FASB voted to defer the effective date by one year to December 15, 2017 for annual reporting periods beginning after that date. The FASB also permitted early adoption of the standard, but not before the original effective date of December 15, 2016. The Company is currently evaluating the impact, if any, the adoption of this standard will have on its financial statements. In August 2014, the FASB issued guidance related to disclosures of uncertainties about an entity’s ability to continue as a going concern. The guidance requires management to evaluate whether there are conditions and events that raise substantial doubt about the entity’s ability to continue as a going concern within one year after the financial statements are issued. Management will be required to make this evaluation for both annual and interim reporting periods and will have to make certain disclosures if it concludes that substantial doubt exists or when its plans alleviate substantial doubt about the entity’s ability to continue as a going concern. Substantial doubt exists when relevant conditions and events, considered in the aggregate, indicate that it is probable that the entity will be unable to meet its obligations as they become due within one year after the date that the financial statements are issued. The guidance is effective for annual periods ending after December 15, 2016 and for interim reporting periods within annual periods beginning after December 15, 2016, with early adoption permitted. The Company is currently evaluating the impact of this guidance and expects to adopt the standard for the annual reporting period ending December 31, 2016. In April 2015, the FASB issued guidance that amends existing guidance to require the presentation of debt issuance costs in the balance sheet as a deduction from the carrying amount of the related debt liability instead of a deferred charge. The guidance will not change the amortization of debt issuance costs, which will continue to follow the existing accounting guidance. The guidance is effective for annual reporting periods beginning after December 15, 2015, but early adoption is permitted. The Company is currently evaluating the impact of adopting this new accounting standard on its financial statements.

Summary of Significant Accoun22

Summary of Significant Accounting Policies (Tables)	6 Months Ended
	Jun. 30, 2015
Accounting Policies [Abstract]
Reconciliation of liabilities measured at fair value using significant unobservable inputs	The following table provides a reconciliation of liabilities measured at fair value using significant unobservable inputs (Level 3) for the six months ended June 30, 2015 (in thousands): Common Stock Warrant Liabilities Balance at December 31, 2014 $ 8,702 Changes in fair value (1,717 ) Balance at June 30, 2015 $ 6,985

Select Balance Sheet Details (T

Select Balance Sheet Details (Tables)	6 Months Ended
	Jun. 30, 2015
Balance Sheet Related Disclosures [Abstract]
Accounts Receivable, net	Accounts receivable, net consist of the following (in thousands): June 30, 2015 December 31, 2014 Accounts receivable $ 39,668 $ 41,233 Allowance for doubtful accounts (811 ) (793 ) Accounts receivable, net $ 38,857 $ 40,440
Inventories, net	Inventories, net consist of the following (in thousands): June 30, 2015 December 31, 2014 Gross Reserve for excess and obsolete Net Gross Reserve for excess and obsolete Net Raw materials $ 5,467 $ — $ 5,467 $ 5,020 $ — $ 5,020 Work-in-process 994 — 994 1,032 — 1,032 Finished goods 54,524 (19,748 ) 34,776 57,020 (21,325 ) 35,695 Inventories $ 60,985 $ (19,748 ) $ 41,237 $ 63,072 $ (21,325 ) $ 41,747
Property and Equipment, net	Property and equipment, net consist of the following (in thousands except as indicated): Useful lives (in years) June 30, 2015 December 31, 2014 Surgical instruments 4 $ 62,690 $ 62,872 Machinery and equipment 7 15,486 15,382 Computer equipment 3 3,260 3,180 Office furniture and equipment 5 3,759 3,789 Leasehold improvements various 3,844 3,841 Building 39 64 65 Land n/a 9 9 Construction in progress n/a 982 1,320 90,094 90,458 Less accumulated depreciation and amortization (66,260 ) (64,418 ) Property and equipment, net $ 23,834 $ 26,040
Intangible Assets, net	Intangible assets, net consist of the following (in thousands except for useful lives): Useful lives (in years) June 30, 2015 December 31, 2014 Developed product technology 3-8 $ 21,805 $ 22,526 Distribution rights 3 2,048 2,095 Intellectual property 5 1,004 1,004 License agreements 1-7 16,716 16,716 Core technology 10 4,174 4,554 Trademarks and trade names 3-9 3,322 3,559 Customer-related 12-15 19,405 20,493 Distribution network 10-12 4,027 4,027 Physician education programs 10 2,568 2,802 Supply agreement 10 225 225 75,294 78,001 Less accumulated amortization (50,409 ) (47,742 ) Intangible assets, net $ 24,885 $ 30,259
Schedule of Intangible assets, future amortization expense	Future amortization expense related to intangible assets as of June 30, 2015 is as follows (in thousands): Year Ending December 31, Remainder of 2015 $ 2,324 2016 4,323 2017 4,316 2018 2,900 2019 2,713 Thereafter 8,309 $ 24,885
Accrued Expenses	Accrued expenses consist of the following (in thousands): June 30, 2015 December 31, 2014 Legal $ 552 $ 967 Accounting 1,000 1,262 Severance 100 318 Restructuring 193 531 Sales milestones 127 107 Accrued taxes 678 1,344 Deferred rent 573 785 Royalties 1,896 2,129 Commissions 4,387 6,152 Payroll and related 6,033 8,291 Litigation settlements 5,399 7,393 Accrued interest 968 946 Other 6,241 5,168 Total accrued expenses $ 28,147 $ 35,393
Schedule of changes in carrying amount of goodwill	The changes in the carrying amount of goodwill from December 31, 2014 through June 30, 2015 are as follows (in thousands): Balance at December 31, 2014 $ 171,333 Effect of foreign exchange rate on goodwill (7,581 ) Balance at June 30, 2015 $ 163,752

Debt (Tables)

Debt (Tables)	6 Months Ended
	Jun. 30, 2015
Debt Disclosure [Abstract]
Fair Value Measurements, Recurring and Nonrecurring, Valuation Techniques [Table Text Block]	At June 30, 2015 , the outstanding warrants were valued using the Black-Scholes option pricing model. This is a Level 3 measurement using the following assumptions: June 30, 2015 Risk-free interest rate 1.5 % Dividend yield — % Expected volatility 51 % Expected life (years) 4.8
Principal Payments on Debt	Principal payments on debt are as follows as of June 30, 2015 (in thousands): Year Ending December 31, Remainder of 2015 $ 3,134 2016 52,299 2017 8,667 2018 8,667 2019 8,667 Thereafter — Total 81,434 Add: capital lease principal payments 1,401 Less: debt discount (6,298 ) Total 76,537 Less: current portion of long-term debt (6,753 ) Long-term debt, net of current portion $ 69,784

Commitments and Contingencies (

Commitments and Contingencies (Tables)	6 Months Ended
	Jun. 30, 2015
Commitments and Contingencies Disclosure [Abstract]
Future Minimum Annual Lease Payments	Future minimum annual lease payments under such leases are as follows as of June 30, 2015 (in thousands): Year Ending December 31, Operating Capital Remainder of 2015 $ 1,758 $ 403 2016 2,276 787 2017 796 347 2018 252 — 2019 128 — $ 5,210 1,537 Less: amount representing interest (136 ) Present value of minimum lease payments 1,401 Current portion of capital leases (710 ) Capital leases, less current portion $ 691

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	6 Months Ended
	Jun. 30, 2015
Earnings Per Share [Abstract]
Weighted Average Number of Common Shares Outstanding	For purposes of this calculation, common stock subject to repurchase by the Company, options and warrants are considered to be common stock equivalents and are only included in the calculation of diluted earnings per share when their effect is dilutive (in thousands, except per share data): Three Months Ended Six Months Ended 2015 2014 2015 2014 Numerator: Net loss for basic earnings per share $ (3,947 ) $ (2,895 ) $ (8,508 ) $ (9,568 ) Decrease in fair value of warrants — — — — Diluted net loss applicable to common stockholders $ (3,947 ) $ (2,895 ) $ (8,508 ) $ (9,568 ) Denominator: Weighted average common shares outstanding 100,162 97,832 100,054 97,730 Weighted average unvested common shares subject to repurchase (904 ) (910 ) (867 ) (870 ) Weighted average common shares outstanding—basic 99,258 96,922 99,187 96,860 Effect of dilutive securities: Conversion of preferred stock — — — — Options — — — — Warrants — — — — Weighted average common shares outstanding—diluted 99,258 96,922 99,187 96,860 Net loss per basic and diluted share $ (0.04 ) $ (0.03 ) $ (0.09 ) $ (0.10 )
Weighted-Average Anti-Dilutive Securities Not Included in Diluted Net Loss Per Share	The anti-dilutive securities not included in diluted net loss per share were as follows (in thousands): Three Months Ended Six Months Ended 2015 2014 2015 2014 Options to purchase common stock 6,954 7,270 7,135 7,320 Unvested restricted share awards 904 910 867 870 Warrants to purchase common stock 11,544 10,844 11,544 10,844 Total 19,402 19,024 19,546 19,034

Segment and Geographical Info27

Segment and Geographical Information (Tables)	6 Months Ended
	Jun. 30, 2015
Segment Reporting [Abstract]
Schedule of Revenues Attributed to Geographic Location of Customer	Revenues attributed to the geographic location of the customer were as follows (in thousands): Three Months Ended Six Months Ended June 30, June 30, 2015 2014 2015 2014 United States $ 27,247 $ 34,518 $ 57,714 $ 66,568 International 19,386 18,649 37,566 35,772 Total consolidated revenues $ 46,633 $ 53,167 $ 95,280 $ 102,340
Schedule of Long Lived Assets by Geographical Areas	Total assets by region were as follows (in thousands): June 30, December 31, United States $ 181,578 $ 200,978 International 132,594 143,945 Total consolidated assets $ 314,172 $ 344,923

The Company and Basis of Pres28

The Company and Basis of Presentation - Additional Information (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2015USD ($)Market	Dec. 31, 2014USD ($)
Accounting Policies [Abstract]
Number of market for products (more than) | Market	50
Cash	$ 8,898	$ 19,735
Anticipated cash flow from operations and other working capital, excluding common stock warrant liabilities	$ 44,900

Summary of Significant Accoun29

Summary of Significant Accounting Policies (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2015USD ($)
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance at December 31, 2014	$ 8,702
Changes in fair value	(1,717)
Balance at June 30, 2015	$ 6,985

Select Balance Sheet Details -

Select Balance Sheet Details - Accounts Receivable, Net (Details) - USD ($) $ in Thousands	Jun. 30, 2015	Dec. 31, 2014
Balance Sheet Related Disclosures [Abstract]
Accounts receivable	$ 39,668	$ 41,233
Allowance for doubtful accounts	(811)	(793)
Accounts receivable, net	$ 38,857	$ 40,440

Select Balance Sheet Details 31

Select Balance Sheet Details - Inventories, Net (Details) - USD ($) $ in Thousands	Jun. 30, 2015	Dec. 31, 2014
Balance Sheet Related Disclosures [Abstract]
Raw materials, Gross	$ 5,467	$ 5,020
Work-in-process, Gross	994	1,032
Finished goods, Gross	54,524	57,020
Inventory, Gross, Total	60,985	63,072
Finished goods, Reserve for excess and obsolete	(19,748)	(21,325)
Inventories, net, Reserve for excess and obsolete	(19,748)	(21,325)
Raw materials, Net	5,467	5,020
Work-in-process, Net	994	1,032
Finished goods, Net	34,776	35,695
Inventories, Net	$ 41,237	$ 41,747

Select Balance Sheet Details 32

Select Balance Sheet Details - Property and Equipment, Net (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014	Jun. 30, 2015	Jun. 30, 2014	Dec. 31, 2014
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 90,094		$ 90,094		$ 90,458
Less accumulated depreciation and amortization	(66,260)		(66,260)		(64,418)
Property and equipment, net	23,834		23,834		26,040
Depreciation	2,800	$ 3,100	$ 5,600	$ 6,400
Surgical instruments [Member]
Property, Plant and Equipment [Line Items]
Useful lives			4 years
Property and equipment, gross	62,690		$ 62,690		62,872
Machinery and equipment [Member]
Property, Plant and Equipment [Line Items]
Useful lives			7 years
Property and equipment, gross	15,486		$ 15,486		15,382
Capital leased assets, gross	3,200		$ 3,200		3,200
Computer equipment [Member]
Property, Plant and Equipment [Line Items]
Useful lives			3 years
Property and equipment, gross	3,260		$ 3,260		3,180
Office furniture and equipment [Member]
Property, Plant and Equipment [Line Items]
Useful lives			5 years
Property and equipment, gross	3,759		$ 3,759		3,789
Leasehold improvements [Member]
Property, Plant and Equipment [Line Items]
Various Useful lives of property and equipments			various
Property and equipment, gross	3,844		$ 3,844		3,841
Building [Member]
Property, Plant and Equipment [Line Items]
Useful lives			39 years
Property and equipment, gross	64		$ 64		65
Land [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	9		9		9
Construction in progress [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	982		982		1,320
Capital leased assets, gross	$ 0		$ 0		$ 600

Select Balance Sheet Details 33

Select Balance Sheet Details - Intangible Assets, Net (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014	Jun. 30, 2015	Jun. 30, 2014	Dec. 31, 2014
Finite-Lived Intangible Assets [Line Items]
Intangible assets, Gross	$ 75,294		$ 75,294		$ 78,001
Less accumulated amortization	(50,409)		(50,409)		(47,742)
Intangible assets, net	24,885		24,885		30,259
Amortization	2,600	$ 1,600	4,000	$ 3,200
Developed product technology [Member]
Finite-Lived Intangible Assets [Line Items]
Intangible assets, Gross	21,805		$ 21,805		22,526
Developed product technology [Member] | Minimum [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives			3 years
Developed product technology [Member] | Maximum [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives			8 years
Distribution rights [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives			3 years
Intangible assets, Gross	2,048		$ 2,048		2,095
Intellectual property [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives			5 years
Intangible assets, Gross	1,004		$ 1,004		1,004
License agreements [Member]
Finite-Lived Intangible Assets [Line Items]
Intangible assets, Gross	16,716		$ 16,716		16,716
License agreements [Member] | Minimum [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives			1 year
License agreements [Member] | Maximum [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives			7 years
License agreements [Member] | NEXoss Synthetic Bone Graft
Finite-Lived Intangible Assets [Line Items]
Impairment charges	300		$ 300
License agreements [Member] | Epicage interbody fusion device
Finite-Lived Intangible Assets [Line Items]
Impairment charges	900		$ 900
Core technology [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives			10 years
Intangible assets, Gross	4,174		$ 4,174		4,554
Trademarks and trade names [Member]
Finite-Lived Intangible Assets [Line Items]
Intangible assets, Gross	3,322		$ 3,322		3,559
Trademarks and trade names [Member] | Minimum [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives			3 years
Trademarks and trade names [Member] | Maximum [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives			9 years
Customer-related [Member]
Finite-Lived Intangible Assets [Line Items]
Intangible assets, Gross	19,405		$ 19,405		20,493
Customer-related [Member] | Minimum [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives			12 years
Customer-related [Member] | Maximum [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives			15 years
Distribution network [Member]
Finite-Lived Intangible Assets [Line Items]
Intangible assets, Gross	4,027		$ 4,027		4,027
Distribution network [Member] | Minimum [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives			10 years
Distribution network [Member] | Maximum [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives			12 years
Physician education programs [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives			10 years
Intangible assets, Gross	2,568		$ 2,568		2,802
Supply Agreement [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives			10 years
Intangible assets, Gross	$ 225		$ 225		$ 225

Select Balance Sheet Details 34

Select Balance Sheet Details - Schedule of Intangible assets, future amortization expense (Details) $ in Thousands	Jun. 30, 2015USD ($)
Balance Sheet Related Disclosures [Abstract]
Remainder of 2015	$ 2,324
2,016	4,323
2,017	4,316
2,018	2,900
2,019	2,713
Thereafter	8,309
Total	$ 24,885

Select Balance Sheet Details 35

Select Balance Sheet Details - Accrued Expense (Details) - USD ($) $ in Thousands	Jun. 30, 2015	Dec. 31, 2014
Balance Sheet Related Disclosures [Abstract]
Legal	$ 552	$ 967
Accounting	1,000	1,262
Severance	100	318
Restructuring	193	531
Sales milestones	127	107
Accrued taxes	678	1,344
Deferred rent	573	785
Royalties	1,896	2,129
Commissions	4,387	6,152
Payroll and related	6,033	8,291
Litigation settlements	5,399	7,393
Accrued interest	968	946
Other	6,241	5,168
Total accrued expenses	$ 28,147	$ 35,393

Select Balance Sheet Details 36

Select Balance Sheet Details - Schedule of Changes in Carrying Amount of Goodwill (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2015USD ($)
Goodwill [Roll Forward]
Balance at December 31, 2014	$ 171,333
Effect of foreign exchange rate on goodwill	(7,581)
Balance at June 30, 2015	$ 163,752

Debt - Additional Information (

Debt - Additional Information (Details)	Jul. 10, 2015USD ($)	Jul. 01, 2015USD ($)	Nov. 21, 2014USD ($)$ / sharesshares	Mar. 20, 2014USD ($)$ / sharesshares	Aug. 30, 2013USD ($)	Apr. 30, 2014USD ($)	Mar. 31, 2014USD ($)	Feb. 28, 2013USD ($)	Jun. 30, 2015USD ($)shares	Jun. 30, 2014USD ($)	Jun. 30, 2015USD ($)paymentshares	Jun. 30, 2014USD ($)	Jul. 09, 2015USD ($)	Dec. 31, 2014USD ($)	Mar. 17, 2014USD ($)$ / sharesshares	Aug. 29, 2013USD ($)
Line of Credit Facility [Line Items]
Repayments under lines of credit											$ 76,086,000	$ 72,757,000
Unamortized debt issuance and debt discount costs									$ 6,298,000		$ 6,298,000
Additional interest rate to be charged in the event of default									5.00%		5.00%
Amendment fee								$ 100,000
Other income (expense), net									$ 2,161,000	$ (685,000)	$ 724,000	$ (302,000)
Restricted cash									4,400,000		4,400,000			$ 4,400,000
Changes in fair value											(1,717,000)
Common stock warrant liabilities									6,985,000		6,985,000			$ 8,702,000
Amended Credit Facilty with MidCap [Member]
Line of Credit Facility [Line Items]
Maximum borrowing capacity					$ 73,000,000											$ 50,000,000
Repayments under lines of credit					28,000,000
Debt issuance costs					400,000
Unamortized debt issuance and debt discount costs									$ 300,000		$ 300,000
Amended Credit Facilty with MidCap [Member] | Term Loan Drawn On Closing [Member]
Line of Credit Facility [Line Items]
Maximum borrowing capacity					33,000,000
Amended Credit Facilty with MidCap [Member] | Term Loan. Delayed Draw [Member]
Line of Credit Facility [Line Items]
Maximum borrowing capacity					5,000,000
Amended Credit Facilty with MidCap [Member] | Term Loan [Member]
Line of Credit Facility [Line Items]
Interest rate description											("LIBOR") plus 8.0%
Debt, spread on variable rate											8.00%
Floor on interest rate											9.50%
Interest rate of revolving line of credit									9.50%		9.50%
Amended Credit Facilty with MidCap [Member] | Credit Facility [Member]
Line of Credit Facility [Line Items]
Maximum borrowing capacity					$ 40,000,000
Interest rate description											LIBOR plus 6.0%
Debt, spread on variable rate											6.00%
Interest rate of revolving line of credit									6.20%		6.20%
Amount of initial draw-down under Facility Agreement									$ 29,200,000		$ 29,200,000
Deerfield [Member]
Line of Credit Facility [Line Items]
Maximum borrowing capacity															$ 50,000,000
Transaction fee as percentage of principal amount															2.50%
Debt instrument, stated interest rate															8.75%
Number of securities called by warrants (in shares) | shares															6,250,000
Exercise price of warrants (dollars per share) | $ / shares			$ 1.39	$ 1.39											$ 1.39
Amount of initial draw-down under Facility Agreement			$ 6,000,000	$ 20,000,000					26,000,000		26,000,000
Net proceeds from initial draw under Facility Agreement				19,500,000
Transaction fee			$ 200,000	$ 500,000
Number of warrants issued (in shares) | shares			1,200,000	4,000,000
Warrants value			$ 900,000	$ 4,700,000
Warrant amount reclassified as debt discount				$ 2,300,000					$ 200,000		$ 200,000
Warrants outstanding (in shares) | shares									11,450,000		11,450,000
Net proceeds from draw under Facility Agreement			$ 5,900,000
Remaining proceeds from funds borrowed									$ 4,600,000		$ 4,600,000
Restricted cash									4,400,000		4,400,000
Long-term restricted cash									$ 200,000		$ 200,000
Equal annual payments | payment											3
Maximum [Member] | Deerfield [Member]
Line of Credit Facility [Line Items]
Number of securities called by warrants associated with each disbursement borrowing (in shares) | shares															10,000,000
Orthotec LLC, Litigation Settlement [Member]
Line of Credit Facility [Line Items]
Litigation settlement expense						$ 15,750,000	$ 1,750,000
Orthotec LLC, Litigation Settlement [Member] | Deerfield [Member]
Line of Credit Facility [Line Items]
Litigation settlement expense											$ 20,800,000
Beginning October 2013 [Member] | Amended Credit Facilty with MidCap [Member]
Line of Credit Facility [Line Items]
Term loan payments											$ 500,000
Subsequent event | Amended Credit Facilty with MidCap [Member] | Term Loan [Member]
Line of Credit Facility [Line Items]
Maximum borrowing capacity	$ 38,000,000												$ 33,000,000
Term loan payments	$ 500,000
Transaction fee as percentage of principal amount	1.00%
Amount of initial draw-down under Facility Agreement	$ 5,000,000
Subsequent event | Orthotec LLC, Litigation Settlement [Member] | Deerfield [Member]
Line of Credit Facility [Line Items]
Litigation settlement expense		$ 1,100,000

Debt- Valuation Assumptions (De

Debt- Valuation Assumptions (Details) - 6 months ended Jun. 30, 2015	Total
Debt Disclosure [Abstract]
Risk-free interest rate	1.50%
Dividend yield	0.00%
Expected volatility	51.00%
Expected life (years)	4 years 9 months 18 days

Debt - Principal Payments on De

Debt - Principal Payments on Debt (Details) $ in Thousands	Jun. 30, 2015USD ($)
Debt Disclosure [Abstract]
Remainder of 2015	$ 3,134
2,016	52,299
2,017	8,667
2,018	8,667
2,019	8,667
Thereafter	0
Total	81,434
Add: capital lease principal payments	1,401
Less: debt discount	(6,298)
Total	76,537
Less: current portion of long-term debt	(6,753)
Long-term debt, net of current portion	$ 69,784

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014	Jun. 30, 2015	Jun. 30, 2014
Loss Contingencies [Line Items]
Capital leases expire date			Jun. 30, 2017
Rent expense	$ 0.7	$ 0.8	$ 1.5	$ 1.8
Minimum [Member]
Loss Contingencies [Line Items]
Lease interest rate			6.60%
Maximum [Member]
Loss Contingencies [Line Items]
Lease interest rate			9.60%

Commitments and Contingencies41

Commitments and Contingencies - Future Minimum Annual Lease Payments (Details) $ in Thousands	Jun. 30, 2015USD ($)
Leases [Abstract]
Operating leases Remainder of 2015	$ 1,758
Operating leases 2016	2,276
Operating leases 2017	796
Operating leases 2018	252
Operating leases 2019	128
Operating leases, Future Minimum Payments Due, Total	5,210
Capital leases Remainder of 2015	403
Capital leases 2016	787
Capital leases 2017	347
Capital leases 2018	0
Capital leases 2019	0
Total Capital leases	1,537
Less: amount representing interest	(136)
Present value of minimum lease payments	1,401
Current portion of capital leases	(710)
Capital leases, less current portion	$ 691

Orthotec Settlement (Details)

Orthotec Settlement (Details) - Orthotec LLC, Litigation Settlement [Member]	Mar. 15, 2014USD ($)Installment	Apr. 30, 2014USD ($)	Mar. 31, 2014USD ($)	Jun. 30, 2015USD ($)
Loss Contingencies [Line Items]
Judgment assessed by court	$ 49,000,000
Litigation settlement expense		$ 15,750,000	$ 1,750,000
Number of quarterly installments | Installment	28
Aggregate quarterly installments				$ 19,700,000
Litigation settlement interest, quarterly installments, amount	$ 1,100,000
Beginning Fourth Quarter of 2014 [Member]
Loss Contingencies [Line Items]
Judgment assessed by court	31,500,000
Litigation settlement, quarterly installments, amount	$ 1,100,000
Litigation settlement interest rate	7.00%
Litigation settlement interest, quarterly installments, amount	$ 1,100,000
Final Installment [Domain]
Loss Contingencies [Line Items]
Number of quarterly installments | Installment	1
Litigation settlement, final installment amount	$ 700,000

Net Loss Per Share - Weighted A

Net Loss Per Share - Weighted Average Number of Common Shares Outstanding (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014	Jun. 30, 2015	Jun. 30, 2014
Numerator:
Net loss for basic earnings per share	$ (3,947)	$ (2,895)	$ (8,508)	$ (9,568)
Decrease in fair value of warrants	0	0	0	0
Diluted net loss applicable to common stockholders	$ (3,947)	$ (2,895)	$ (8,508)	$ (9,568)
Denominator:
Weighted average common shares outstanding (in shares)	100,162	97,832	100,054	97,730
Weighted average unvested common shares subject to repurchase (in shares)	(904)	(910)	(867)	(870)
Weighted average common shares outstanding—basic (in shares)	99,258	96,922	99,187	96,860
Effect of dilutive securities:
Weighted average common shares outstanding - diluted (in shares)	99,258	96,922	99,187	96,860
Net loss per basic and diluted share (in dollars per share)	$ (0.04)	$ (0.03)	$ (0.09)	$ (0.10)

Net Loss Per Share - Weighted-A

Net Loss Per Share - Weighted-Average Anti-Dilutive Securities Not Included in Diluted Net Loss Per Share (Details) - shares shares in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014	Jun. 30, 2015	Jun. 30, 2014
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in diluted net loss per share	19,402	19,024	19,546	19,034
Options to purchase common stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in diluted net loss per share	6,954	7,270	7,135	7,320
Unvested restricted share awards [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in diluted net loss per share	904	910	867	870
Warrants to purchase common stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in diluted net loss per share	11,544	10,844	11,544	10,844

Stock Benefit Plans and Stock45

Stock Benefit Plans and Stock-Based Compensation (Details) - Feb. 28, 2015 - 2005 Employee, Director and Consultant Stock Plan [Member] - Performance-based Restricted Stock Units [Member] - $ / shares	Total
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Non-option equity instruments, granted shares	1,854,000
Non-option equity instruments, grant date fair value (dollars per share)	$ 1.35
Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting percentage	0.00%
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting percentage	200.00%

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2015	Dec. 31, 2014
Income Tax Disclosure [Abstract]
Unrecognized tax benefits increase (decrease) (less than)	$ (0.2)
Unrecognized tax benefits	$ 8.7	$ 8.9

Segment and Geographical Info47

Segment and Geographical Information - Additional Information (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2015USD ($)Location	Jun. 30, 2014USD ($)Location	Jun. 30, 2015USD ($)SegmentLocation	Jun. 30, 2014USD ($)Location
Revenues from External Customers and Long-Lived Assets [Line Items]
Number of operating segments | Segment			1
Number of reportable business segment | Segment			1
Number of geographic regions | Location	2	2	2	2
Revenue	$ 46,633	$ 53,167	$ 95,280	$ 102,340
Japan [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Revenue	$ 7,900	$ 7,700	$ 15,400	$ 15,400
Minimum percentage of revenues (greater than)			10.00%	10.00%

Segment and Geographical Info48

Segment and Geographical Information - Schedule of Revenues Attributed to Geographic Location of Customer (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014	Jun. 30, 2015	Jun. 30, 2014
Segment Reporting, Revenue Reconciling Item [Line Items]
Total consolidated revenues	$ 46,633	$ 53,167	$ 95,280	$ 102,340
Reportable Geographical Components [Member] | United States [Member]
Segment Reporting, Revenue Reconciling Item [Line Items]
Total consolidated revenues	27,247	34,518	57,714	66,568
Reportable Geographical Components [Member] | International [Member]
Segment Reporting, Revenue Reconciling Item [Line Items]
Total consolidated revenues	$ 19,386	$ 18,649	$ 37,566	$ 35,772

Segment and Geographical Info49

Segment and Geographical Information - Schedule of Long Lived Assets by Geographical Areas (Details) - USD ($) $ in Thousands	Jun. 30, 2015	Dec. 31, 2014
Revenues from External Customers and Long-Lived Assets [Line Items]
Total consolidated assets	$ 314,172	$ 344,923
Reportable Geographical Components [Member] | United States [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total consolidated assets	181,578	200,978
Reportable Geographical Components [Member] | International [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total consolidated assets	$ 132,594	$ 143,945

Restructuring - Additional Info

Restructuring - Additional Information (Details) $ in Millions	Jun. 30, 2015USD ($)
Restructuring and Related Activities [Abstract]
Total restructuring costs incurred	$ 10.3

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Details)	6 Months Ended
	Jun. 30, 2015USD ($)Director	Jun. 30, 2014USD ($)
Healthpoint Capital [Member]
Related Party Transaction [Line Items]
Incurred expenses (less than)	$ 100,000	$ 100,000
Payable liability	200,000
New York Orthotec matter [Member]
Related Party Transaction [Line Items]
Legal expenses (less than $0.1 million)	$ 0	$ 100,000
Number of former directors | Director	2

Subsequent Events (Details)

Subsequent Events (Details) - USD ($)	Jul. 10, 2015	Jul. 09, 2015	Jul. 06, 2015	Jun. 30, 2015	Nov. 21, 2014	Mar. 20, 2014	Mar. 17, 2014	Aug. 30, 2013	Aug. 29, 2013
Amended Credit Facilty with MidCap [Member]
Subsequent Event [Line Items]
Maximum borrowing capacity								$ 73,000,000	$ 50,000,000
Amended Credit Facilty with MidCap [Member] | Term Loan [Member] | Subsequent event
Subsequent Event [Line Items]
Maximum borrowing capacity	$ 38,000,000	$ 33,000,000
Amount of draw under facility agreement	5,000,000
Term loan payments	$ 500,000
Transaction fee as percentage of principal amount	1.00%
Deerfield [Member]
Subsequent Event [Line Items]
Maximum borrowing capacity							$ 50,000,000
Amount of draw under facility agreement				$ 26,000,000	$ 6,000,000	$ 20,000,000
Transaction fee as percentage of principal amount							2.50%
Deerfield [Member] | Line of Credit [Member] | Subsequent event
Subsequent Event [Line Items]
Amount of draw under facility agreement	$ 5,000,000
Maximum [Member] | Manufacturing operations in California [Member] | Subsequent event
Subsequent Event [Line Items]
Expected restructuring costs			$ 4,000,000