Alphatec (ATEC) 10-Q 9 Nov 16 2016 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2016	Nov. 08, 2016
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	Sep. 30, 2016
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus (Q1,Q2,Q3,FY)	Q3
Amendment Flag	false
Entity Common Stock, Shares Outstanding		8,909,601

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Current assets:
Cash	$ 25,598	$ 6,295
Restricted cash	0	2,350
Accounts receivable, net	16,546	26,870
Inventories, net	27,661	32,632
Prepaid expenses and other current assets	2,941	3,138
Current assets of discontinued operations	2,828	30,210
Total current assets	75,574	101,495
Property and equipment, net	13,712	16,081
Intangible assets, net	6,152	8,806
Other assets	516	502
Noncurrent assets of discontinued operations	71	19,457
Total assets	96,025	146,341
Current liabilities:
Accounts payable	6,821	13,542
Accrued expenses	30,705	21,175
Common stock warrant liabilities	0	687
Current portion of long-term debt	2,647	79,742
Current liabilities of discontinued operations	2,207	9,891
Total current liabilities	42,380	125,037
Long-term debt, less current portion	38,215	480
Other long-term liabilities	29,951	32,281
Long term liabilities of discontinued operations	87	1,516
Redeemable preferred stock, $0.0001 par value; 20,000 authorized at September 30, 2016 and December 31, 2015; 3,319 shares issued and outstanding at both September 30, 2016 and December 31, 2015	23,603	23,603
Commitments and contingencies
Stockholders’ deficit:
Common stock, $0.0001 par value; 200,000 authorized at September 30, 2016 and December 31, 2015; 8,810 and 8,513 shares issued and outstanding at September 30, 2016 and December 31, 2015, respectively	1	10
Treasury stock, at cost, 2 shares, at both September 30, 2016 and December 31, 2015	(97)	(97)
Additional paid-in capital	418,927	416,939
Shareholder note receivable	(5,000)	(5,000)
Accumulated other comprehensive income (loss)	769	(21,188)
Accumulated deficit	(452,811)	(427,240)
Total stockholders’ deficit	(38,211)	(36,576)
Total liabilities and stockholders’ deficit	$ 96,025	$ 146,341

CONDENSED CONSOLIDATED BALANCE3

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) (Parenthetical) - $ / shares	Sep. 30, 2016	Dec. 31, 2015
Statement of Financial Position [Abstract]
Redeemable preferred stock, par value (dollars per share)	$ 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 (dollars per share)	$ 0.0001	$ 0.0001
Common stock, shares authorized	200,000,000	200,000,000
Common stock, shares issued	8,810,000	8,513,000
Common stock, shares outstanding	8,810,000	8,513,000
Treasury stock, shares	2,000	2,000

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Income Statement [Abstract]
Revenues	$ 26,711	$ 31,687	$ 93,158	$ 99,597
Cost of revenues	10,849	10,029	31,651	35,174
Gross profit	15,862	21,658	61,507	64,423
Operating expenses:
Research and development	1,087	1,850	6,799	9,538
In-process research and development	0	274	0	274
Sales and marketing	11,764	12,774	39,498	37,864
General and administrative	4,136	6,541	19,760	21,579
Amortization of acquired intangible assets	83	280	249	896
Goodwill and intangible impairment	1,736	164,263	1,736	164,263
Restructuring expenses	1,605	351	1,778	351
Total operating expenses	20,411	186,333	69,820	234,765
Operating loss	(4,549)	(164,675)	(8,313)	(170,342)
Other income (expense):
Interest expense, net	(1,123)	(965)	(3,118)	(3,009)
Loss on debt extinguishment	(9,478)	0	(9,478)	0
Other income (expense), net	90	6,159	(273)	7,233
Total other income (expense)	(10,511)	5,194	(12,869)	4,224
Loss from continuing operations before taxes	(15,060)	(159,481)	(21,182)	(166,118)
Income tax benefit	(4,997)	(2,483)	(4,962)	(1,328)
Net loss from continuing operations	(10,063)	(156,998)	(16,220)	(164,790)
Discontinued operations:
Net loss from discontinued operations, net of applicable taxes	(3,658)	(3,267)	(9,351)	(3,983)
Net loss	$ (13,721)	$ (160,265)	$ (25,571)	$ (168,773)
Net loss per share, basic and diluted:
Continuing operations, net loss per share, basic and diluted (in dollars per share)	$ (1.17)	$ (18.96)	$ (1.91)	$ (19.92)
Discontinued operations, net loss per share, basic and diluted (in dollars per share)	(0.43)	(0.39)	(1.10)	(0.48)
Net loss per basic and diluted share (in dollars per share)	$ (1.60)	$ (19.35)	$ (3.01)	$ (20.40)
Shares used in calculating basic and diluted net loss per share (in shares)	8,560	8,281	8,505	8,272

CONDENSED CONSOLIDATED STATEME5

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Statement of Comprehensive Income [Abstract]
Net loss	$ (13,721)	$ (160,265)	$ (25,571)	$ (168,773)
Foreign currency translation adjustments related to continuing operations	961	624	2,602	(9,034)
Foreign currency translation realized to discontinued operations	19,355	0	19,355	0
Comprehensive income (loss)	$ 6,595	$ (159,641)	$ (3,614)	$ (177,807)

CONDENSED CONSOLIDATED STATEME6

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015
Operating activities:
Net loss	$ (25,571)	$ (168,773)
Adjustments to reconcile net loss to net cash (used in) provided by operating activities:
Depreciation and amortization	10,403	14,099
Stock-based compensation	1,510	2,440
Interest expense related to amortization of debt discount and debt issuance costs	3,320	3,630
Impairment of goodwill and intangible assets	1,736	165,171
Provision for (recovery of) doubtful accounts	(53)	465
Provision for excess and obsolete inventory	4,488	1,529
Deferred income tax expense	0	(1,320)
Gain on sale of business	(5,361)	0
Loss on extinguishment of debt	3,863	0
Other non-cash items	280	(4,885)
Changes in operating assets and liabilities:
Restricted cash	2,350	3,300
Accounts receivable	10,658	3,475
Inventories	(4,723)	(2,202)
Prepaid expenses and other current assets	1,797	1,871
Other assets	191	15
Accounts payable	(5,247)	(277)
Accrued expenses and other	233	(12,972)
Net cash (used in) provided by operating activities	(126)	5,566
Investing activities:
Purchases of property and equipment	(7,291)	(8,738)
Proceeds from sale of business, net	69,894	0
Cash received from sale of assets	1,316	0
Net cash provided by (used in) investing activities	63,919	(8,738)
Financing activities:
Borrowings under lines of credit	94,241	105,523
Repayments under lines of credit	(110,840)	(110,354)
Principal payments on capital lease obligations	(606)	(555)
Proceeds from sale of stock	57	0
Proceeds from notes payable, net	23,046	5,000
Principal payments on notes payable and term loan	(53,820)	(6,163)
Net cash used in financing activities	(47,922)	(6,549)
Effect of exchange rate changes on cash	(1,220)	488
Net increase (decrease) in cash	14,651	(9,233)
Cash at end of period, including discontinued operations	11,229	19,735
Cash at end of period, including discontinued operations	25,880	10,502
Supplemental disclosure of cash flow information:
Cash paid for interest	6,122	5,677
Cash paid for income taxes	920	580
Purchases of property and equipment in accounts payable	$ 543	$ 2,458

The Company and Basis of Presen

The Company and Basis of Presentation	9 Months Ended
	Sep. 30, 2016
Organization, Consolidation and Presentation of Financial Statements [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. Prior to September 1, 2016, the Company marketed its products in the U.S. market and 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 conducted its operations through its Brazilian subsidiary, Cibramed Productos Medicos. In Japan, the Company marketed its products through its subsidiary, Alphatec Pacific, Inc. and its subsidiaries (“Alphatec Pacific”). On September 1, 2016, the Company completed the sale of its international distribution operations and agreements to Globus Medical Ireland, Ltd., a subsidiary of Globus Medical, Inc., and its affiliated entities (collectively “Globus”), including the Company’s wholly-owned subsidiaries in Japan, Brazil, Australia and Singapore and substantially all of the assets of the Company’s other sales operations in the United Kingdom and Italy (collectively, the “International Business”), pursuant to a purchase and sale agreement, dated as of July 25, 2016 (as amended, the “Purchase and Sale Agreement”) (the “Globus Transaction”). As a result of the Globus Transaction, the Company's International Business has been excluded from continuing operations for all periods presented in this report and is reported as discontinued operations. See Note 4 for additional information on the divestiture of the International Business. The Company operates in one reportable business segment. The sale of the international operations represents a strategic shift and has a significant impact on the Company's operations and financial results. Basis of Presentation The accompanying condensed consolidated balance sheet as of December 31, 2015 , 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, including normal recurring 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. These unaudited condensed consolidated financial statements should be read in conjunction with the Company’s audited consolidated financial statements for the year ended December 31, 2015 , which are included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2015 that was filed with the SEC on March 15, 2016 . Operating results for the three and nine months ended September 30, 2016 are not necessarily indicative of the results that may be expected for the year ending December 31, 2016 , or any other future periods. On August 24, 2016, the Company filed a certificate of amendment to its certificate of incorporation with the Secretary of State of the state of Delaware to effectuate a 1-for-12 reverse stock split of the Company’s issued and outstanding common stock. The accompanying condensed consolidated financial statements and notes thereto give retrospective effect to the reverse stock split for all periods presented. All issued and outstanding common stock, options exercisable for common stock, warrants exercisable for common stock, restricted stock units, and per share amounts contained in the Company’s condensed consolidated financial statements have been retroactively adjusted to reflect this reverse stock split for all periods presented. The Company has incurred significant net losses since inception and has relied on its ability to fund its operations through revenues from the sale of its products, equity financings and debt financings. As the Company has incurred losses, successful transition to profitability is dependent upon achieving a level of revenues adequate to support the Company’s cost structure. This may not occur and, unless and until it does, the Company will continue to need to raise additional capital. These conditions raise substantial doubt about the Company's ability to continue as a going concern. The accompanying condensed consolidated financial statements have been prepared assuming that the Company will continue as a going concern and do not include any adjustments that might result from the outcome of this uncertainty. 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. Operating losses and negative cash flows may continue for at least the next year as the Company continues to incur costs related to the execution of its operating plan and introduction of new products.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2016
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, 2015 , which are included in the Company’s Annual Report on Form 10-K that was filed with the SEC on March 15, 2016 . Except for revenue recognition as discussed below, these accounting policies have not significantly changed during the nine months ended September 30, 2016 . Revenue Recognition The application of the multiple element guidance requires subjective determinations, and requires the Company to make judgments about the individual deliverables and whether such deliverables are separable from the other aspects of the contractual relationship. Deliverables are considered separate units of accounting provided that: (1) the delivered items has value to the customer on a stand-alone basis and (2) if the arrangement includes a general right of return relative to the delivered items, delivery or performance of the undelivered items is considered probable and substantially in the Company's control. In determining the units of accounting, the Company evaluates certain criteria, including whether the deliverables have stand-alone value, based on the consideration of the relevant facts and circumstances for each arrangement. In addition, the Company considers whether the buyer can use the other deliverables for their intended purpose without the receipt of the remaining elements, whether the value of the deliverable is dependent on the undelivered items, and whether there are other vendors that can provide the undelivered elements. Revenue arrangements with multiple elements are divided into separate units of accounting if certain criteria are met, including whether the delivered element has stand-alone value to the customer. The consideration received is allocated among the separate units based on their respective fair values, and the applicable revenue recognition criteria are applied to each of the separate units. Arrangement consideration that is fixed or determinable is allocated among the separate units of accounting using the relative selling price method, and the applicable revenue recognition criteria are applied to each of the separate units of accounting in determining the appropriate period or pattern of recognition. The Company determines the estimated selling price for deliverables within each agreement using vendor-specific objective evidence (VSOE) of selling price, if available, third-party evidence (TPE) of selling price if VSOE is not available, or management's best estimate of selling price (BESP) if neither VSOE nor TPE is available. Determining the BESP for a unit of accounting requires significant judgment. In developing the BESP for a unit of accounting, the Company considers applicable market conditions and relevant entity-specific factors, including factors that were contemplated in negotiating the agreement with the customer and estimated costs. 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 September 30, 2016 or December 31, 2015 . 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 nine months ended September 30, 2016 (in thousands): Common Stock Warrant Liabilities Balance at December 31, 2015 $ 687 Change in fair value 387 Conversion to common stock (1,074 ) Balance at September 30, 2016 $ — Prior to the conversion to common stock described in Note 6, the common stock warrant liabilities were 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 (described in Note 6 below) was the expected volatility. Recent Accounting Pronouncements In May 2014, the Financial Accounting Standards Board (“FASB”) issued new accounting guidance related to revenue recognition. This new standard replaces all current U.S. GAAP guidance on this topic and eliminates 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 for which the entity expects to be entitled in exchange for those goods or services. This guidance, including all subsequent clarifications, is effective for the Company for annual and interim reporting periods in fiscal years beginning after December 15, 2017 and can be applied either retrospectively to each period presented or as a cumulative-effect adjustment as of the date of adoption. The Company is evaluating the impact of adopting this new accounting standard 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 thereafter. The Company is 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, which amends current presentation guidance by requiring that debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability, consistent with debt discounts. Prior to the issuance this guidance, debt issuance costs were required to be presented as an asset in the balance sheet. The Company adopted the provisions of the new guidance during the interim period ended March 31, 2016 and prior period amounts have been reclassified to conform to the current period presentation. As of December 31, 2015, $0.4 million of debt issuance costs were reclassified in the consolidated balance sheet from prepaid expenses and other current assets to current portion of long-term debt. The adoption of ASU 2015-03 did not impact the Company's consolidated statement of operations, comprehensive income (loss) or cash flows. In July 2015, the FASB issued new accounting guidance, which changes the measurement principle for inventory from the lower of cost or market to lower of cost and net realizable value for entities that do not measure inventory using the last-in, first-out or retail inventory method. The guidance also eliminates the requirement for these entities to consider replacement cost or net realizable value less an approximately normal profit margin when measuring inventory. The guidance is effective for annual periods beginning after December 15, 2016, and interim periods within those annual periods. The Company is evaluating the impact of adopting this new accounting standard on its financial statements. In February 2016, the FASB issued new accounting guidance, which changes several aspects of the accounting for leases, including the requirement that all leases with durations greater than twelve months be recognized on the balance sheet. The guidance is effective for annual periods and interim periods in fiscal years beginning after December 15, 2018. The Company is evaluating the impact of adopting this new accounting standard on its financial statements. In March 2016, the FASB issued new accounting guidance, which changes several aspects of the accounting for share-based payment award transactions, including accounting and cash flow classification for excess tax benefits and deficiencies, forfeitures, and tax withholding requirements and cash flow classification. The guidance is effective for annual periods and interim periods in fiscal years beginning after December 15, 2016. The Company is evaluating the impact of adopting this new accounting standard on its financial statements. In August 2016, the FASB issued new accounting guidance, which eliminates the diversity in practice related to the classification of certain cash receipts and payments in the statement of cash flows, by adding or clarifying guidance on eight specific cash flow issues. The guidance is effective for annual and interim reporting periods beginning after December 15, 2017, with early adoption permitted. The amendments in this update should be applied retrospectively to all periods presented, unless deemed impracticable, in which case, prospective application is permitted. The Company is currently evaluating the new guidance and has not determined the impact this standards update may have on its financial statements.

Select Condensed Consolidated B

Select Condensed Consolidated Balance Sheet Details	9 Months Ended
	Sep. 30, 2016
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Select Condensed Consolidated Balance Sheet Details	Select Condensed Consolidated Balance Sheet Details Accounts Receivable, net Accounts receivable, net consist of the following (in thousands): September 30, 2016 December 31, 2015 Accounts receivable $ 16,665 $ 27,639 Allowance for doubtful accounts (119 ) (769 ) Accounts receivable, net $ 16,546 $ 26,870 Inventories, net Inventories, net consist of the following (in thousands): September 30, 2016 December 31, 2015 Raw materials $ 6,350 $ 7,237 Work-in-process 1,120 1,908 Finished goods 36,020 39,388 43,490 48,533 Less reserve for excess and obsolete finished goods (15,829 ) (15,901 ) Inventories, net $ 27,661 $ 32,632 Property and Equipment, net Property and equipment, net consist of the following (in thousands except as indicated): Useful lives (in years) September 30, 2016 December 31, 2015 Surgical instruments 4 $ 51,253 $ 52,404 Machinery and equipment 7 5,435 14,416 Computer equipment 3 3,511 3,816 Office furniture and equipment 5 2,695 3,426 Leasehold improvements various 3,467 3,467 Construction in progress n/a 59 139 66,420 77,668 Less accumulated depreciation and amortization (52,708 ) (61,587 ) Property and equipment, net $ 13,712 $ 16,081 Total depreciation expense was $1.6 million and $2.8 million for the three months ended September 30, 2016 and 2015 , respectively. Total depreciation expense was $5.6 million and $7.5 million for the nine months ended September 30, 2016 and 2015 , respectively. At September 30, 2016 , assets recorded under capital leases of $2.1 million were included in the machinery and equipment balance. At December 31, 2015 , assets recorded under capital leases of $2.6 million were included in the machinery and equipment balance and $0.1 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): Remaining Avg. Useful lives (in years) September 30, 2016 December 31, 2015 Developed product technology 1 $ 13,876 $ 13,876 Distribution rights 4 390 390 Intellectual property — 1,004 1,004 License agreements 1 14,016 14,016 Trademarks and trade names 2 732 732 Customer-related 9 7,458 7,458 Distribution network 5 4,027 4,027 Supply agreement — 225 225 41,728 41,728 Less accumulated amortization (35,576 ) (32,922 ) Intangible assets, net $ 6,152 $ 8,806 Total amortization expense was $0.3 million and $0.5 million for the three months ended September 30, 2016 and 2015 , respectively. Total amortization expense was $0.9 million and $3.3 million for the nine months ended September 30, 2016 and 2015 , respectively. In connection with the sale of the International Business (see Note 4), the Company determined that certain intangible assets related to the Company's previous acquisition of Scient'x, including customer relationships, distribution network and key product tradename intangible assets, no longer had a business purpose and no cash flows associated with these assets are expected in the future. As a result, the Company recorded $1.7 million as intangible impairment expense during the three and nine months ended September 30, 2016 . Prior to the impairment, amortization of these intangible assets had been recorded in amortization of acquired intangible assets within operating expenses. On June 19, 2015, the Company entered into an exclusive distribution agreement with a third party to market a biologic product. The Company expensed $0.3 million as an impairment charge in cost of goods sold in the nine months ended September 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. As a result of this impairment analysis, the Company expensed $0.9 million as an impairment charge in cost of goods sold for the nine months ended September 30, 2015 for the write-off of an intangible asset related to this product. In the third quarter of 2015, the market value of the Company’s common stock substantially declined. As a result of this decline, the Company determined that it had an indicator of impairment of its goodwill, and an interim test of goodwill impairment was required. As a result of this interim test, the Company recorded a charge of $164.3 million , representing the write-off of the remaining balance of goodwill in the three and nine months ended September 30, 2015 . In connection with the step two goodwill impairment test performed in the third quarter of 2015, the Company determined that the physician education intangible acquired in the Scient’x acquisition was impaired. As a result, the Company expensed $0.9 million included in goodwill and intangible impairment of discontinued operations in the three and nine months ended September 30, 2015 . Future amortization expense related to intangible assets as of September 30, 2016 is as follows (in thousands): Year Ending December 31, Remainder of 2016 $ 223 2017 892 2018 846 2019 832 2020 712 Thereafter 2,647 $ 6,152 Accrued Expenses Accrued expenses consist of the following (in thousands): September 30, 2016 December 31, 2015 Commissions and sales milestones $ 3,455 $ 3,963 Payroll and payroll related 2,621 3,947 Deferred revenue from Globus Transaction 3,900 — Globus inventory obligation 2,375 — Litigation settlements 4,400 4,400 Accrued professional fees 2,199 1,972 Royalties 1,340 1,199 Restructuring and severance accruals 1,463 505 Accrued taxes 3,849 765 Guaranteed collaboration compensation, current 1,543 — Accrued interest 205 999 Other 3,355 3,425 Total accrued expenses $ 30,705 $ 21,175

Discontinued Operations

Discontinued Operations	9 Months Ended
	Sep. 30, 2016
Discontinued Operations and Disposal Groups [Abstract]
Discontinued Operations	Discontinued Operations In order to pay down a portion of its debt and improve its liquidity position and future cash flows, on September 1, 2016, the Company closed the Globus Transaction (described in Note 1). Following the closing of the Globus Transaction, the Company only sells its products in the U.S. market and is prohibited from marketing and selling its products outside the United States and its possessions and territories until the date that is two years following the termination of the Supply Agreement (as described below). As a result of the Globus Transaction, the Company has retrospectively revised the condensed consolidated statements of operations and cash flows for the three and nine month periods ended September 30, 2015 and the condensed consolidated balance sheet as of December 31, 2015 to reflect the financial results from the International Business, and the related assets and liabilities, as discontinued operations. At the closing of the Globus Transaction, Globus paid the Company $80 million in cash, subject to a working capital adjustment. On September 1, 2016, the Company used approximately $69 million of the consideration received to (i) repay in full all amounts outstanding and due under the Company’s Deerfield Facility Agreement (described in Note 6 below) and (ii) repay certain of its outstanding indebtedness under the Company’s Amended Credit Facility with MidCap (described in Note 6), in each case, including debt-related costs. Also on September 1, 2016, the Company entered into a five -year term credit, security and guaranty agreement with Globus (the “Globus Facility Agreement”), as further described in Note 6, pursuant to which Globus agreed to loan the Company up to $30 million , subject to the terms and conditions set forth in the Globus Facility Agreement. The following table summarizes the preliminary calculation of the gain on sale, which will be finalized during the fourth quarter of 2016 (in thousands): Consideration received $ 80,000 Cash included in assets sold (4,250 ) Transaction costs (5,328 ) Product supply obligation (3,900 ) Preliminary working capital adjustment 3,372 Net cash proceeds 69,894 Less: Carrying value of business and assets sold 64,533 Net gain on sale of business $ 5,361 The results of operations from discontinued operations presented below include certain allocations that management believes fairly reflect the utilization of services provided to the International Business. The allocations do not include amounts related to general corporate administrative expenses. Therefore, the results of operations from the International Business do not necessarily reflect what the results of operations would have been had the International Business operated as a stand-alone entity. In connection with the Globus Transaction, the Company entered into a product manufacture and supply agreement (the “Supply Agreement”) with Globus, pursuant to which the Company agreed to supply to Globus certain of its implants and instruments (the “Products”), previously offered for sale by the Company in international markets at agreed-upon prices for a minimum term of three years, with the option for Globus to extend the term for up to two additional twelve month periods subject to Globus meeting specified purchase requirements. In accordance with authoritative guidance, certain intercompany sales transactions have been reported under continuing operations as the Company will have continuing involvement due to future sales to Globus under the Supply Agreement. In connection with the Globus Transaction, Globus received a credit of up to a $3.9 million to be applied against Product purchases pursuant to the Supply Agreement during a six -month period commencing one month after the closing of the Globus Transaction, which has been included as a reduction of the consideration received for the sale of the International Business. The agreements entered into concurrently with the sale of the International Business, including the Transition Services Agreement and Supply Agreement, contain various elements and, as such, are deemed to be an arrangement with multiple deliverables as defined under authoritative accounting guidance (see Note 2). Several non-contingent deliverables were identified within the agreements. The Company identified the contract supply services, transition services and the Globus Facility as separate non-contingent deliverables within the arrangement. The Company determined the estimated selling price (fair value) for each of the non-contingent deliverables on a standalone basis by utilizing relevant market data and entity-specific factors. Based on the respective standalone fair values of the deliverables, there was no discount to allocate among the deliverables and the consideration received for each deliverable approximated standalone fair value. As such, none of the purchase consideration was allocated to these elements. Included in the results of continuing operations for the three months ended September 30, 2016 and 2015 are revenues of $1.4 million and $4.2 million , respectively, and cost of revenue of $1.8 million and $3.5 million , respectively, that represent intercompany transactions that, prior to the Globus Transaction, were eliminated in the Company's condensed consolidated financial statements. Included in the results of continuing operations for the nine months ended September 30, 2016 and 2015 are revenues of $8.9 million and $13.5 million , respectively, and cost of revenue of $8.9 million and $13.5 million , respectively, that represent intercompany transactions that, prior to the Globus Transaction, were eliminated in the Company's condensed consolidated financial statements. During the three and nine months ended September 30, 2016 , the Company recorded less than $0.1 million in revenue and cost of sales from the Supply Agreement that are included in the continuing operations. In connection with the Globus Transaction, the Company included the interest expense of $2.2 million and $7.2 million for the three and nine months ended September 30, 2016 , respectively, and $2.1 million and $6.5 million for the three and nine months ended September 30, 2015 , respectively incurred in connection with repayment from the proceeds from the Globus Transaction of all amounts outstanding and due under the Deerfield Facility Agreement and Amended Credit Facility (as further described in Note 6) in the loss from discontinued operations to the extent these debt facilities were repaid using the proceeds from the Globus Transaction. The following table summarizes the results of discontinued operations for the periods presented in the condensed consolidated statements of operations and comprehensive income (loss) for the three and nine months ended September 30, 2016 and 2015 (in thousands): Three Months Ended Nine Months Ended September 30, September 30, Discontinued operations 2016 2015 2016 2015 Revenues $ 18,043 $ 11,309 $ 40,146 $ 38,679 Cost of revenues 11,469 4,111 19,694 13,060 Amortization of acquired intangible assets 555 376 1,291 1,093 Gross profit 6,019 6,822 19,161 24,526 Operating (income) expenses: Research and development 16 48 50 123 Sales and marketing 2,865 4,360 12,391 14,109 General and administrative 1,440 1,553 5,079 4,894 Amortization of acquired intangible assets 155 241 622 971 Goodwill and intangible impairment — 908 — 908 Restructuring expenses 4 (16 ) 620 (188 ) Net gain on sale of business (5,361 ) — (5,361 ) — Total operating (income) expenses (881 ) 7,094 13,401 20,817 Operating income (loss) 6,900 (272 ) 5,760 3,709 Other income (expense): Interest income 12 15 46 29 Interest expense (2,156 ) (2,142 ) (7,240 ) (6,504 ) Other income (expense), net 243 (102 ) 1,892 (451 ) Total other income (expense) (1,901 ) (2,229 ) (5,302 ) (6,926 ) Income (loss) from discontinued operations before taxes 4,999 (2,501 ) 458 (3,217 ) Income tax provision 8,657 766 9,809 766 Loss from discontinued operations, net of applicable taxes $ (3,658 ) $ (3,267 ) $ (9,351 ) $ (3,983 ) The following table summarizes the assets and liabilities of discontinued operations as of September 30, 2016 and December 31, 2015 related to the International Business (in thousands): September 30, December 31, Assets Current assets: Cash $ 288 $ 4,934 Accounts receivable, net — 11,449 Inventories, net 2,375 12,276 Prepaid expenses and other current assets 165 1,551 Total current assets of discontinued operations 2,828 30,210 Property and equipment, net 10 5,864 Intangible assets, net — 12,810 Other assets 61 783 Total assets of discontinued operations $ 2,899 $ 49,667 Liabilities Current liabilities: Accounts payable $ 143 $ 627 Accrued expenses 1,290 8,616 Deferred revenue 147 648 Other current liabilities 627 — Total current liabilities of discontinued operations 2,207 9,891 Other long-term liabilities 87 1,516 Total liabilities of discontinued operations $ 2,294 $ 11,407 Included in the cash flows for the nine months ended September 30, 2016 and September 30, 2015 are the following non-cash adjustments related to the discontinued operations (in thousands): Nine Months Ended September 30, 2016 2015 Depreciation and amortization $ 3,836 $ 3,965 Provision for excess and obsolete inventory $ 151 $ — Capital expenditures $ 1,319 $ 2,229 Interest expense related to amortization of debt discount and debt issuance costs $ 2,052 $ 2,065

License and Consulting Agreemen

License and Consulting Agreements	9 Months Ended
	Sep. 30, 2016
Contractors [Abstract]
License and Consulting Agreements	License and Consulting Agreements The Company’s license and consulting agreements are described in Note 4 to its audited consolidated financial statements for the year ended December 31, 2015 , which are included in its Annual Report on Form 10-K which was filed with the SEC on March 15, 2016 .

Debt

Debt	9 Months Ended
	Sep. 30, 2016
Debt Disclosure [Abstract]
Debt	Debt MidCap Facility Agreement On August 30, 2013, the Company entered into the amended and restated credit, security and guaranty agreement with MidCap Funding IV, LLC (“MidCap”), as amended to date (the “ Amended Credit Facility ” ), which amended and restated the prior credit facility that the Company had with MidCap. On September 1, 2016, the Company and MidCap entered into a Fifth Amendment to the Amended Credit Facility (the “MidCap Fifth Amendment”) that: (a) permitted (i) the Globus Transaction, (ii) the release of Alphatec International LLC and Alphatec Pacific, Inc. as credit parties, (iii) the payment in full of all obligations to 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”) under the Facility Agreement between the Company and Deerfield, dated as of March 17, 2014, as amended to date (the “Deerfield Facility Agreement”), and (iv) the incurrence of debt under the Globus Facility Agreement and the granting of liens in favor of Globus; (b) reduced the revolving credit commitment to $22.5 million and the term loan commitment to $5 million ; (c) revised the existing financial covenant package; and (d) extended the commitment expiry date from December 31, 2016 to December 31, 2019. In connection with the prepayment of the term loan under the Amended Credit Facility , the Company incurred a prepayment fee of $0.6 million payable to MidCap. As of September 30, 2016 , $12.2 million was outstanding under the revolving line of credit and $4.9 million was outstanding under the term loan. 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 September 30, 2016 , the revolving line of credit carried an interest rate of 6.5% 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 $0.1 million through the end of 2016, $0.2 million in 2017 and $0.3 million in 2018 through maturity are due, with the remaining principal due upon maturity. 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 event of default provisions, 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. The financial covenants of the Amended Credit Facility are not effective until April 2017. There is no assurance that the Company will be in compliance with the financial covenants of the Amended Credit Facility in the future. On March 11, 2016, the Company entered into a third amendment and waiver to the Amended Credit Facility with MidCap (the "Third Amendment to the Amended Credit Facility"). The Third Amendment to the Amended Credit Facility extended the maturity date of the Amended Credit Facility from August 30, 2016 to December 31, 2016 and contained an amendment fee in the amount of $0.5 million , which was due and payable at the earlier of the termination of the Amended Credit Facility or the maturity date. The Third Amendment to the Amended Credit Facility also contained a waiver of the December 2015 defaults under the Amended Credit Facility, provided a waiver for the fixed charge coverage ratio for January 2016 and eliminated the fixed charge coverage ratio covenant for February 2016. At September 30, 2016 , $2.1 million remains as unamortized debt discount related to the prior and Amended Credit Facility within the condensed consolidated balance sheet, which will be amortized over the remaining term of the Amended Credit Facility. On August 8, 2016, the Company entered into a Fourth Amendment to the Amended Credit Facility with MidCap (the "Fourth Amendment to the Amended Credit Facility"). The Fourth Amendment to the Amended Credit Facility provided for a $2.2 million increase to the borrowing base until September 15, 2016, and included an amendment fee of $0.2 million , which was due and payable on August 8, 2016. The Fourth Amendment to the Amended Credit Facility also contained a waiver for the May and June 2016 non-compliances. Deerfield Facility Agreement On March 17, 2014, the Company entered into the Deerfield Facility Agreement, pursuant to which Deerfield agreed to loan the Company up to $50 million , subject to the terms and conditions set forth in the Deerfield Facility Agreement. Under the terms of the Deerfield Facility Agreement, the Company had the option, but was not required, upon certain conditions to draw the entire amount available under the Deerfield Facility Agreement, at any time until January 30, 2015, 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 agreed to pay Deerfield, upon each disbursement of funds under the Deerfield Facility Agreement, a transaction fee equal to 2.5% of the principal amount of the funds disbursed. In connection with the execution of the Deerfield Facility Agreement on March 17, 2014, the Company issued to Deerfield warrants to purchase an aggregate of 520,833 shares of the Company’s common stock, which are immediately exercisable and have an exercise price equal to $16.68 per share (the “Initial Warrants”). Additionally, the Company agreed that each disbursement borrowing under the Deerfield Facility Agreement be accompanied by the issuance to Deerfield of warrants to purchase up to 833,333 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 Deerfield 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 was recorded as a debt discount and was 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 333,333 shares of common stock at an exercise price of $16.68 per share, which were valued at $4.7 million and recorded as a debt discount, which were 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 Deerfield 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 was 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 100,000 shares of common stock at an exercise price of $16.68 per share, which Draw Warrants were valued at $0.9 million and were recorded as a debt discount, which was 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 was being amortized through interest expense over the term of the debt using the effective interest method. No amounts remain available for the Company to borrow under the Facility Agreement. On February 5, 2016, the Company entered into a Limited Waiver and Second Amendment to the Deerfield Facility Agreement (the “Deerfield Facility Agreement Second Amendment”) with Deerfield. The Deerfield Facility Agreement Second Amendment increased the interest rate under the Facility Agreement from 8.75% per annum to 14.75% per annum. In addition, the Deerfield Facility Agreement Second Amendment provided that the Company may elect to have (i) until August 30, 2016, six percent ( 6% ), and (ii) thereafter, three percent ( 3% ), in each case, of the interest on the outstanding principal amount under the Facility Agreement paid in kind, which would be added to the outstanding principal amount under the Deerfield Facility Agreement and bear interest at the interest rate of 14.75% per annum (the “PIK Interest”). All accrued and unpaid PIK Interest was due and payable when the outstanding amounts under the Facility Agreement were due and payable thereunder or were fully repaid, whichever occurs first. The Deerfield Facility Agreement Second Amendment also contained an amendment fee in the amount of $0.6 million , which was due and payable in installments of $0.2 million on each of the third, fourth and fifth anniversaries of the Deerfield Facility Agreement; provided that all unpaid amendment fees shall be due and payable when the outstanding amounts under the Facility Agreement are due and payable or are fully repaid, whichever occurs first. The Deerfield Facility Agreement Second Amendment also changed the date from March 31, 2017 to March 31, 2018, as the date through which the Company must pay interest in the event the Company prepays amounts outstanding under the Deerfield Facility Agreement prior to such date. The Second Amendment also contained a waiver of the defaults under the Deerfield Facility Agreement for the fixed charge coverage ratio for the month of January 2016. In September 2016, in connection with the Globus Transaction, Deerfield exercised its right to convert all outstanding Initial Warrants and Draw Warrants into shares of the Company's common stock based on the Black-Scholes value of the warrants. The outstanding warrants were converted into 268,614 shares of the Company's common stock. Prior to the conversion, the outstanding warrants were periodically revalued to their fair value resulting in income of $0.1 million and an expense of $0.4 million for the three and nine months ended September 30, 2016 , respectively, included in other income and expense. The revaluation of the warrants to their fair value during the three and nine months ended September 30, 2015 , respectively, resulted in income of $6.3 million and $8.0 million , respectively. On September 1, 2016, in connection with the Globus Transaction, the Company repaid in full all amounts outstanding and due under the Deerfield Facility Agreement and terminated the Deerfield Facility Agreement. Pursuant to the Globus Facility Agreement and the MidCap Fifth Amendment, the Company made a final payment of $33.5 million to Deerfield, consisting of outstanding principal and accrued interest of $27.9 million , a prepayment premium of $5.6 million and other related fees and wrote-off $3.9 million of unamortized expenses resulting in a loss on debt extinguishment of $9.5 million . The interest expense historically incurred in connection with the Deerfield Facility Agreement of $2.2 million and $7.2 million for three and nine months ended September 30, 2016 , respectively and $2.1 million and $6.5 million for three and nine months ended September 30, 2015 , respectively is included in the loss from discontinued operations. Globus Facility Agreement On September 1, 2016, the Company and Globus entered into the Globus Facility Agreement, pursuant to which Globus agreed to loan the Company up to $30 million , subject to the terms and conditions set forth in the Globus Facility Agreement. At the closing of the Globus Transaction, the Company made an initial draw of $25 million under the Globus Facility Agreement. The remaining amount may be advanced in up to two additional draws, each in an aggregate amount of no less than $2 million , as requested by the Company at any time prior to December 31, 2017. As of September 30, 2016, the outstanding balance under the Globus Facility Agreement was $25.0 million , which becomes due and payable in quarterly payments of $0.8 million starting in September 2018, with a final payment of the remaining amount outstanding due on September 1, 2021. The term loan interest rate is priced at LIBOR plus 8.0% through September 1, 2018, and LIBOR plus 13.0% , thereafter. As collateral for the Globus Facility Agreement, the Company granted Globus a first lien security interest in substantially all of its assets, other than accounts receivable and related assets, which will secure the Globus Facility Agreement on a second lien basis. The Globus Facility Agreement includes traditional lending and reporting covenants including a fixed charge coverage ratio to be maintained by the Company. The financial covenants of the Globus Facility Agreement are not effective until April 2017. There is no assurance that the Company will be in compliance with the financial covenants of the Globus Facility Agreement in the future. The Globus Facility Agreement also includes several event of default provisions, 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 Globus’s right to declare all outstanding obligations immediately due and payable. Principal payments on the Company's debt are as follows as of September 30, 2016 (in thousands): Year Ending December 31, Remainder of 2016 $ 624 2017 3,236 2018 4,045 2019 16,137 2020 and thereafter 20,000 Total 44,042 Add: capital lease principal payments 672 Less: unamortized debt discount and debt issuance costs (3,852 ) Total 40,862 Less: current portion of long-term debt (2,647 ) Long-term debt, net of current portion $ 38,215

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2016
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 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 2018. Future minimum annual lease payments under such leases are as follows as of September 30, 2016 (in thousands): Year Ending December 31, Operating Capital Remainder of 2016 $ 666 $ 205 2017 1,590 437 2018 1,455 68 2019 1,420 — 2020 and thereafter 2,311 — $ 7,442 710 Less: amount representing interest (38 ) Present value of minimum lease payments 672 Current portion of capital leases (544 ) Capital leases, less current portion $ 128 Rent expense under operating leases for the three months ended September 30, 2016 and 2015 was $0.7 million and $0.6 million , respectively. Rent expense under operating leases for the nine months ended September 30, 2016 and 2015 was $2.0 million and $1.8 million , respectively. Litigation The Company is and may become involved in various legal proceedings arising from its business activities. While management is not aware of any litigation matter that in and of itself would 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 a proceeding, 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 the Company's 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 the Company may be unsupported, exaggerated or unrelated to reasonably possible outcomes, and as such are not meaningful indicators of the Company’s potential liability. Indemnifications In the normal course of business, the Company enters into agreements under which it occasionally indemnifies third-parties for intellectual property infringement claims or claims arising from breaches of representations or warranties. In addition, from time to time, the Company provides indemnity protection to third-parties for claims relating to past performance arising from undisclosed liabilities, product liabilities, environmental obligations, representations and warranties, and other claims. In these agreements, the scope and amount of remedy, or the period in which claims can be made, may be limited. It is not possible to determine the maximum potential amount of future payments, if any, due under these indemnities due to the conditional nature of the obligations and the unique facts and circumstances involved in each agreement. 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	9 Months Ended
	Sep. 30, 2016
Commitments and Contingencies Disclosure [Abstract]
Orthotec Settlement	Orthotec Settlement 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”). Pursuant to the Settlement Agreement, the Company agreed to pay Orthotec, LLC $49.0 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 one additional quarterly installment of $0.7 million , commencing October 1, 2014. As of September 30, 2016 , the Company has made installment payments in the aggregate of $26.3 million , with a remaining outstanding balance of $24.8 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 Settlement Agreement 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.

Net Loss Per Share

Net Loss Per Share	9 Months Ended
	Sep. 30, 2016
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, performance-based restricted stock units 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. The following table presents the computation of basic and diluted net loss per share for continuing and discontinued operations (in thousands, except per share amounts): Three Months Ended Nine Months Ended 2016 2015 2016 2015 Numerator: Loss from continuing operations $ (10,063 ) $ (156,998 ) $ (16,220 ) $ (164,790 ) Loss from discontinued operations (3,658 ) (3,267 ) (9,351 ) (3,983 ) Net loss $ (13,721 ) $ (160,265 ) $ (25,571 ) $ (168,773 ) Denominator: Weighted average common shares outstanding 8,623 8,345 8,554 8,341 Weighted average unvested common shares subject to repurchase (63 ) (64 ) (49 ) (69 ) Weighted average common shares outstanding—basic 8,560 8,281 8,505 8,272 Effect of dilutive securities: Conversion of preferred stock — — — — Options — — — — Warrants — — — — Weighted average common shares outstanding—diluted 8,560 8,281 8,505 8,272 Net loss per share, basic and diluted: Continuing operations $ (1.17 ) $ (18.96 ) $ (1.91 ) $ (19.92 ) Discontinued operations (0.43 ) (0.39 ) (1.10 ) (0.48 ) Net loss per share, basic and diluted $ (1.60 ) $ (19.35 ) $ (3.01 ) $ (20.40 ) The anti-dilutive securities not included in diluted net loss per share were as follows (in thousands): Three Months Ended Nine Months Ended 2016 2015 2016 2015 Options to purchase common stock 594 655 611 669 Unvested restricted share awards 63 64 49 69 Warrants to purchase common stock 8 962 8 962 Total 665 1,681 668 1,700

Stock Benefit Plans and Stock-B

Stock Benefit Plans and Stock-Based Compensation	9 Months Ended
	Sep. 30, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock Benefit Plans and Stock-Based Compensation	Stock Benefit Plans and Stock-Based Compensation In 2005, the Company adopted its 2005 Employee, Director, and Consultant Stock Plan (the “2005 Plan”). The 2005 Plan expired in April 2016. As of September 30, 2016 , there were 742,183 shares issuable under the 2005 Plan. In the third quarter of 2016, the Company adopted its 2016 Equity Incentive Plan (the “2016 Plan”). The 2016 Plan allows for the grant of options, restricted stock, restricted stock unit awards and performance unit awards to employees, directors, and consultants of the Company. Since its adoption, the 2016 Plan has had 1,083,333 shares of common stock reserved for issuance. The Board of Directors determines the terms of the grants made under the 2016 Plan. Options granted under the 2016 Plan expire no later than ten years from the date of grant ( five years for incentive stock options granted to holders of more than 10% of the Company’s voting stock). Options generally vest over a four year period and may be immediately exercisable upon a change of control of the Company. The exercise price of incentive stock options may not be less than 100% of the fair value of the Company’s common stock on the date of grant. The exercise price of any option granted to a 10% stockholder may be no less than 110% of the fair value of the Company’s common stock on the date of grant. During the three months ended September 30, 2016 , the Company granted 102,101 options and awards to consultants under the 2016 Plan. At September 30, 2016 , 981,232 shares of common stock remained available for issuance under the 2016 Plan. The 2016 Plan will expire in May 2026. On October 4, 2016, the Compensation Committee of the Company’s Board of Directors adopted the 2016 Employment Inducement Award Plan (the “Inducement Plan”). The Inducement Plan allows for the grant of options, restricted stock, restricted stock unit awards and performance unit awards to new employees of the Company by granting an award to such new employee as an inducement for such new employee to begin employment with the Company. Since its adoption, the Inducement Plan has had 350,000 shares of common stock reserved for issuance, which may only be granted to an employee who has not previously been an employee or member of the board of directors of the Company. The terms of the Inducement Plan are substantially similar to the terms of the Company’s 2016 Plan with two principal exceptions: (i) incentive stock options may not be granted under the Inducement Plan; and (ii) the annual compensation paid by the Company to specified executives will be deductible only to the extent that it does not exceed $1.0 million . Under the Inducement Plan, in October 2016, the Company granted 173,322 Restricted Share Units ("RSUs") and $0.8 million of value Performance Restricted Share Units ("PRSUs") with the grant date fair value of $0.8 million and $0.7 million , respectively. The PRSUs will vest in a dollar amount representing between 0% to 250% of the target value upon the earlier of September 14, 2019 or a change in control of he Company. The actual payout amount will be based on the Company’s market capitalization on the vesting date and the fair-market value of the Company’s common stock on such vesting date and will be paid in shares of the Company's common stock.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2016
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 the tax environment changes. Intraperiod tax allocation rules require the Company to allocate the provision for income taxes between continuing operations and other categories of earnings, such as discontinued operations. In periods in which the Company has a year-to-date pre-tax loss from continuing operations and pre-tax income in other categories of earnings, such as discontinued operations, the Company must allocate the tax provision to the other categories of earnings, and then record a related tax benefit in continuing operations. During the three and nine months ended September 30, 2016 the Company recognized net income from discontinued operations, and, as a result, recorded income tax expense of $8.7 million and $9.8 million , respectively, which is included in net income (loss) from discontinued operations in the condensed consolidated statement of operations. Accordingly, the Company recognized a related income tax benefit of $5.0 million and $5.0 million from continuing operations in the condensed consolidated statement of operations for the three and nine months ended September 30, 2016, respectively. As a result of these intraperiod allocation rules, the Company expects to record an additional tax benefit to continuing operations in the fourth quarter of 2016. 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 by $0.7 million during the nine months ended September 30, 2016 . The decrease in unrecognized tax benefits during the nine months ended September 30, 2016 was primarily related to reversal of reserves related to its French net operating losses and foreign currency fluctuations, partially offset by increases in reserves related to U.S. federal and state research credits. The unrecognized tax benefits at September 30, 2016 and December 31, 2015 were $9.7 million and $10.4 million , respectively. With the facts and circumstances currently available to the Company, it is reasonably possible that the amount of reserves that could reverse over the next 12 months is approximately $0.2 million . The income tax benefit from continuing operations consists primarily of income tax benefits related to domestic losses offset by state income taxes. The Company's effective tax rate of 33.2% for the three months ended September 30, 2016 differs from the federal statutory rate of 35% primarily due to permanent differences between domestic tax and financial reporting losses and offset and state income taxes. The Company is not currently under examination by the Internal Revenue Service, or by any foreign, state or local tax authorities.

Related Party Transactions

Related Party Transactions	9 Months Ended
	Sep. 30, 2016
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions For the nine months ended September 30, 2016 and 2015 , respectively, the Company incurred expenses of less than $0.1 million related to HealthpointCapital , LLC. As of September 30, 2016 , the Company also had a liability of less than $0.1 million payable to HealthpointCapital, LLC for travel and administrative expenses. In July 2016, the Company entered into a forbearance agreement with HealthpointCapital, LLC, HealthpointCapital Partners , L.P., and HealthpointCapital Partners II, L.P. (collectively, "HealthpointCapital"), pursuant to which HealthpointCapital, on behalf of the Company, paid $1.0 million of the $1.1 million payment due and payable by the Company to Orthotec on July 1, 2016 and agreed to not exercise its contractual rights to seek an immediate repayment of such amount. Pursuant to this forbearance agreement, the Company repaid this amount in September 2016.

Restructuring

Restructuring	9 Months Ended
	Sep. 30, 2016
Restructuring and Related Activities [Abstract]
Restructuring	Restructuring In connection with the Globus Transaction (described in Note 4), the Company terminated employment agreements with several executive officers and managers including the chief executive officer and the chief financial officer, and recorded restructuring expenses of $1.5 million , which is included in the total restructuring expense of $1.6 million and $1.8 million for the three and nine months ended September 30, 2016 , respectively, related to the severance liability and post-employment benefits. On October 5, 2016, the Company reduced its U.S. workforce by approximately 20% , or approximately 35 employees, primarily in California. As a result of this workforce reduction, the Company estimates that it will incur restructuring charges, primarily in the fourth quarter of 2016, of approximately $0.4 million , in connection with one-time employee termination costs, including severance and other benefits. 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 included a reduction in workforce and closing the California manufacturing facility. The Company incurred expenses of $0.4 million and $0.4 million during the three and nine months ended September 30, 2015 , respectively, related to these restructuring activities. Certain restructuring costs are based upon estimates. Actual amounts paid may ultimately be different from these estimates. If additional costs are incurred, such additional costs will be recognized when incurred.

Summary of Significant Accoun20

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2016
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying condensed consolidated balance sheet as of December 31, 2015 , 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, including normal recurring 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. These unaudited condensed consolidated financial statements should be read in conjunction with the Company’s audited consolidated financial statements for the year ended December 31, 2015 , which are included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2015 that was filed with the SEC on March 15, 2016 .
Revenue Recognition	The application of the multiple element guidance requires subjective determinations, and requires the Company to make judgments about the individual deliverables and whether such deliverables are separable from the other aspects of the contractual relationship. Deliverables are considered separate units of accounting provided that: (1) the delivered items has value to the customer on a stand-alone basis and (2) if the arrangement includes a general right of return relative to the delivered items, delivery or performance of the undelivered items is considered probable and substantially in the Company's control. In determining the units of accounting, the Company evaluates certain criteria, including whether the deliverables have stand-alone value, based on the consideration of the relevant facts and circumstances for each arrangement. In addition, the Company considers whether the buyer can use the other deliverables for their intended purpose without the receipt of the remaining elements, whether the value of the deliverable is dependent on the undelivered items, and whether there are other vendors that can provide the undelivered elements. Revenue arrangements with multiple elements are divided into separate units of accounting if certain criteria are met, including whether the delivered element has stand-alone value to the customer. The consideration received is allocated among the separate units based on their respective fair values, and the applicable revenue recognition criteria are applied to each of the separate units. Arrangement consideration that is fixed or determinable is allocated among the separate units of accounting using the relative selling price method, and the applicable revenue recognition criteria are applied to each of the separate units of accounting in determining the appropriate period or pattern of recognition. The Company determines the estimated selling price for deliverables within each agreement using vendor-specific objective evidence (VSOE) of selling price, if available, third-party evidence (TPE) of selling price if VSOE is not available, or management's best estimate of selling price (BESP) if neither VSOE nor TPE is available. Determining the BESP for a unit of accounting requires significant judgment. In developing the BESP for a unit of accounting, the Company considers applicable market conditions and relevant entity-specific factors, including factors that were contemplated in negotiating the agreement with the customer and estimated costs.
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 September 30, 2016 or December 31, 2015 . 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	Prior to the conversion to common stock described in Note 6, the common stock warrant liabilities were 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 (described in Note 6 below) was the expected volatility.
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 replaces all current U.S. GAAP guidance on this topic and eliminates 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 for which the entity expects to be entitled in exchange for those goods or services. This guidance, including all subsequent clarifications, is effective for the Company for annual and interim reporting periods in fiscal years beginning after December 15, 2017 and can be applied either retrospectively to each period presented or as a cumulative-effect adjustment as of the date of adoption. The Company is evaluating the impact of adopting this new accounting standard 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 thereafter. The Company is 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, which amends current presentation guidance by requiring that debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability, consistent with debt discounts. Prior to the issuance this guidance, debt issuance costs were required to be presented as an asset in the balance sheet. The Company adopted the provisions of the new guidance during the interim period ended March 31, 2016 and prior period amounts have been reclassified to conform to the current period presentation. As of December 31, 2015, $0.4 million of debt issuance costs were reclassified in the consolidated balance sheet from prepaid expenses and other current assets to current portion of long-term debt. The adoption of ASU 2015-03 did not impact the Company's consolidated statement of operations, comprehensive income (loss) or cash flows. In July 2015, the FASB issued new accounting guidance, which changes the measurement principle for inventory from the lower of cost or market to lower of cost and net realizable value for entities that do not measure inventory using the last-in, first-out or retail inventory method. The guidance also eliminates the requirement for these entities to consider replacement cost or net realizable value less an approximately normal profit margin when measuring inventory. The guidance is effective for annual periods beginning after December 15, 2016, and interim periods within those annual periods. The Company is evaluating the impact of adopting this new accounting standard on its financial statements. In February 2016, the FASB issued new accounting guidance, which changes several aspects of the accounting for leases, including the requirement that all leases with durations greater than twelve months be recognized on the balance sheet. The guidance is effective for annual periods and interim periods in fiscal years beginning after December 15, 2018. The Company is evaluating the impact of adopting this new accounting standard on its financial statements. In March 2016, the FASB issued new accounting guidance, which changes several aspects of the accounting for share-based payment award transactions, including accounting and cash flow classification for excess tax benefits and deficiencies, forfeitures, and tax withholding requirements and cash flow classification. The guidance is effective for annual periods and interim periods in fiscal years beginning after December 15, 2016. The Company is evaluating the impact of adopting this new accounting standard on its financial statements. In August 2016, the FASB issued new accounting guidance, which eliminates the diversity in practice related to the classification of certain cash receipts and payments in the statement of cash flows, by adding or clarifying guidance on eight specific cash flow issues. The guidance is effective for annual and interim reporting periods beginning after December 15, 2017, with early adoption permitted. The amendments in this update should be applied retrospectively to all periods presented, unless deemed impracticable, in which case, prospective application is permitted. The Company is currently evaluating the new guidance and has not determined the impact this standards update may have on its financial statements.

Summary of Significant Accoun21

Summary of Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2016
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 nine months ended September 30, 2016 (in thousands): Common Stock Warrant Liabilities Balance at December 31, 2015 $ 687 Change in fair value 387 Conversion to common stock (1,074 ) Balance at September 30, 2016 $ —

Select Condensed Consolidated22

Select Condensed Consolidated Balance Sheet Details (Tables)	9 Months Ended
	Sep. 30, 2016
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Accounts receivable, net	Accounts receivable, net consist of the following (in thousands): September 30, 2016 December 31, 2015 Accounts receivable $ 16,665 $ 27,639 Allowance for doubtful accounts (119 ) (769 ) Accounts receivable, net $ 16,546 $ 26,870
Inventories, net	Inventories, net consist of the following (in thousands): September 30, 2016 December 31, 2015 Raw materials $ 6,350 $ 7,237 Work-in-process 1,120 1,908 Finished goods 36,020 39,388 43,490 48,533 Less reserve for excess and obsolete finished goods (15,829 ) (15,901 ) Inventories, net $ 27,661 $ 32,632
Property and equipment, net	Property and equipment, net consist of the following (in thousands except as indicated): Useful lives (in years) September 30, 2016 December 31, 2015 Surgical instruments 4 $ 51,253 $ 52,404 Machinery and equipment 7 5,435 14,416 Computer equipment 3 3,511 3,816 Office furniture and equipment 5 2,695 3,426 Leasehold improvements various 3,467 3,467 Construction in progress n/a 59 139 66,420 77,668 Less accumulated depreciation and amortization (52,708 ) (61,587 ) Property and equipment, net $ 13,712 $ 16,081
Intangible assets, net	Intangible assets, net consist of the following (in thousands except for useful lives): Remaining Avg. Useful lives (in years) September 30, 2016 December 31, 2015 Developed product technology 1 $ 13,876 $ 13,876 Distribution rights 4 390 390 Intellectual property — 1,004 1,004 License agreements 1 14,016 14,016 Trademarks and trade names 2 732 732 Customer-related 9 7,458 7,458 Distribution network 5 4,027 4,027 Supply agreement — 225 225 41,728 41,728 Less accumulated amortization (35,576 ) (32,922 ) Intangible assets, net $ 6,152 $ 8,806
Schedule of intangible assets, future amortization expense	Future amortization expense related to intangible assets as of September 30, 2016 is as follows (in thousands): Year Ending December 31, Remainder of 2016 $ 223 2017 892 2018 846 2019 832 2020 712 Thereafter 2,647 $ 6,152
Accrued expenses	Accrued expenses consist of the following (in thousands): September 30, 2016 December 31, 2015 Commissions and sales milestones $ 3,455 $ 3,963 Payroll and payroll related 2,621 3,947 Deferred revenue from Globus Transaction 3,900 — Globus inventory obligation 2,375 — Litigation settlements 4,400 4,400 Accrued professional fees 2,199 1,972 Royalties 1,340 1,199 Restructuring and severance accruals 1,463 505 Accrued taxes 3,849 765 Guaranteed collaboration compensation, current 1,543 — Accrued interest 205 999 Other 3,355 3,425 Total accrued expenses $ 30,705 $ 21,175

Discontinued Operations (Tables

Discontinued Operations (Tables)	9 Months Ended
	Sep. 30, 2016
Discontinued Operations and Disposal Groups [Abstract]
Summary of discontinued business segment	The following table summarizes the preliminary calculation of the gain on sale, which will be finalized during the fourth quarter of 2016 (in thousands): Consideration received $ 80,000 Cash included in assets sold (4,250 ) Transaction costs (5,328 ) Product supply obligation (3,900 ) Preliminary working capital adjustment 3,372 Net cash proceeds 69,894 Less: Carrying value of business and assets sold 64,533 Net gain on sale of business $ 5,361 The following table summarizes the results of discontinued operations for the periods presented in the condensed consolidated statements of operations and comprehensive income (loss) for the three and nine months ended September 30, 2016 and 2015 (in thousands): Three Months Ended Nine Months Ended September 30, September 30, Discontinued operations 2016 2015 2016 2015 Revenues $ 18,043 $ 11,309 $ 40,146 $ 38,679 Cost of revenues 11,469 4,111 19,694 13,060 Amortization of acquired intangible assets 555 376 1,291 1,093 Gross profit 6,019 6,822 19,161 24,526 Operating (income) expenses: Research and development 16 48 50 123 Sales and marketing 2,865 4,360 12,391 14,109 General and administrative 1,440 1,553 5,079 4,894 Amortization of acquired intangible assets 155 241 622 971 Goodwill and intangible impairment — 908 — 908 Restructuring expenses 4 (16 ) 620 (188 ) Net gain on sale of business (5,361 ) — (5,361 ) — Total operating (income) expenses (881 ) 7,094 13,401 20,817 Operating income (loss) 6,900 (272 ) 5,760 3,709 Other income (expense): Interest income 12 15 46 29 Interest expense (2,156 ) (2,142 ) (7,240 ) (6,504 ) Other income (expense), net 243 (102 ) 1,892 (451 ) Total other income (expense) (1,901 ) (2,229 ) (5,302 ) (6,926 ) Income (loss) from discontinued operations before taxes 4,999 (2,501 ) 458 (3,217 ) Income tax provision 8,657 766 9,809 766 Loss from discontinued operations, net of applicable taxes $ (3,658 ) $ (3,267 ) $ (9,351 ) $ (3,983 ) The following table summarizes the assets and liabilities of discontinued operations as of September 30, 2016 and December 31, 2015 related to the International Business (in thousands): September 30, December 31, Assets Current assets: Cash $ 288 $ 4,934 Accounts receivable, net — 11,449 Inventories, net 2,375 12,276 Prepaid expenses and other current assets 165 1,551 Total current assets of discontinued operations 2,828 30,210 Property and equipment, net 10 5,864 Intangible assets, net — 12,810 Other assets 61 783 Total assets of discontinued operations $ 2,899 $ 49,667 Liabilities Current liabilities: Accounts payable $ 143 $ 627 Accrued expenses 1,290 8,616 Deferred revenue 147 648 Other current liabilities 627 — Total current liabilities of discontinued operations 2,207 9,891 Other long-term liabilities 87 1,516 Total liabilities of discontinued operations $ 2,294 $ 11,407 Included in the cash flows for the nine months ended September 30, 2016 and September 30, 2015 are the following non-cash adjustments related to the discontinued operations (in thousands): Nine Months Ended September 30, 2016 2015 Depreciation and amortization $ 3,836 $ 3,965 Provision for excess and obsolete inventory $ 151 $ — Capital expenditures $ 1,319 $ 2,229 Interest expense related to amortization of debt discount and debt issuance costs $ 2,052 $ 2,065

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2016
Debt Disclosure [Abstract]
Principal payments on debt	Principal payments on the Company's debt are as follows as of September 30, 2016 (in thousands): Year Ending December 31, Remainder of 2016 $ 624 2017 3,236 2018 4,045 2019 16,137 2020 and thereafter 20,000 Total 44,042 Add: capital lease principal payments 672 Less: unamortized debt discount and debt issuance costs (3,852 ) Total 40,862 Less: current portion of long-term debt (2,647 ) Long-term debt, net of current portion $ 38,215

Commitments and Contingencies (

Commitments and Contingencies (Tables)	9 Months Ended
	Sep. 30, 2016
Commitments and Contingencies Disclosure [Abstract]
Future minimum annual lease payments	Future minimum annual lease payments under such leases are as follows as of September 30, 2016 (in thousands): Year Ending December 31, Operating Capital Remainder of 2016 $ 666 $ 205 2017 1,590 437 2018 1,455 68 2019 1,420 — 2020 and thereafter 2,311 — $ 7,442 710 Less: amount representing interest (38 ) Present value of minimum lease payments 672 Current portion of capital leases (544 ) Capital leases, less current portion $ 128

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	9 Months Ended
	Sep. 30, 2016
Earnings Per Share [Abstract]
Weighted average number of common shares outstanding	The following table presents the computation of basic and diluted net loss per share for continuing and discontinued operations (in thousands, except per share amounts): Three Months Ended Nine Months Ended 2016 2015 2016 2015 Numerator: Loss from continuing operations $ (10,063 ) $ (156,998 ) $ (16,220 ) $ (164,790 ) Loss from discontinued operations (3,658 ) (3,267 ) (9,351 ) (3,983 ) Net loss $ (13,721 ) $ (160,265 ) $ (25,571 ) $ (168,773 ) Denominator: Weighted average common shares outstanding 8,623 8,345 8,554 8,341 Weighted average unvested common shares subject to repurchase (63 ) (64 ) (49 ) (69 ) Weighted average common shares outstanding—basic 8,560 8,281 8,505 8,272 Effect of dilutive securities: Conversion of preferred stock — — — — Options — — — — Warrants — — — — Weighted average common shares outstanding—diluted 8,560 8,281 8,505 8,272 Net loss per share, basic and diluted: Continuing operations $ (1.17 ) $ (18.96 ) $ (1.91 ) $ (19.92 ) Discontinued operations (0.43 ) (0.39 ) (1.10 ) (0.48 ) Net loss per share, basic and diluted $ (1.60 ) $ (19.35 ) $ (3.01 ) $ (20.40 )
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 Nine Months Ended 2016 2015 2016 2015 Options to purchase common stock 594 655 611 669 Unvested restricted share awards 63 64 49 69 Warrants to purchase common stock 8 962 8 962 Total 665 1,681 668 1,700

The Company and Basis of Pres27

The Company and Basis of Presentation - Additional Information (Details)	Aug. 24, 2016	Sep. 30, 2016marketsegment
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of product markets (more than 50) | market		50
Number of reportable segments | segment		1
Reverse stock split ratio	0.0833

Summary of Significant Accoun28

Summary of Significant Accounting Policies - Additional Information (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2016	Dec. 31, 2015
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Roll Forward]
Dividend yield	0.00%
Fair value, inputs, level 3 [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Roll Forward]
Balance at December 31, 2015	$ 687
Change in fair value	387
Conversion to common stock	(1,074)
Balance at September 30, 2016	$ 0
Accounting Standards Update 2015-03 [Member] | Prepaid expenses and other current assets [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Debt issuance costs		$ (400)
Accounting Standards Update 2015-03 [Member] | Long-term debt, current [Member]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Debt issuance costs		$ 400

Select Condensed Consolidated29

Select Condensed Consolidated Balance Sheet Details - Accounts Receivable, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Accounts receivable	$ 16,665	$ 27,639
Allowance for doubtful accounts	(119)	(769)
Accounts receivable, net	$ 16,546	$ 26,870

Select Condensed Consolidated30

Select Condensed Consolidated Balance Sheet Details - Inventories, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Raw materials	$ 6,350	$ 7,237
Work-in-process	1,120	1,908
Finished goods	36,020	39,388
Inventory, gross, total	43,490	48,533
Less reserve for excess and obsolete finished goods	(15,829)	(15,901)
Inventories, net	$ 27,661	$ 32,632

Select Condensed Consolidated31

Select Condensed Consolidated Balance Sheet Details - Property and Equipment, Net (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015	Dec. 31, 2015
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 66,420		$ 66,420		$ 77,668
Less accumulated depreciation and amortization	(52,708)		(52,708)		(61,587)
Property and equipment, net	13,712		13,712		16,081
Depreciation	1,600	$ 2,800	$ 5,600	$ 7,500
Surgical instruments
Property, Plant and Equipment [Line Items]
Useful lives			4 years
Property and equipment, gross	51,253		$ 51,253		52,404
Machinery and equipment
Property, Plant and Equipment [Line Items]
Useful lives			7 years
Property and equipment, gross	5,435		$ 5,435		14,416
Capital leased assets, gross	2,100		$ 2,100		2,600
Computer equipment
Property, Plant and Equipment [Line Items]
Useful lives			3 years
Property and equipment, gross	3,511		$ 3,511		3,816
Office furniture and equipment
Property, Plant and Equipment [Line Items]
Useful lives			5 years
Property and equipment, gross	2,695		$ 2,695		3,426
Leasehold improvements
Property, Plant and Equipment [Line Items]
Various useful lives of leasehold improvements			various
Property and equipment, gross	3,467		$ 3,467		3,467
Construction in progress
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 59		$ 59		139
Capital leased assets, gross					$ 100

Select Condensed Consolidated32

Select Condensed Consolidated Balance Sheet Details - Intangible Assets, Net (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015	Dec. 31, 2015
Finite-Lived Intangible Assets [Line Items]
Intangible assets, Gross	$ 41,728		$ 41,728		$ 41,728
Less accumulated amortization	(35,576)		(35,576)		(32,922)
Intangible assets, net	6,152		6,152		8,806
Impairment of intangible assets	1,700		1,700
Goodwill, impairment loss	164,300		0
Amortization	300	$ 500	$ 900	$ 3,300
Developed product technology
Finite-Lived Intangible Assets [Line Items]
Useful lives			1 year
Intangible assets, Gross	13,876		$ 13,876		13,876
Distribution rights
Finite-Lived Intangible Assets [Line Items]
Useful lives			4 years
Intangible assets, Gross	390		$ 390		390
Intellectual property
Finite-Lived Intangible Assets [Line Items]
Intangible assets, Gross	1,004		$ 1,004		1,004
License agreements
Finite-Lived Intangible Assets [Line Items]
Useful lives			1 year
Intangible assets, Gross	14,016		$ 14,016		14,016
License agreements | NEXoss Synthetic Bone Graft
Finite-Lived Intangible Assets [Line Items]
Impairment of intangible assets				300
License agreements | Epicage Interbody Fusion Device
Finite-Lived Intangible Assets [Line Items]
Impairment of intangible assets				900
Trademarks and trade names
Finite-Lived Intangible Assets [Line Items]
Useful lives			2 years
Intangible assets, Gross	732		$ 732		732
Customer-related
Finite-Lived Intangible Assets [Line Items]
Useful lives			9 years
Intangible assets, Gross	7,458		$ 7,458		7,458
Distribution network
Finite-Lived Intangible Assets [Line Items]
Useful lives			5 years
Intangible assets, Gross	4,027		$ 4,027		4,027
Supply agreement
Finite-Lived Intangible Assets [Line Items]
Intangible assets, Gross	$ 225		$ 225		$ 225
Discontinued operations, disposed of by sale | International operations | Physician education programs
Finite-Lived Intangible Assets [Line Items]
Impairment of intangible assets				$ 900

Select Condensed Consolidated33

Select Condensed Consolidated Balance Sheet Details - Schedule of Intangible Assets, Future Amortization Expense (Details) $ in Thousands	Sep. 30, 2016USD ($)
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Remainder of 2016	$ 223
2,017	892
2,018	846
2,019	832
2,020	712
Thereafter	2,647
Total	$ 6,152

Select Condensed Consolidated34

Select Condensed Consolidated Balance Sheet Details - Accrued Expenses (Details) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Commissions and sales milestones	$ 3,455	$ 3,963
Payroll and payroll related	2,621	3,947
Deferred revenue from Globus Transaction	3,900	0
Globus inventory obligation	2,375	0
Litigation settlements	4,400	4,400
Accrued professional fees	2,199	1,972
Royalties	1,340	1,199
Restructuring and severance accruals	1,463	505
Accrued taxes	3,849	765
Guaranteed collaboration compensation, current	1,543	0
Accrued interest	205	999
Other	3,355	3,425
Total accrued expenses	$ 30,705	$ 21,175

Discontinued Operations - Addit

Discontinued Operations - Additional Information (Details)	Sep. 01, 2016USD ($)option	Sep. 30, 2016USD ($)	Sep. 30, 2015USD ($)	Sep. 30, 2016USD ($)	Sep. 30, 2015USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Repayments of lines of credit				$ 110,840,000	$ 110,354,000
Revenues		$ 26,711,000	$ 31,687,000	93,158,000	99,597,000
Cost of revenues		10,849,000	10,029,000	31,651,000	35,174,000
Globus facility agreement | Line of credit
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Line of credit, expiration period	5 years
Maximum borrowing capacity	$ 30,000,000
Deerfield facility agreement and amended credit facility | Line of credit
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Repayments of lines of credit	$ 69,000,000
Supply agreement [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Contracts revenue (less than)		100,000		100,000
Cost of sales on contract revenues		100,000		100,000
Discontinued operations, disposed of by sale | International operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Noncompete agreement term	2 years
Consideration received	$ 80,000,000
Supply commitment term	3 years
Supply agreement, number of annual options to extend | option	2
Supply obligation credit	$ 3,900,000
Supply obligation credit term	6 months
Interest expense, debt excluding amortization		2,156,000	2,142,000	7,240,000	6,504,000
Discontinued operations, disposed of by sale | International operations | Deerfield facility agreement and amended credit facility
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Interest expense, debt excluding amortization		2,200,000	2,100,000	7,200,000	6,500,000
International
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenues		1,400,000	4,200,000	8,900,000	13,500,000
Cost of revenues		$ 1,800,000	$ 3,500,000	$ 8,900,000	$ 13,500,000

Discontinued Operations - Sched

Discontinued Operations - Schedule of Gain on Sale of Business (Details) - USD ($) $ in Thousands	Sep. 01, 2016	Sep. 30, 2016	Sep. 30, 2015	Dec. 31, 2015
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Net cash proceeds		$ 69,894	$ 0
Discontinued operations, disposed of by sale | International operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Consideration received	$ 80,000
Cash included in assets sold	(4,250)	$ (288)		$ (4,934)
Transaction costs	(5,328)
Product supply obligation	(3,900)
Preliminary working capital adjustment	3,372
Net cash proceeds	69,894
Carrying value of business and assets sold	64,533
Net gain on sale of business	$ 5,361

Discontinued Operations - Resul

Discontinued Operations - Results from Discontinued Operations (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Other income (expense):
Income tax provision	$ 8,700		$ 9,800
Loss from discontinued operations, net of applicable taxes	(3,658)	$ (3,267)	(9,351)	$ (3,983)
International operations | Discontinued operations, disposed of by sale
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenues	18,043	11,309	40,146	38,679
Cost of revenues	11,469	4,111	19,694	13,060
Amortization of acquired intangible assets	555	376	1,291	1,093
Gross profit	6,019	6,822	19,161	24,526
Operating (income) expenses:
Research and development	16	48	50	123
Sales and marketing	2,865	4,360	12,391	14,109
General and administrative	1,440	1,553	5,079	4,894
Amortization of acquired intangible assets	155	241	622	971
Goodwill and intangible impairment	0	908	0	908
Restructuring expenses	4	(16)	620	(188)
Net gain on sale of business	(5,361)	0	(5,361)	0
Total operating (income) expenses	(881)	7,094	13,401	20,817
Operating income (loss)	6,900	(272)	5,760	3,709
Other income (expense):
Interest income	12	15	46	29
Interest expense	(2,156)	(2,142)	(7,240)	(6,504)
Other income (expense), net	243	(102)	1,892	(451)
Total other income (expense)	(1,901)	(2,229)	(5,302)	(6,926)
Income (loss) from discontinued operations before taxes	4,999	(2,501)	458	(3,217)
Income tax provision	8,657	766	9,809	766
Loss from discontinued operations, net of applicable taxes	$ (3,658)	$ (3,267)	$ (9,351)	$ (3,983)

Discontinued Operations - Sch38

Discontinued Operations - Schedule of Assets and Liabilities Discontinued Operations (Details) - USD ($) $ in Thousands	Sep. 30, 2016	Sep. 01, 2016	Dec. 31, 2015
Current assets:
Total current assets of discontinued operations	$ 2,828		$ 30,210
Current liabilities:
Deferred revenue	3,900		0
Total current liabilities of discontinued operations	2,207		9,891
International operations | Discontinued operations, disposed of by sale
Current assets:
Cash	288	$ 4,250	4,934
Accounts receivable, net	0		11,449
Inventories, net	2,375		12,276
Prepaid expenses and other current assets	165		1,551
Total current assets of discontinued operations	2,828		30,210
Non-current assets:
Property and equipment, net	10		5,864
Intangible assets, net	0		12,810
Other assets	61		783
Total assets of discontinued operations	2,899		49,667
Current liabilities:
Accounts payable	143		627
Accrued expenses	1,290		8,616
Deferred revenue	147		648
Other current liabilities	627		0
Total current liabilities of discontinued operations	2,207		9,891
Non-current liabilities:
Other long-term liabilities	87		1,516
Total liabilities of discontinued operations	$ 2,294		$ 11,407

Discontinued Operations - Sch39

Discontinued Operations - Schedule of Non-Cash Adjustments from Discontinued Operations (Details) - International operations - Discontinued operations, disposed of by sale - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Depreciation and amortization	$ 3,836	$ 3,965
Provision for excess and obsolete inventory	151	0
Capital expenditures	1,319	2,229
Interest expense related to amortization of debt discount and debt issuance costs	$ 2,052	$ 2,065

Debt - MidCap Facility Agreemen

Debt - MidCap Facility Agreement (Details) - USD ($)	Aug. 08, 2016	Dec. 31, 2016	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Sep. 01, 2016	Mar. 11, 2016
Fifth amendment credit facility with MidCap | Revolving credit facility
Line of Credit Facility [Line Items]
Maximum borrowing capacity						$ 22,500,000
Fifth amendment credit facility with MidCap | Term loan
Line of Credit Facility [Line Items]
Maximum borrowing capacity						5,000,000
Debt instrument, prepayment fee						$ 600,000
Amended credit facility with MidCap | Revolving credit facility
Line of Credit Facility [Line Items]
Line of credit			$ 12,200,000
Interest rate			6.50%
Amended credit facility with MidCap | Term loan
Line of Credit Facility [Line Items]
Line of credit			$ 4,900,000
Floor on interest rate			9.50%
Interest rate			9.50%
Third amendment credit facility with MidCap
Line of Credit Facility [Line Items]
Amendment fee amount							$ 500,000
Debt issuance costs			$ 2,100,000
Fourth Amendment to the amended credit facility with MidCap
Line of Credit Facility [Line Items]
Amendment fee amount	$ 200,000
Line of credit facility, increase in maximum borrowing capacity	$ 2,200,000
LIBOR | Amended credit facility with MidCap | Revolving credit facility
Line of Credit Facility [Line Items]
Interest rate description			LIBOR plus 6.0%
Basis spread			6.00%
LIBOR | Amended credit facility with MidCap | Term loan
Line of Credit Facility [Line Items]
Interest rate description			("LIBOR") plus 8.0%
Basis spread			8.00%
Forecast | Amended credit facility with MidCap
Line of Credit Facility [Line Items]
Monthly term loan payments		$ 100,000		$ 300,000	$ 200,000
Line of credit | Amended credit facility with MidCap | Maximum
Line of Credit Facility [Line Items]
Debt default, interest rate increase			5.00%

Debt - Deerfield Facility Agree

Debt - Deerfield Facility Agreement (Details) - USD ($)	Sep. 01, 2016	Feb. 05, 2016	Nov. 21, 2014	Mar. 20, 2014	Sep. 30, 2016	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015	Feb. 04, 2016	Mar. 17, 2014
Line of Credit Facility [Line Items]
Repayments under lines of credit								$ 110,840,000	$ 110,354,000
Loss on debt extinguishment						$ (9,478,000)	$ 0	(9,478,000)	0
Deerfield
Line of Credit Facility [Line Items]
Maximum borrowing capacity											$ 50,000,000
Transaction fee as percentage of principal amount											2.50%
Line of credit			$ 6,000,000	$ 20,000,000
Net proceeds from initial draw under Facility Agreement				19,500,000
Unamortized debt discount			200,000	$ 500,000
Net proceeds from draw under Facility Agreement			$ 5,900,000
Remaining borrowing capacity					$ 0	0		0
Debt instrument, stated interest rate										8.75%
Repayments under lines of credit	$ 33,500,000
Repayments of lines of credit, principle and accrued interest	27,900,000
Repayments of lines of credit, prepayment of premium	5,600,000
Write off of unamortized expense	3,900,000
Loss on debt extinguishment	$ (9,500,000)
Second amendment with deerfield
Line of Credit Facility [Line Items]
Debt instrument, stated interest rate		14.75%
Portion of interest paid-in-kind, percentage	3.00%	6.00%
Amendment fee amount		$ 600,000
Amendment fee, installment amount		$ 200,000
Initial and draw warrants | Deerfield
Line of Credit Facility [Line Items]
Warrants converted to shares (in shares)					268,614
Expense (income) from change in fair value of warrants						(100,000)	(6,300,000)	400,000	(8,000,000)
Draw warrants | Deerfield
Line of Credit Facility [Line Items]
Maximum borrowing capacity											$ 50,000,000
Exercise price of warrants (dollars per share)			$ 16.68	$ 16.68
Line of credit				$ 20,000,000
Number of warrants issued (in shares)			100,000	333,333
Warrants value			$ 900,000	$ 4,700,000
Draw warrants | Maximum | Deerfield
Line of Credit Facility [Line Items]
Number of securities called by warrants associated with each disbursement borrowing (in shares)											833,333
Initial warrants | Deerfield
Line of Credit Facility [Line Items]
Number of securities called by warrants (in shares)											520,833
Exercise price of warrants (dollars per share)											$ 16.68
Warrant amount reclassified as debt discount			$ 200,000	$ 2,300,000
International operations | Discontinued operations, disposed of by sale
Line of Credit Facility [Line Items]
Interest expense, debt excluding amortization						2,156,000	2,142,000	7,240,000	6,504,000
International operations | Discontinued operations, disposed of by sale | Deerfield facility agreement and amended credit facility
Line of Credit Facility [Line Items]
Interest expense, debt excluding amortization						$ 2,200,000	$ 2,100,000	$ 7,200,000	$ 6,500,000

Debt - Globus Facility Agreemen

Debt - Globus Facility Agreement (Details) - USD ($)	Sep. 02, 2018	Sep. 30, 2016	Sep. 01, 2016	Sep. 30, 2016	Sep. 30, 2015
Debt Instrument [Line Items]
Borrowings under lines of credit				$ 94,241,000	$ 105,523,000
Line of credit | Globus facility agreement
Debt Instrument [Line Items]
Maximum borrowing capacity			$ 30,000,000
Borrowings under lines of credit			25,000,000
Debt instrument, line of credit, minimum draw amount			$ 2,000,000
Line of credit		$ 25,000,000		$ 25,000,000
Debt instrument, periodic payment		$ 800,000
Line of credit | Maximum | Globus facility agreement
Debt Instrument [Line Items]
Debt default, interest rate increase			5.00%
Line of credit | LIBOR | Globus facility agreement
Debt Instrument [Line Items]
Interest rate description				LIBOR plus 8.0%
Basis spread				8.00%
Line of credit | Forecast | LIBOR | Globus facility agreement
Debt Instrument [Line Items]
Interest rate description	LIBOR plus 13.0%
Basis spread	13.00%

Debt - Principal Payments on De

Debt - Principal Payments on Debt (Details) $ in Thousands	Sep. 30, 2016USD ($)
Debt Disclosure [Abstract]
Remainder of 2016	$ 624
2,017	3,236
2,018	4,045
2,019	16,137
2020 and thereafter	20,000
Total	44,042
Add: capital lease principal payments	672
Less: unamortized debt discount and debt issuance costs	(3,852)
Total	40,862
Less: current portion of long-term debt	(2,647)
Long-term debt, net of current portion	$ 38,215

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Loss Contingencies [Line Items]
Rent expense	$ 0.7	$ 0.6	$ 2	$ 1.8
Minimum
Loss Contingencies [Line Items]
Lease interest rate			6.60%
Maximum
Loss Contingencies [Line Items]
Lease interest rate			9.60%

Commitments and Contingencies45

Commitments and Contingencies - Future Minimum Annual Lease Payments (Details) $ in Thousands	Sep. 30, 2016USD ($)
Commitments and Contingencies Disclosure [Abstract]
Operating leases Remainder of 2016	$ 666
Operating leases 2017	1,590
Operating leases 2018	1,455
Operating leases 2019	1,420
Operating leases 2020 and thereafter	2,311
Total Operating leases	7,442
Capital leases remainder of 2016	205
Capital leases 2017	437
Capital leases 2018	68
Capital leases 2019	0
Capital leases 2020 and thereafter	0
Total Capital leases	710
Less: amount representing interest	(38)
Present value of minimum lease payments	672
Current portion of capital leases	(544)
Capital leases, less current portion	$ 128

Orthotec Settlement - Additiona

Orthotec Settlement - Additional Information (Details) - Orthotec LLC, litigation settlement	Oct. 01, 2014USD ($)	Aug. 13, 2014USD ($)installment	Apr. 30, 2014USD ($)	Mar. 31, 2014USD ($)	Sep. 30, 2016USD ($)
Loss Contingencies [Line Items]
Judgment assessed by court for (against) company		$ (49,000,000)
Payments of settlement			$ 15,750,000	$ 1,750,000	$ 26,300,000
Loss contingency accrual					$ 24,800,000
Number of quarterly installments | installment		28
Litigation settlement interest, quarterly installments, amount		$ 1,100,000
Beginning fourth quarter of 2014
Loss Contingencies [Line Items]
Settlement amount, remaining balance	$ 31,500,000
Litigation settlement payments, quarterly payment amount		$ 1,100,000
Litigation settlement interest rate		7.00%
Litigation settlement interest, quarterly installments, amount		$ 1,100,000
Final installment
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		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Numerator:
Loss from continuing operations	$ (10,063)	$ (156,998)	$ (16,220)	$ (164,790)
Loss from discontinued operations	(3,658)	(3,267)	(9,351)	(3,983)
Net loss	$ (13,721)	$ (160,265)	$ (25,571)	$ (168,773)
Denominator:
Weighted average common shares outstanding (in shares)	8,623	8,345	8,554	8,341
Weighted average unvested common shares subject to repurchase (in shares)	(63)	(64)	(49)	(69)
Weighted average common shares outstanding—basic (in shares)	8,560	8,281	8,505	8,272
Effect of dilutive securities:
Effect of dilutive securities: conversion of preferred stock (in shares)	0	0	0	0
Effect of dilutive securities: options (in shares)	0	0	0	0
Effect of dilutive securities: warrants (in shares)	0	0	0	0
Weighted average common shares outstanding - diluted (in shares)	8,560	8,281	8,505	8,272
Net loss per share, basic and diluted:
Continuing operations, net loss per share, basic and diluted (in dollars per share)	$ (1.17)	$ (18.96)	$ (1.91)	$ (19.92)
Discontinued operations, net loss per share, basic and diluted (in dollars per share)	(0.43)	(0.39)	(1.10)	(0.48)
Net loss per basic and diluted share (in dollars per share)	$ (1.60)	$ (19.35)	$ (3.01)	$ (20.40)

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		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in diluted net loss per share (in shares)	665	1,681	668	1,700
Options to purchase common stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in diluted net loss per share (in shares)	594	655	611	669
Unvested restricted share awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in diluted net loss per share (in shares)	63	64	49	69
Warrants to purchase common stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in diluted net loss per share (in shares)	8	962	8	962

Stock Benefit Plans and Stock49

Stock Benefit Plans and Stock-Based Compensation (Details) - USD ($)	1 Months Ended	3 Months Ended
	Oct. 31, 2016	Sep. 30, 2016	Nov. 09, 2016	Oct. 04, 2016
2005 Employee, Director and Consultant Stock Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares available for grant		742,183
2016 Equity Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares available for grant		981,232
Common stock reserved for future issuance		1,083,333
Grants in period (in shares)		102,101
2016 Equity Incentive Plan | Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration period		10 years
Award vesting period		4 years
Exercise price minimum percentage of market price on grant date		100.00%
2016 Equity Incentive Plan | Employee Stock Option | 10 Percent Stockholder
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration period		5 years
Exercise price minimum percentage of market price on grant date		110.00%
Inducement Plan | Subsequent event
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock reserved for future issuance			350,000
Maximum award to be deductible				$ 1,000,000
Inducement Plan | RSUs | Subsequent event
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Equity instruments other than options granted in period (in shares)	173,322
Equity instruments other than options, grants in period, fair value	$ 800,000
Inducement Plan | PRSUs | Subsequent event
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Equity instruments other than options, grants in period, nominal value	800,000
Equity instruments other than options, grants in period, fair value	$ 700,000
Minimum | Inducement Plan | PRSUs | Subsequent event
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Target value, vesting percentage	0.00%
Maximum | Inducement Plan | PRSUs | Subsequent event
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Target value, vesting percentage	250.00%

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Tax expense related to discontinued operations	$ 8,700		$ 9,800
Income tax benefit	4,997	$ 2,483	4,962	$ 1,328
Unrecognized tax benefits increase (decrease)			(700)
Unrecognized tax benefits	9,700		9,700		$ 10,400
Reasonably possible amount of unrecognized tax benefit that could reverse in the next twelve months	$ 200		$ 200
Effective income tax rate	33.20%
Federal statutory income tax rate			35.00%

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Details) - USD ($) $ in Thousands	Jul. 01, 2016	Sep. 30, 2016	Apr. 30, 2014	Mar. 31, 2014	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016
HealthpointCapital, LLC
Related Party Transaction [Line Items]
Incurred expenses (less than $.1 million)					$ 100	$ 100
Payable liability (less than $.1 million)		$ 100			$ 100		$ 100
Orthotec LLC, litigation settlement
Related Party Transaction [Line Items]
Payments of settlement			$ 15,750	$ 1,750			$ 26,300
Orthotec LLC, litigation settlement | Forbearance agreement, settlement payment
Related Party Transaction [Line Items]
Payments of settlement		$ 1,100
HealthpointCapital, LLC | Orthotec LLC, litigation settlement | Forbearance agreement, settlement payment
Related Party Transaction [Line Items]
Payments of settlement	$ 1,000

Restructuring (Details)

Restructuring (Details) $ in Thousands	Oct. 05, 2016employee	Sep. 01, 2016USD ($)	Dec. 31, 2016USD ($)	Sep. 30, 2016USD ($)	Sep. 30, 2015USD ($)	Sep. 30, 2016USD ($)	Sep. 30, 2015USD ($)
Restructuring Cost and Reserve [Line Items]
Restructuring expenses				$ 1,605	$ 351	$ 1,778	$ 351
Subsequent event
Restructuring Cost and Reserve [Line Items]
Percentage of positions eliminated	20.00%
Expected number of positions eliminated | employee	35
Forecast | Subsequent event
Restructuring Cost and Reserve [Line Items]
Restructuring expenses			$ 400
Severance liability and post employment benefits in connection with Globus transaction
Restructuring Cost and Reserve [Line Items]
Restructuring expenses				1,600		1,800
2015 California manufacturing operations restructuring plan
Restructuring Cost and Reserve [Line Items]
Restructuring expenses				$ 400		$ 400
Employee severance | Severance liability and post employment benefits in connection with Globus transaction
Restructuring Cost and Reserve [Line Items]
Restructuring expenses		$ 1,500