Alphatec (ATEC) 10-Q 9 Nov 17 2017 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2017	Nov. 01, 2017
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	Smaller Reporting Company
Document Type	10-Q
Trading Symbol	ATEC
Document Period End Date	Sep. 30, 2017
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus (Q1,Q2,Q3,FY)	Q3
Amendment Flag	false
Entity Common Stock, Shares Outstanding		16,724,080

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Current assets:
Cash	$ 15,437	$ 19,593
Accounts receivable, net	13,303	18,512
Inventories, net	29,747	30,093
Prepaid expenses and other current assets	2,019	4,262
Current assets of discontinued operations	236	364
Total current assets	60,742	72,824
Property and equipment, net	13,275	15,076
Intangible assets, net	5,482	5,711
Other assets	222	516
Noncurrent assets of discontinued operations	52	61
Total assets	79,773	94,188
Current liabilities:
Accounts payable	2,865	8,701
Accrued expenses	22,606	27,589
Current portion of long-term debt	3,037	3,113
Current liabilities of discontinued operations	283	732
Total current liabilities	28,791	40,135
Long-term debt, less current portion	37,228	43,092
Other long-term liabilities	23,666	28,862
Redeemable preferred stock, $0.0001 par value; 20,000 shares authorized at September 30, 2017 and December 31, 2016; 3,319 shares issued and outstanding at both September 30, 2017 and December 31, 2016	23,603	23,603
Commitments and contingencies
Series A convertible preferred stock, $0.0001 par value; 15 and 0 shares authorized at September 30, 2017 and December 31, 2016, respectively; 7 shares issued and outstanding at September 30, 2017
Common stock, $0.0001 par value; 200,000 authorized at September 30, 2017 and December 31, 2016; 15,148 and 9,049 shares issued and outstanding at September 30, 2017 and December 31, 2016, respectively	2	1
Treasury stock, at cost, 2 shares, at both September 30, 2017 and December 31, 2016	(97)	(97)
Additional paid-in capital	438,969	419,787
Shareholder note receivable	(5,000)	(5,000)
Accumulated other comprehensive income	1,125	970
Accumulated deficit	(468,514)	(457,165)
Total stockholders’ deficit	(33,515)	(41,504)
Total liabilities and stockholders’ deficit	$ 79,773	$ 94,188

CONDENSED CONSOLIDATED BALANCE3

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) (Parenthetical) - $ / shares	Sep. 30, 2017	Dec. 31, 2016
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
Series A convertible preferred stock, par value (dollars per share)	$ 0.0001	$ 0.0001
Series A convertible preferred stock, shares authorized	15,000	0
Series A convertible preferred stock, shares issued	7,000
Series A convertible preferred stock, shares outstanding	7,000
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	15,148,000	9,049,000
Common stock, shares outstanding	15,148,000	9,049,000
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, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Income Statement [Abstract]
Revenues	$ 23,099	$ 26,711	$ 75,456	$ 93,158
Cost of revenues	8,587	10,849	28,417	31,651
Gross profit	14,512	15,862	47,039	61,507
Operating expenses:
Research and development	1,044	1,087	3,483	6,799
Sales and marketing	10,015	11,764	31,416	39,498
General and administrative	4,403	4,136	15,977	19,416
Amortization of intangible assets	172	83	516	593
Goodwill and intangible asset impairment		1,736		1,736
Restructuring expenses	139	1,605	1,898	1,778
Gain on sale of assets			(856)
Total operating expenses	15,773	20,411	52,434	69,820
Operating loss	(1,261)	(4,549)	(5,395)	(8,313)
Other income (expense):
Interest expense, net	(1,807)	(1,123)	(5,669)	(3,118)
Loss on debt extinguishment		(9,478)		(9,478)
Other income (expense), net	(15)	90	(8)	(273)
Total other income (expense)	(1,822)	(10,511)	(5,677)	(12,869)
Loss from continuing operations before taxes	(3,083)	(15,060)	(11,072)	(21,182)
Income tax (benefit) provision	(7)	(4,997)	57	(4,962)
Loss from continuing operations	(3,076)	(10,063)	(11,129)	(16,220)
Loss from discontinued operations, net of applicable taxes	(61)	(3,658)	(220)	(9,351)
Net loss	$ (3,137)	$ (13,721)	$ (11,349)	$ (25,571)
Net loss per share, basic and diluted:
Continuing operations, net loss per share, basic and diluted (in dollars per share)	$ (0.22)	$ (1.17)	$ (0.98)	$ (1.91)
Discontinued operations, net loss per share, basic and diluted (in dollars per share)	(0.01)	(0.43)	(0.02)	(1.10)
Net loss per basic and diluted share (in dollars per share)	$ (0.23)	$ (1.60)	$ (1)	$ (3.01)
Shares used in calculating basic and diluted net loss per share (in shares)	13,938	8,560	11,349	8,505

CONDENSED CONSOLIDATED STATEME5

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Statement Of Income And Comprehensive Income [Abstract]
Net loss	$ (3,137)	$ (13,721)	$ (11,349)	$ (25,571)
Foreign currency translation adjustments related to continuing operations	207	961	155	2,602
Foreign currency translation adjustments related to discontinued operations		19,355		19,355
Comprehensive (loss) income	$ (2,930)	$ 6,595	$ (11,194)	$ (3,614)

CONDENSED CONSOLIDATED STATEME6

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Operating activities:
Net loss	$ (11,349)	$ (25,571)
Adjustments to reconcile net loss to net cash (used in) provided by operating activities:
Depreciation and amortization	5,536	10,403
Stock-based compensation	1,669	1,510
Amortization of debt discount and debt issuance costs	2,107	3,320
Impairment of goodwill and intangible assets		1,736
Provision for doubtful accounts	(145)	(53)
Provision for excess and obsolete inventory	1,640	4,488
Deferred income tax expense	(1)
Gain on sale of assets	(856)
Loss on disposal of instruments	1,043
Gain on sale of business		(5,361)
Loss on extinguishment of debt		3,863
Other non-cash items		280
Changes in operating assets and liabilities:
Restricted cash		2,350
Accounts receivable, net	5,354	10,658
Inventories, net	(1,294)	(4,723)
Prepaid expenses and other current assets	2,745	1,797
Other assets	297	191
Accounts payable	(3,597)	(5,247)
Accrued expenses and other	(11,552)	233
Deferred revenues	289
Net cash used in operating activities	(8,114)	(126)
Investing activities:
Purchases of property and equipment	(7,185)	(7,291)
Proceeds from sale of business, net		69,894
Cash received from sale of equipment	869	1,316
Net cash (used in) provided by investing activities	(6,316)	63,919
Financing activities:
Borrowings under lines of credit	70,547	94,241
Repayments under lines of credit	(74,056)	(110,840)
Principal payments on capital lease obligations	(353)	(606)
Proceeds from sale of stock, net	17,210	57
Proceeds from/(payments on) notes payable, net	(1,800)	23,046
Principal payments on notes payable and term loan	(1,528)	(53,820)
Net cash provided by (used in) financing activities	10,020	(47,922)
Effect of exchange rate changes on cash	254	(1,220)
Net (decrease) increase in cash	(4,156)	14,651
Cash at beginning of period, including discontinued operations	19,593	11,229
Cash at end of period, including discontinued operations	15,437	25,880
Supplemental disclosure of cash flow information:
Cash paid for interest	3,568	6,122
Cash paid for income taxes	90	920
Purchases of property and equipment in accounts payable	2,240	543
Common stock issued for acquisition of intangible assets	$ 473
Cashless warrant conversion		$ 1,074

The Company and Basis of Presen

The Company and Basis of Presentation	9 Months Ended
	Sep. 30, 2017
Organization Consolidation And Presentation Of Financial Statements [Abstract]
The Company and Basis of Presentation	1. The Company and Basis of Presentation The Company Alphatec Holdings, Inc. (the “Company”), through its wholly owned subsidiary, Alphatec Spine, Inc. and its subsidiaries (“Alphatec Spine”), is a medical technology company focused on the design, development and promotion of products for the surgical treatment of spine disorders. The Company has a comprehensive product portfolio and pipeline that addresses the cervical, thoracolumbar and intervertebral regions of the spine and covers a variety of spinal disorders and surgical procedures. The Company’s principal product offerings are focused on the U.S. market for fusion-based spinal disorder solutions. 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 Quarterly Report on Form 10-Q 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 represented 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, 2016, 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, 2016, which are included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2016 that was filed with the SEC on March 31, 2017. Operating results for the three and nine months ended September 30, 2017 are not necessarily indicative of the results that may be expected for the year ending December 31, 2017, 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. As a result of the sale of the International Business, the Company has retrospectively revised the condensed consolidated statements of operations for the three and nine months ended September 30, 2016, to reflect the financial results from the International Business, and the related assets and liabilities, as discontinued operations. The Company’s annual operating plan projects that its existing working capital at September 30, 2017 of $32.0 million (including cash of $15.4 million) plus committed financing proceeds and borrowings under the Company’s existing MidCap revolving credit facility allows the Company to fund its operations through one year subsequent to the date the financial statements are issued. 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 historically 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. 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. As more fully described in Note 5, the Company is a party to debt agreements with MidCap Funding IV, LLC and Globus International (the “Debt Agreements”). The Debt Agreements include traditional lending and reporting covenants, including a financial covenant that requires the Company to maintain a minimum fixed charge coverage ratio, beginning in April 2018. Should at any time the Company fail to maintain compliance with this covenant, the Company will need to seek waivers or amendments to the Debt Agreements. If the Company is unable to secure such waivers or amendments, it may be required to classify its obligations under the Debt Agreements in current liabilities on its consolidated balance sheet. The Company may also be required to repay all or a portion of outstanding indebtedness under the Debt Agreements, which would require the Company to obtain further financing. There is no assurance that the Company will be able to obtain further financing, or do so on reasonable terms. 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. Reclassification Certain amounts in the condensed consolidated financial statements included in our Form 10-Q for the nine months ended September 30, 2016 have been reclassified to conform to current period's presentation. Reclassifications between general and administrative and amortization of intangible assets were made to improve the comparability of the statements. None of the adjustments had any effect on the prior period net loss.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2017
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. 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, 2016, which are included in the Company’s Annual Report on Form 10-K that was filed with the SEC on March 31, 2017. Except as discussed below, these accounting policies have not significantly changed during the nine months ended September 30, 2017. Warrant Accounting As more fully described in Note 10, the Company issued warrants to purchase shares of the Company’s common stock in connection with a private placement transaction that closed on March 29, 2017. These warrants contain a feature that could require the transfer of cash in the event of a Fundamental Transaction, as defined in such warrants (other than a Fundamental Transaction not approved by the Company’s Board of Directors). As of September 30, 2017, the warrant holders did not control the Company’s Board of Directors, and therefore, the Company’s control, the warrants 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 performed a preliminary assessment of the impact of the new standard on the consolidated financial statements, and considered all items outlined in the standard. In assessing the impact, the Company has outlined all revenue generating activities, mapped those activities to performance obligations and traced those performance obligations to the standard. The Company is now assessing what impact the change in standard will have on those performance obligations. The Company will continue to evaluate the future impact and method of adoption of the new standard and related amendments on the consolidated financial statements and related disclosures throughout 2017. The Company will adopt the new standard beginning January 1, 2018. 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 was effective for the Company for annual and interim reporting periods in fiscal years beginning after December 15, 2016. The adoption, effective January 1, 2017, did not have a material impact on the Company’s condensed consolidated 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 and interim reporting 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 and interim reporting periods in fiscal years beginning after December 15, 2016. The Company adopted the standard for reporting periods beginning January 1, 2017. The Company elected to keep its policy consistent for the application of a forfeiture rate and, therefore, the adoption of the guidance did not have a material impact on its unaudited condensed 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 in fiscal years 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 evaluating the new guidance and has not determined the impact this standards update may have on its financial statements. In January 2017, the FASB issued new accounting guidance, which was created to assist entities with evaluating whether transactions should be accounted for as acquisitions (or disposals) of assets or businesses. This guidance provides a screen to determine whether an integrated set of assets and activities is a business. The screen requires that when substantially all of the fair value of the gross assets acquired (or disposed of) is concentrated in a single identifiable asset or a group of similar identifiable assets, the set is not a business. The guidance is effective for annual and interim reporting periods in fiscal years beginning after December 15, 2017. The Company does not anticipate this standard to have an impact on the Company’s consolidated financial statements unless a transaction occurs that would need to be evaluated under this guidance at which time the Company will assess the impact of this standard. In May 2017, the FASB recently issued ASU 2017-09, Compensation-Stock Compensation , to provide clarity and reduce both 1) diversity in practice and 2) cost and complexity when applying the guidance in Topic 718 to a change in the terms or conditions of a share-based payment award. ASU 2017-09 provides guidance about which changes to the terms or conditions of a share-based payment award require an entity to apply modification accounting under Topic 718. The amendments in ASU 2017-09 are effective for fiscal and interim reporting periods in fiscal years beginning after December 15, 2017. Early adoption is permitted, including adoption in any interim period. The amendments in ASU 2017-09 should be applied prospectively to an award modified on or after the adoption date. In July 2017, the FASB issued ASU 2017-11, Earnings Per Share (Topic 260); Distinguishing Liabilities from Equity (Topic 480); Derivatives and Hedging (Topic 815): (Part I) Accounting for Certain Financial Instruments with Down Round Features, (Part II) Replacement of the Indefinite Deferral for Mandatorily Redeemable Financial Instruments of Certain Nonpublic Entities and Certain Mandatorily Redeemable Non-controlling Interests with a Scope Exception. The ASU allows companies to exclude a down round feature when determining whether a financial instrument (or embedded conversion feature) is considered indexed to the entity’s own stock. As a result, financial instruments (or embedded conversion features) with down round features may no longer be required to be accounted classified as liabilities. A company will recognize the value of a down round feature only when it is triggered and the strike price has been adjusted downward. For equity-classified freestanding financial instruments, such as warrants, an entity will treat the value of the effect of the down round, when triggered, as a dividend and a reduction of income available to common shareholders in computing basic earnings per share. For convertible instruments with embedded conversion features containing down round provisions, entities will recognize the value of the down round as a beneficial conversion discount to be amortized to earnings. The guidance in ASU 2017-11 is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years. Early adoption is permitted, and the guidance is to be applied using a full or modified retrospective approach. The Company does not anticipate that the adoption of ASU 2017-11 will have a material impact on its consolidated financial statements unless a transaction occurs that would need to be evaluated under this guidance at which time the Company will assess the impact of this standard.

Select Condensed Consolidated B

Select Condensed Consolidated Balance Sheet Details	9 Months Ended
	Sep. 30, 2017
Balance Sheet Related Disclosures [Abstract]
Select Condensed Consolidated Balance Sheet Details	3. Select Condensed Consolidated Balance Sheet Details Accounts Receivable, net Accounts receivable, net consist of the following (in thousands): September 30, 2017 December 31, 2016 Accounts receivable $ 13,819 $ 19,870 Allowance for doubtful accounts (516 ) (1,358 ) Accounts receivable, net $ 13,303 $ 18,512 Inventories, net Inventories, net consist of the following (in thousands): September 30, 2017 December 31, 2016 Raw materials $ 5,454 $ 7,301 Work-in-process 926 823 Finished goods 38,910 38,469 45,290 46,593 Less reserve for excess and obsolete finished goods (15,543 ) (16,500 ) Inventories, net $ 29,747 $ 30,093 Property and Equipment, net Property and equipment, net consist of the following (in thousands except as indicated): Useful lives (in years) September 30, 2017 December 31, 2016 Surgical instruments 4 $ 53,116 $ 53,095 Machinery and equipment 7 5,492 5,435 Computer equipment 3 3,512 3,511 Office furniture and equipment 5 2,707 2,695 Leasehold improvements various 1,664 3,467 Construction in progress n/a - 445 66,491 68,648 Less accumulated depreciation and amortization (53,216 ) (53,572 ) Property and equipment, net $ 13,275 $ 15,076 Total depreciation expense was $1.6 million and $1.6 million for the three months ended September 30, 2017 and 2016 and $4.8 million and $5.6 million for the nine months ended September 30, 2017 and 2016, respectively. At September 30, 2017 and December 31, 2016, assets recorded under capital leases of $2.1 million were included in the machinery and equipment balance. Amortization of assets under capital leases is 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, 2017 December 31, 2016 Developed product technology — $ 13,876 $ 13,876 Intellectual property — 1,004 1,004 License agreements 2 5,738 5,265 Trademarks and trade names — 732 732 Customer-related 8 7,458 7,458 Distribution network 8 4,027 4,027 32,835 32,362 Less accumulated amortization (27,353 ) (26,651 ) Intangible assets, net $ 5,482 $ 5,711 Total amortization expense was $0.2 million and $0.3 million for the three months ended September 30, 2017 and 2016 and $0.7 million and $0.9 million for the nine months ended September 30, 2017 and 2016, respectively. Future amortization expense related to intangible assets as of September 30, 2017 is as follows (in thousands): Year Ending December 31, Remainder of 2017 $ 234 2018 801 2019 757 2020 756 2021 756 Thereafter 2,178 $ 5,482 Accrued Expenses Accrued expenses consist of the following (in thousands): September 30, 2017 December 31, 2016 Commissions and sales milestones $ 4,378 $ 4,202 Payroll and payroll related 2,322 2,384 Litigation settlements 4,400 4,400 Globus related accruals — 3,830 Accrued professional fees 1,605 3,093 Royalties 1,131 1,347 Restructuring and severance accruals 470 1,328 Accrued taxes 237 404 Guaranteed collaboration compensation, current 4,529 2,228 Accrued interest 361 387 Other 3,173 3,986 Total accrued expenses $ 22,606 $ 27,589

Discontinued Operations

Discontinued Operations	9 Months Ended
	Sep. 30, 2017
Discontinued Operations And Disposal Groups [Abstract]
Discontinued Operations	4. Discontinued Operations As a result of the Globus Transaction, the Company has retrospectively revised the condensed consolidated statements of operations for the three and nine month periods ended September 30, 2016 to reflect the financial results from the International Business 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 $66 million of the consideration received to (i) repay in full all amounts outstanding and due under the Company’s Facility Agreement between the Company and 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., dated as of March 17, 2014, as amended to date (the “Deerfield Facility Agreement”) and (ii) repay certain of its outstanding indebtedness under the Company’s credit facility, as amended to date (the “Amended Credit Facility”) with MidCap Funding IV, LLC (“MidCap”) (described in Note 5), 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 5, 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 calculation of the gain on sale (in thousands). The Company recorded an adjustment of $104,000 to the preliminary purchase price accounting during November 2016. Consideration received $ 80,000 Cash included in assets sold (4,250 ) Transaction costs (5,960 ) Net cash proceeds 69,790 Less: Product supply obligation (1,927 ) Working capital adjustment (2,295 ) Carrying value of business and assets sold (57,633 ) Net gain on sale of business $ 7,935 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 $1.9 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 and has been recognized as revenue. Included in the results of continuing operations for the three months ended September 30, 2016 are revenues of $1.4 million and cost of revenue of $1.8 million and for the nine months ended September 30, 2016 revenues of $8.9 million and cost of revenue of $8.9 million that represent intercompany transactions that, prior to the Globus Transaction, were eliminated in the Company's condensed consolidated financial statements. During the three months ended September 30, 2017, the Company recorded $2.3 million in revenue and $2.0 million in cost of revenue from the Supply Agreement in continuing operations. During the nine months ended September 30, 2017, the Company recorded $9.1 million in revenue and $7.8 million in cost of revenue from the Supply Agreement in 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, 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 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 loss for the three and nine months ended September 30, 2017 and 2016 (in thousands): Three Months Ended Nine Months Ended September 30, September 30, Discontinued operations 2017 2016 2017 2016 Revenues $ — $ 18,043 $ — $ 40,146 Cost of revenues — 11,469 — 19,694 Amortization of acquired intangible assets — 555 — 1,291 Gross profit — 6,019 — 19,161 Operating expenses: Research and development — 16 — 50 Sales and marketing — 2,865 — 12,391 General and administrative 16 1,440 157 5,079 Amortization of acquired intangible assets — 155 — 622 Restructuring expenses — 4 — 620 Net gain on sale of business — (5,361 ) — (5,361 ) Total operating expenses 16 (881 ) 157 13,401 Operating loss (16 ) 6,900 (157 ) 5,760 Other income (expense): Interest expense, net — (2,144 ) — (7,194 ) Other income, net — 243 — 1,892 Total other income (expense) — (1,901 ) — (5,302 ) Loss from discontinued operations before taxes (16 ) 4,999 (157 ) 458 Income tax provision 45 8,657 63 9,809 Loss from discontinued operations, net of applicable taxes $ (61 ) $ (3,658 ) $ (220 ) $ (9,351 ) The following table summarizes the assets and liabilities of discontinued operations as of September 30, 2017 and December 31, 2016 related to the International Business (in thousands): September 30, 2017 December 31, 2016 Assets Current assets: Cash $ — $ 159 Inventories, net — 48 Prepaid expenses and other current assets 236 157 Total current assets of discontinued operations 236 364 Other assets 52 61 Total assets of discontinued operations $ 288 $ 425 Liabilities Current liabilities: Accounts payable $ — $ 43 Accrued expenses 283 689 Other current liabilities — — Total current liabilities of discontinued operations $ 283 $ 732 Total long-term liabilities of discontinued operations — — Total liabilities of discontinued operations $ 283 $ 732 Included in the cash flows for the nine months ended September 30, 2017 and 2016 are the following non-cash adjustments related to the discontinued operations (in thousands): Three Months Ended September , Nine Months Ended September 30, 2017 2016 2017 2016 Depreciation and amortization $ — $ 1,024 $ — $ 3,836 Provision for excess and obsolete inventory $ — $ 15 $ — $ 151 Capital expenditures $ — $ 211 $ — $ 1,319 Interest expense related to amortization of debt discount and debt issuance costs $ — $ — $ — $ 2,052

Debt

Debt	9 Months Ended
	Sep. 30, 2017
Debt Disclosure [Abstract]
Debt	5. Debt MidCap Facility Agreement The Company’s Amended Credit Facility with MidCap provides for a revolving credit commitment up to $22.5 million and a term loan commitment up to $5 million. As of September 30, 2017, $9.2 million was outstanding under the revolving line of credit and $2.9 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, 2017, the revolving line of credit carried an interest rate of 7.24% and the term loan carried an interest rate of 9.5%. The borrowing base is determined, from time to time, based on the value of domestic eligible accounts receivable. 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 $0.2 million in 2017 and $0.3 million in 2018 are due through the maturity date in August 2018, with the remaining principal due on the maturity date. At September 30, 2017, $1.4 million remains as unamortized debt discount related to the Amended Credit Facility within the condensed consolidated balance sheet, which will be amortized over the remaining term of the Amended Credit Facility. On March 30, 2017, the Company entered into a sixth amendment to the Amended Credit Facility with MidCap (the “Sixth Amendment”). The Sixth Amendment extends the date that the financial covenants of the Amended Credit Facility are effective from April 2017 to April 2018. The Amended Credit Facility includes traditional lending and reporting covenants including a fixed charge coverage ratio to be maintained by the Company. The Amended Credit Facility also includes several event of default provisions, such as payment default, insolvency conditions and a material adverse effect clause, 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. There is no assurance that the Company will be in compliance with the financial covenants of the Amended Credit Facility in the future. 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 with an additional draw of $5 million made in the fourth quarter of 2016. As of September 30, 2017, the outstanding balance under the Globus Facility Agreement was $30.0 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. At September 30, 2017, unamortized debt discount related to the Globus Facility Agreement within the condensed consolidated balance sheet was $0.9 million. 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 secures 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 2018. 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, insolvency conditions and a material adverse effect clause, 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, 2017 (in thousands): Year Ending December 31, Remainder of 2017 $ 600 2018 4,130 2019 12,658 2020 3,380 2021 and thereafter 21,666 Total 42,434 Add: capital lease principal payments 127 Less: unamortized debt discount and debt issuance costs (2,296 ) Total 40,265 Less: current portion of long-term debt (3,037 ) Long-term debt, net of current portion $ 37,228

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2017
Commitments And Contingencies Disclosure [Abstract]
Commitments and Contingencies	6. 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 7.6% 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 2021. Future minimum annual lease payments under such leases are as follows as of September 30, 2017 (in thousands): Year Ending December 31, Operating Capital Remainder of 2017 $ 452 $ 64 2018 1,656 68 2019 1,542 — 2020 1,584 — 2021 and thereafter 971 — $ 6,205 132 Less: amount representing interest (5 ) Present value of minimum lease payments 127 Current portion of capital leases (127 ) Capital leases, less current portion $ - Rent expense under operating leases for the three months ended September 30, 2017 and 2016 was $0.3 million and $1.0 million, respectively, and for the nine months ended September 30, 2017 and 2016 was $0.9 million and $2.0 million, respectively. In June 2017, we received a cash payment from a landlord for tenant improvements in the amount of $0.5 million, which is amortized through the remainder of the lease term as an offset to rent expenses. Litigation The Company is and may become involved in various legal proceedings arising from its business activities. While the Company has no material accruals for pending litigation or claims for which accrual amounts are not disclosed in the Company’s consolidated financial statements, 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, 2017
Commitments And Contingencies Disclosure [Abstract]
Orthotec Settlement	7. 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, 2017, the Company has made installment payments in the aggregate of $30.7 million, with a remaining outstanding balance of $27.1 million (including interest). 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.

Sale of Assets

Sale of Assets	9 Months Ended
	Sep. 30, 2017
Discontinued Operations And Disposal Groups [Abstract]
Sale of Assets	8. Sale of Assets On May 5, 2017, the Company entered into an agreement to sell certain inventory and intellectual property to a third party for $1.0 million in consideration, payable via a credit to future minimum royalties owed to the third party under an existing exclusive license agreement between the two parties. The Company recorded a net gain on sale of assets of $0.9 million which is included under operating expenses on the Company’s condensed consolidated statement of operations.

Net Loss Per Share

Net Loss Per Share	9 Months Ended
	Sep. 30, 2017
Earnings Per Share [Abstract]
Net Loss Per Share	9. 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 September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Numerator: Loss from continuing operations $ (3,076 ) $ (10,063 ) $ (11,129 ) $ (16,220 ) Loss from discontinued operations (61 ) (3,658 ) (220 ) (9,351 ) Net loss $ (3,137 ) $ (13,721 ) $ (11,349 ) $ (25,571 ) Denominator: Weighted average common shares outstanding 13,954 8,623 11,400 8,554 Weighted average unvested common shares subject to repurchase (16 ) (63 ) (51 ) (49 ) Weighted average common shares outstanding—basic 13,938 8,560 11,349 8,505 Effect of dilutive securities: Conversion of preferred stock — — — — Options — — — — Warrants — — — — Weighted average common shares outstanding—diluted 13,938 8,560 11,349 8,505 Net loss per share, basic and diluted: Continuing operations $ (0.22 ) $ (1.17 ) $ (0.98 ) $ (1.91 ) Discontinued operations $ (0.01 ) $ (0.43 ) $ (0.02 ) $ (1.10 ) Net loss per share, basic and diluted $ (0.23 ) $ (1.60 ) $ (1.00 ) $ (3.01 ) The anti-dilutive securities not included in diluted net Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Options to purchase common stock 2,948 594 1,861 611 Unvested restricted share awards 16 63 51 49 Series A Convertible Preferred Stock 4,848 — 4,135 — Warrants to purchase common stock - 8 1,013 8 Total 7,812 665 7,060 668

Stock Benefit Plans and Equity

Stock Benefit Plans and Equity Transactions	9 Months Ended
	Sep. 30, 2017
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Stock Benefit Plans and Equity Transactions	10. Stock Benefit Plans and Equity Transactions Stock Benefit Plans On October 4, 2016, 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. The Inducement Plan currently has 1,550,000 shares of common stock reserved for issuance, of which, 600,000 shares of common stock were added on March 30, 2017. Equity awards under the Inducement Plan 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 Equity Incentive 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. Stock Options A summary of the Company’s stock option activity under the Plans and related information is as follows (in thousands, except as indicated and per share data), as adjusted for the 1-for-12 reverse stock split: Shares Weighted average exercise price Weighted average remaining contractual term (in years) Aggregate intrinsic value Outstanding at December 31, 2016 1,155 $ 12.17 7.75 $ — Granted 2,686 $ 1.91 Forfeited (383 ) $ 12.18 Outstanding at September 30, 2017 3,458 $ 4.20 8.94 $ 1,276 Options vested and exercisable at September 30, 2017 421 $ 17.91 4.20 $ 10 Options vested and expected to vest at September 30, 2017 3,096 $ 4.44 8.86 $ 1,113 The weighted-average grant-date fair value per share of stock options granted during the nine months ended September 30, 2017 was $1.30. As of September 30, 2017, there was $3.7 million of unrecognized compensation expense for stock options which is expected to be recognized on a straight-line basis over a weighted average period of approximately 3.5 years. Restricted Stock Awards and Units The following table summarizes information about the restricted stock awards, restricted stock units and performance-based restricted units activity (in thousands, except as indicated and per share data), as adjusted for the 1-for-12 reverse stock split: Shares Weighted average grant date fair value Weighted average remaining recognition period (in years) Unvested at December 31, 2016 1,092 $ 7.48 3.02 Awarded 357 $ 2.15 Vested (81 ) $ 4.49 Forfeited (238 ) $ 2.30 Unvested at September 30, 2017 1,130 $ 4.50 2.78 As of September 30, 2017, there was $2.6 million of unrecognized compensation expense for restricted stock awards which is expected to be recognized on a straight-line basis over a weighted average period of approximately 2.8 years. Total share based compensation expense recognized in general and administrative, selling and marketing, research and development expenses and cost of sales were $1.4 million, $0.2 million, $0.1 million and $12,000 for the nine months ended September 30, 2017, and $0.2 million, $31,000, $18,000 and $5,000 for the nine months ended September 30, 2016, respectively. Shares Reserved For Future Issuance As of September 30, 2017, the Company had reserved shares of its common stock for future issuance as follows: Shares Reserved Stock options outstanding 3,458 Unvested restricted stock award 1,130 Employee stock purchase plan 451 Available for future grants under the Inducement Plan 440 Series A convertible preferred stock 3,686 Warrants to purchase common stock 9,904 Total shares reserved 19,069 Private Placement Transaction On March 22, 2017, the Company entered into the Securities Purchase Agreement with certain institutional and accredited investors, including certain directors, executive officers and employees of the Company (collectively, the “Purchasers”), providing for the sale by the Company of 1,809,628 shares of the Company’s common stock at a purchase price of $2.00 per share (the “Common Shares”), 15,245 shares of newly designated Series A Convertible Preferred Stock at a purchase price of $1,000 per share (which shares are convertible into approximately 7,622,372 shares of common stock, and were initially subject to limitations on conversion prior to the approval by the Company’s stockholders (“Stockholder Approval”) as required in accordance with the NASDAQ listing rules), and warrants to purchase up to 9,432,000 shares of the Company’s common stock at an exercise price of $2.00 per share (the “Purchaser Warrants”), in a private placement (the “Private Placement”). The Purchaser Warrants became exercisable following Stockholder Approval, are subject to certain ownership limitations, and expire five years after June 15, 2017, the date Stockholder Approval was received. An aggregate of $2.35 million of shares of Series A Convertible Preferred Stock, which shares are convertible into approximately 1,175,000 shares of common stock, and Purchaser Warrants to purchase up to 1,175,000 shares of common stock were purchased by certain directors, executive officers and employees of the Company. On June 15, 2017, shareholder approval was received for the conversion of the Series A Convertible Preferred Stock and 7,797 shares of preferred stock were converted into 3,936,225 shares of common stock as of September 30, 2017. The Company also entered into an engagement letter (the “Engagement Letter”) on March 1, 2017 with H.C. Wainwright & Co., LLC (“Wainwright”), pursuant to which Wainwright agreed to serve as exclusive placement agent for the issuance and sale of the securities in the Private Placement. Pursuant to the Engagement Letter, the Company issued to Wainwright and its designees warrants to purchase up to an aggregate of 471,600 shares of the Company’s common stock (the “Wainwright Warrants,” and together with the Purchaser Warrants, the “Common Stock Warrants”). The Wainwright Warrants have substantially the same terms as the Purchaser Warrants, except that the Wainwright Warrants have an exercise price equal $2.50 per share. The Private Placement, including the issuance of the Wainwright Warrants, closed on March 29, 2017, with aggregate gross proceeds to the Company of approximately $18.9 million. Series A Convertible Preferred Stock On March 29, 2017, in connection with the closing of the Private Placement, the Company filed a Certificate of Designation of Preferences, Rights and Limitations of Series A Convertible Preferred Stock with the Secretary of State of the State of Delaware (the “Certificate of Designation”). The shares of Series A Convertible Preferred Stock have a stated value of $1,000 per share and were convertible into approximately 500 shares of common stock upon receipt of Stockholder Approval. Prior to the date that Stockholder Approval was obtained, the Certificate of Designation limited the number of shares of common stock that were issuable upon conversion of the Series A Convertible Preferred Stock such that, when aggregated with the shares of common stock issued in the Private Placement, such issuances did not exceed 19.99% of the Company’s issued and outstanding common stock, as required by NASDAQ listing rules. In addition, the Company’s directors, executive officers and employees who participated in the Private Placement were unable to convert shares of Series A Convertible Preferred Stock until Stockholder Approval was obtained, pursuant to the NASDAQ listing rules. The Series A Convertible Preferred Stock will be entitled to dividends on an as-if-converted basis in the same form as any dividends actually paid on shares of common stock or other securities. Except as otherwise required by law, the holders of Series A Convertible Preferred Stock will have no right to vote on matters submitted to a vote of the Company’s stockholders. Without the prior written consent of 75% of the outstanding shares of Series A Convertible Preferred Stock, the Company may not: (a) alter or change adversely the powers, preferences or rights given to the Series A Convertible Preferred Stock or alter or amend the Certificate of Designation, (b) amend the Company’s certificate of incorporation or other charter documents in any manner that adversely affects any rights of the holders of Series A Convertible Preferred Stock, (c) increase the number of authorized shares of Series A Convertible Preferred Stock, or (d) enter into any agreement with respect to any of the foregoing. In the event of the dissolution and winding up of the Company, the proceeds available for distribution to the Company’s stockholders shall be distributed pari passu among the holders of the shares of common stock and Series A Convertible Preferred Stock, pro rata based upon the number of shares held by each such holder, as if the outstanding shares of Series A Convertible Preferred Stock were convertible, and were converted, into shares of common stock. Common Stock Warrants The Common Stock Warrants are exercisable for cash or, solely, if at any time after the six-month anniversary of the closing date of the Private Placement, there is not an effective registration statement or prospectus registering the issuance of shares of the Company’s common stock upon exercise of the Common Stock Warrants, by cashless exercise. The exercise price of the Common Stock Warrants is subject to adjustment in the case of stock dividends or other distributions on shares of common stock or any other equity or equity equivalent securities payable in shares of common stock, stock splits, stock combinations, reclassifications or similar events affecting the Company’s common stock, and also, subject to limitations, upon any distribution of assets, including cash, stock or other property to the Company’s stockholders. Prior to the exercise, holders of the Common Stock Warrants will not have any of the rights of holders of the common stock purchasable upon exercise, including voting rights; however, the holders of the Common Stock Warrants will have certain rights to participate in distributions or dividends paid on the Company’s common stock to the extent set forth in the Common Stock Warrants. The Common Stock Warrants may not be exercised by the holder to the extent that the holder, together with its affiliates, would beneficially own, after such exercise more than 4.99% of the shares of the Company’s common stock then outstanding (subject to the right of the holder to increase or decrease such beneficial ownership limitation upon notice to us, provided that such limitation cannot exceed 9.99%) and provided that any increase in the beneficial ownership limitation shall not be effective until 61 days after such notice is delivered. If the Company effects a fundamental transaction, then upon any subsequent exercise of any Common Stock Warrants, the holder thereof shall have the right to receive, for each share of common stock that would have been issuable upon such exercise immediately prior to the occurrence of such fundamental transaction, the number of shares of the successor’s or acquiring corporation’s common stock or of the Company’s common stock, if the Company is the surviving corporation, and any additional consideration receivable as a result of such fundamental transaction by a holder of the number of shares of common stock into which the Common Stock Warrants were exercisable immediately prior to such fundamental transaction. In addition, in the event of a fundamental transaction (other than a fundamental transaction not approved by the Company’s Board of Directors), the Company or any successor entity shall, at the holder’s option, purchase the holder’s Common Stock Warrants for an amount of cash equal to the value of the Common Stock Warrants as determined in accordance with the Black Scholes option pricing model. A fundamental transaction as described in the Common Stock Warrants generally includes any merger with or into another entity, sale of all or substantially all of the Company’s assets, tender offer or exchange offer, reclassification of the Company’s common stock or the consummation of a transaction whereby another entity acquires more than 50% of the Company’s outstanding voting stock. In accordance with authoritative guidance, the Purchaser Warrants and the Wainwright Warrants are classified within additional paid in capital on the condensed consolidated balance sheet.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2017
Income Tax Disclosure [Abstract]
Income Taxes	11. 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. 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 increased by less than $0.1 million during the nine months ended September 30, 2017. The increase in unrecognized tax benefits during the nine months ended September 30, 2017 was primarily related to foreign currency fluctuations partially offset by a decrease in reserves for taxes related to imputed interest on trade receivables. The Company recognized a tax benefit of $35 thousand related to decrease in tax reserves related to imputed interest on trade receivables in the condensed consolidated statement of operations for the three and nine months ended September 30, 2017. The unrecognized tax benefits at September 30, 2017 and December 31, 2016 were $9.4 million and $9.3 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 $2.8 million. The Company is not currently under examination by the Internal Revenue Service, or state or local tax authorities; however, Scient’x’s 2013 and 2014 tax years are currently under audit by the French tax authorities. The Company completed the audit of its 2013 tax year in Texas, which resulted in no additional taxes. The income tax provision from continuing operations for the three and nine months ended September 30, 2017 consists primarily of state income taxes partially offset by a decrease in income tax contingency reserves. The Company’s effective tax rate of 0.30% and 0.51% for the three and nine months ended September 30, 2017, respectively, differs from the federal statutory rate of 35% primarily due to a full valuation allowance and state income taxes partially offset by a decrease in income tax contingency reserves.

Related Party Transactions

Related Party Transactions	9 Months Ended
	Sep. 30, 2017
Related Party Transactions [Abstract]
Related Party Transactions	12. Related Party Transactions For the nine months ended September 30, 2017 and 2016, respectively, the Company incurred expenses of less than $0.1 million related to HealthpointCapital, LLC. As of September 30, 2017, 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. The Company and HealthpointCapital also entered into an agreement for joint payment of settlement whereby HealthpointCapital has agreed to contribute $5 million to the $49 million Orthotec settlement amount.

Restructuring

Restructuring	9 Months Ended
	Sep. 30, 2017
Restructuring And Related Activities [Abstract]
Restructuring	13. Restructuring In connection with the Globus Transaction (described in Note 4), the Company terminated employment agreements with several executive officers, including the chief executive officer and the chief financial officer, and commenced an employee headcount reduction program. The Company had additional headcount reductions in February 2017, and recorded restructuring expenses of $0.1 million and $1.9 million for the three and nine months ended September 30, 2017, related to severance liability and post-employment benefits. A rollforward of the accrued restructuring liability is presented below (in thousands): Balance as of January 1, 2017 $ 1,328 Accrued restructuring charges 1,231 Payments (940 ) Balance as of March 31, 2017 1,619 Accrued restructuring charges 528 Payments (1,115 ) Balance as of June 30, 2017 $ 1,032 Accrued restructuring charges 139 Payments (701) Balance as of September 30, 2017 $ 470 All activities and costs are expected to be completed during 2018 . 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 $1.6 million and $1.8 million during the three and nine months ended September 30, 2016, related to these restructuring activities.

Subsequent events

Subsequent events	9 Months Ended
	Sep. 30, 2017
Subsequent Events [Abstract]
Subsequent events	14. Subsequent events On October 2, 2017, the Company entered into Securities Purchase Agreements (collectively, the “Purchase Agreements”) with accredited investors Patrick Miles and Quentin Blackford (collectively, the “Purchasers”), pursuant to which Messrs. Miles and Blackford have agreed, subject to the satisfaction of customary closing conditions under the Purchase Agreements, to purchase from the Company, collectively, no less than 1,549,116 and as many as 1,769,912 shares of its common stock at a purchase price of $2.26 per share. The closing of the share purchases under the Purchase Agreements by Messrs. Miles and Blackford is expected to occur on or before January 1, 2018, subject to the satisfaction of customary closing conditions. As more fully described in Note 10, the Company issued warrants to purchase shares of the Company’s common stock in connection with a private placement transaction that closed on March 29, 2017. During October 2017, we received proceeds of approximately $1.7 million in connection with the exercise of approximately 0.9 million warrants. In addition, these warrants contain a feature that could require the transfer of cash in the event of a Fundamental Transaction, as defined in such warrants (other than a Fundamental Transaction not approved by the Company’s Board of Directors). As of September 30, 2017, the warrant holders did not control the Company’s Board of Directors, and therefore, since potential future cash settlement was deemed to be within the Company’s control, the warrants were classified in stockholder’s equity in accordance with the authoritative accounting guidance. Subsequent to September 30, 2017, concurrent with the appointment of Ward W. Woods to the Company’s board of directors effective October 17, 2017, the holders of the warrants represent a majority of the Board of Directors. As a result of this change, the Company may be required to re-classify the warrants as a liability in accordance with the authoritative accounting guidance. The Company is currently assessing the impact of this change, if any, on its financial statements for the three months and year ended December 31, 2017.

Summary of Significant Accoun21

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2017
Accounting Policies [Abstract]
Warrant Accounting	Warrant Accounting As more fully described in Note 10, the Company issued warrants to purchase shares of the Company’s common stock in connection with a private placement transaction that closed on March 29, 2017. These warrants contain a feature that could require the transfer of cash in the event of a Fundamental Transaction, as defined in such warrants (other than a Fundamental Transaction not approved by the Company’s Board of Directors). As of September 30, 2017, the warrant holders did not control the Company’s Board of Directors, and therefore, the Company’s control, the warrants
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 performed a preliminary assessment of the impact of the new standard on the consolidated financial statements, and considered all items outlined in the standard. In assessing the impact, the Company has outlined all revenue generating activities, mapped those activities to performance obligations and traced those performance obligations to the standard. The Company is now assessing what impact the change in standard will have on those performance obligations. The Company will continue to evaluate the future impact and method of adoption of the new standard and related amendments on the consolidated financial statements and related disclosures throughout 2017. The Company will adopt the new standard beginning January 1, 2018. 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 was effective for the Company for annual and interim reporting periods in fiscal years beginning after December 15, 2016. The adoption, effective January 1, 2017, did not have a material impact on the Company’s condensed consolidated 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 and interim reporting 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 and interim reporting periods in fiscal years beginning after December 15, 2016. The Company adopted the standard for reporting periods beginning January 1, 2017. The Company elected to keep its policy consistent for the application of a forfeiture rate and, therefore, the adoption of the guidance did not have a material impact on its unaudited condensed 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 in fiscal years 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 evaluating the new guidance and has not determined the impact this standards update may have on its financial statements. In January 2017, the FASB issued new accounting guidance, which was created to assist entities with evaluating whether transactions should be accounted for as acquisitions (or disposals) of assets or businesses. This guidance provides a screen to determine whether an integrated set of assets and activities is a business. The screen requires that when substantially all of the fair value of the gross assets acquired (or disposed of) is concentrated in a single identifiable asset or a group of similar identifiable assets, the set is not a business. The guidance is effective for annual and interim reporting periods in fiscal years beginning after December 15, 2017. The Company does not anticipate this standard to have an impact on the Company’s consolidated financial statements unless a transaction occurs that would need to be evaluated under this guidance at which time the Company will assess the impact of this standard. In May 2017, the FASB recently issued ASU 2017-09, Compensation-Stock Compensation , to provide clarity and reduce both 1) diversity in practice and 2) cost and complexity when applying the guidance in Topic 718 to a change in the terms or conditions of a share-based payment award. ASU 2017-09 provides guidance about which changes to the terms or conditions of a share-based payment award require an entity to apply modification accounting under Topic 718. The amendments in ASU 2017-09 are effective for fiscal and interim reporting periods in fiscal years beginning after December 15, 2017. Early adoption is permitted, including adoption in any interim period. The amendments in ASU 2017-09 should be applied prospectively to an award modified on or after the adoption date. In July 2017, the FASB issued ASU 2017-11, Earnings Per Share (Topic 260); Distinguishing Liabilities from Equity (Topic 480); Derivatives and Hedging (Topic 815): (Part I) Accounting for Certain Financial Instruments with Down Round Features, (Part II) Replacement of the Indefinite Deferral for Mandatorily Redeemable Financial Instruments of Certain Nonpublic Entities and Certain Mandatorily Redeemable Non-controlling Interests with a Scope Exception. The ASU allows companies to exclude a down round feature when determining whether a financial instrument (or embedded conversion feature) is considered indexed to the entity’s own stock. As a result, financial instruments (or embedded conversion features) with down round features may no longer be required to be accounted classified as liabilities. A company will recognize the value of a down round feature only when it is triggered and the strike price has been adjusted downward. For equity-classified freestanding financial instruments, such as warrants, an entity will treat the value of the effect of the down round, when triggered, as a dividend and a reduction of income available to common shareholders in computing basic earnings per share. For convertible instruments with embedded conversion features containing down round provisions, entities will recognize the value of the down round as a beneficial conversion discount to be amortized to earnings. The guidance in ASU 2017-11 is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years. Early adoption is permitted, and the guidance is to be applied using a full or modified retrospective approach. The Company does not anticipate that the adoption of ASU 2017-11 will have a material impact on its consolidated financial statements unless a transaction occurs that would need to be evaluated under this guidance at which time the Company will assess the impact of this standard.

Select Condensed Consolidated22

Select Condensed Consolidated Balance Sheet Details (Tables)	9 Months Ended
	Sep. 30, 2017
Balance Sheet Related Disclosures [Abstract]
Accounts receivable, net	Accounts receivable, net consist of the following (in thousands): September 30, 2017 December 31, 2016 Accounts receivable $ 13,819 $ 19,870 Allowance for doubtful accounts (516 ) (1,358 ) Accounts receivable, net $ 13,303 $ 18,512
Inventories, net	Inventories, net consist of the following (in thousands): September 30, 2017 December 31, 2016 Raw materials $ 5,454 $ 7,301 Work-in-process 926 823 Finished goods 38,910 38,469 45,290 46,593 Less reserve for excess and obsolete finished goods (15,543 ) (16,500 ) Inventories, net $ 29,747 $ 30,093
Property and equipment, net	Property and equipment, net consist of the following (in thousands except as indicated): Useful lives (in years) September 30, 2017 December 31, 2016 Surgical instruments 4 $ 53,116 $ 53,095 Machinery and equipment 7 5,492 5,435 Computer equipment 3 3,512 3,511 Office furniture and equipment 5 2,707 2,695 Leasehold improvements various 1,664 3,467 Construction in progress n/a - 445 66,491 68,648 Less accumulated depreciation and amortization (53,216 ) (53,572 ) Property and equipment, net $ 13,275 $ 15,076
Intangible assets, net	Intangible assets, net consist of the following (in thousands except for useful lives): Remaining Avg. Useful lives (in years) September 30, 2017 December 31, 2016 Developed product technology — $ 13,876 $ 13,876 Intellectual property — 1,004 1,004 License agreements 2 5,738 5,265 Trademarks and trade names — 732 732 Customer-related 8 7,458 7,458 Distribution network 8 4,027 4,027 32,835 32,362 Less accumulated amortization (27,353 ) (26,651 ) Intangible assets, net $ 5,482 $ 5,711
Schedule of intangible assets, future amortization expense	Future amortization expense related to intangible assets as of September 30, 2017 is as follows (in thousands): Year Ending December 31, Remainder of 2017 $ 234 2018 801 2019 757 2020 756 2021 756 Thereafter 2,178 $ 5,482
Accrued expenses	Accrued expenses consist of the following (in thousands): September 30, 2017 December 31, 2016 Commissions and sales milestones $ 4,378 $ 4,202 Payroll and payroll related 2,322 2,384 Litigation settlements 4,400 4,400 Globus related accruals — 3,830 Accrued professional fees 1,605 3,093 Royalties 1,131 1,347 Restructuring and severance accruals 470 1,328 Accrued taxes 237 404 Guaranteed collaboration compensation, current 4,529 2,228 Accrued interest 361 387 Other 3,173 3,986 Total accrued expenses $ 22,606 $ 27,589

Discontinued Operations (Tables

Discontinued Operations (Tables)	9 Months Ended
	Sep. 30, 2017
Discontinued Operations And Disposal Groups [Abstract]
Summary of discontinued business segment	The following table summarizes the calculation of the gain on sale (in thousands). The Company recorded an adjustment of $104,000 to the preliminary purchase price accounting during November 2016. Consideration received $ 80,000 Cash included in assets sold (4,250 ) Transaction costs (5,960 ) Net cash proceeds 69,790 Less: Product supply obligation (1,927 ) Working capital adjustment (2,295 ) Carrying value of business and assets sold (57,633 ) Net gain on sale of business $ 7,935 The following table summarizes the results of discontinued operations for the periods presented in the condensed consolidated statements of operations and comprehensive loss for the three and nine months ended September 30, 2017 and 2016 (in thousands): Three Months Ended Nine Months Ended September 30, September 30, Discontinued operations 2017 2016 2017 2016 Revenues $ — $ 18,043 $ — $ 40,146 Cost of revenues — 11,469 — 19,694 Amortization of acquired intangible assets — 555 — 1,291 Gross profit — 6,019 — 19,161 Operating expenses: Research and development — 16 — 50 Sales and marketing — 2,865 — 12,391 General and administrative 16 1,440 157 5,079 Amortization of acquired intangible assets — 155 — 622 Restructuring expenses — 4 — 620 Net gain on sale of business — (5,361 ) — (5,361 ) Total operating expenses 16 (881 ) 157 13,401 Operating loss (16 ) 6,900 (157 ) 5,760 Other income (expense): Interest expense, net — (2,144 ) — (7,194 ) Other income, net — 243 — 1,892 Total other income (expense) — (1,901 ) — (5,302 ) Loss from discontinued operations before taxes (16 ) 4,999 (157 ) 458 Income tax provision 45 8,657 63 9,809 Loss from discontinued operations, net of applicable taxes $ (61 ) $ (3,658 ) $ (220 ) $ (9,351 ) The following table summarizes the assets and liabilities of discontinued operations as of September 30, 2017 and December 31, 2016 related to the International Business (in thousands): September 30, 2017 December 31, 2016 Assets Current assets: Cash $ — $ 159 Inventories, net — 48 Prepaid expenses and other current assets 236 157 Total current assets of discontinued operations 236 364 Other assets 52 61 Total assets of discontinued operations $ 288 $ 425 Liabilities Current liabilities: Accounts payable $ — $ 43 Accrued expenses 283 689 Other current liabilities — — Total current liabilities of discontinued operations $ 283 $ 732 Total long-term liabilities of discontinued operations — — Total liabilities of discontinued operations $ 283 $ 732 Included in the cash flows for the nine months ended September 30, 2017 and 2016 are the following non-cash adjustments related to the discontinued operations (in thousands): Three Months Ended September , Nine Months Ended September 30, 2017 2016 2017 2016 Depreciation and amortization $ — $ 1,024 $ — $ 3,836 Provision for excess and obsolete inventory $ — $ 15 $ — $ 151 Capital expenditures $ — $ 211 $ — $ 1,319 Interest expense related to amortization of debt discount and debt issuance costs $ — $ — $ — $ 2,052

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2017
Debt Disclosure [Abstract]
Principal Payments on Debt	Principal payments on the Company's debt are as follows as of September 30, 2017 (in thousands): Year Ending December 31, Remainder of 2017 $ 600 2018 4,130 2019 12,658 2020 3,380 2021 and thereafter 21,666 Total 42,434 Add: capital lease principal payments 127 Less: unamortized debt discount and debt issuance costs (2,296 ) Total 40,265 Less: current portion of long-term debt (3,037 ) Long-term debt, net of current portion $ 37,228

Commitments and Contingencies (

Commitments and Contingencies (Tables)	9 Months Ended
	Sep. 30, 2017
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, 2017 (in thousands): Year Ending December 31, Operating Capital Remainder of 2017 $ 452 $ 64 2018 1,656 68 2019 1,542 — 2020 1,584 — 2021 and thereafter 971 — $ 6,205 132 Less: amount representing interest (5 ) Present value of minimum lease payments 127 Current portion of capital leases (127 ) Capital leases, less current portion $ -

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	9 Months Ended
	Sep. 30, 2017
Earnings Per Share [Abstract]
Computation of basic and diluted net loss per share for continuing and discontinued operations	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 September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Numerator: Loss from continuing operations $ (3,076 ) $ (10,063 ) $ (11,129 ) $ (16,220 ) Loss from discontinued operations (61 ) (3,658 ) (220 ) (9,351 ) Net loss $ (3,137 ) $ (13,721 ) $ (11,349 ) $ (25,571 ) Denominator: Weighted average common shares outstanding 13,954 8,623 11,400 8,554 Weighted average unvested common shares subject to repurchase (16 ) (63 ) (51 ) (49 ) Weighted average common shares outstanding—basic 13,938 8,560 11,349 8,505 Effect of dilutive securities: Conversion of preferred stock — — — — Options — — — — Warrants — — — — Weighted average common shares outstanding—diluted 13,938 8,560 11,349 8,505 Net loss per share, basic and diluted: Continuing operations $ (0.22 ) $ (1.17 ) $ (0.98 ) $ (1.91 ) Discontinued operations $ (0.01 ) $ (0.43 ) $ (0.02 ) $ (1.10 ) Net loss per share, basic and diluted $ (0.23 ) $ (1.60 ) $ (1.00 ) $ (3.01 )
Anti-dilutive securities not included in diluted net loss per share calculated on weighted average basis	The anti-dilutive securities not included in diluted net Three Months Ended September 30, Nine Months Ended September 30, 2017 2016 2017 2016 Options to purchase common stock 2,948 594 1,861 611 Unvested restricted share awards 16 63 51 49 Series A Convertible Preferred Stock 4,848 — 4,135 — Warrants to purchase common stock - 8 1,013 8 Total 7,812 665 7,060 668

Stock Benefit Plans, Stock-Base

Stock Benefit Plans, Stock-Based Compensation and Equity Transactions (Tables)	9 Months Ended
	Sep. 30, 2017
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Summary of Stock Option Activity	A summary of the Company’s stock option activity under the Plans and related information is as follows (in thousands, except as indicated and per share data), as adjusted for the 1-for-12 reverse stock split: Shares Weighted average exercise price Weighted average remaining contractual term (in years) Aggregate intrinsic value Outstanding at December 31, 2016 1,155 $ 12.17 7.75 $ — Granted 2,686 $ 1.91 Forfeited (383 ) $ 12.18 Outstanding at September 30, 2017 3,458 $ 4.20 8.94 $ 1,276 Options vested and exercisable at September 30, 2017 421 $ 17.91 4.20 $ 10 Options vested and expected to vest at September 30, 2017 3,096 $ 4.44 8.86 $ 1,113
Summary of Information about Restricted Stock Awards, Restricted Stock Units and Performance-Based Restricted Units Activity (Detail)	The following table summarizes information about the restricted stock awards, restricted stock units and performance-based restricted units activity (in thousands, except as indicated and per share data), as adjusted for the 1-for-12 reverse stock split: Shares Weighted average grant date fair value Weighted average remaining recognition period (in years) Unvested at December 31, 2016 1,092 $ 7.48 3.02 Awarded 357 $ 2.15 Vested (81 ) $ 4.49 Forfeited (238 ) $ 2.30 Unvested at September 30, 2017 1,130 $ 4.50 2.78
Summary of Common Stock Reserved for Future Issuance	As of September 30, 2017, the Company had reserved shares of its common stock for future issuance as follows: Shares Reserved Stock options outstanding 3,458 Unvested restricted stock award 1,130 Employee stock purchase plan 451 Available for future grants under the Inducement Plan 440 Series A convertible preferred stock 3,686 Warrants to purchase common stock 9,904 Total shares reserved 19,069

Restructuring (Tables)

Restructuring (Tables)	9 Months Ended
	Sep. 30, 2017
Restructuring And Related Activities [Abstract]
Rollforward of accrued restructuring liability	A rollforward of the accrued restructuring liability is presented below (in thousands): Balance as of January 1, 2017 $ 1,328 Accrued restructuring charges 1,231 Payments (940 ) Balance as of March 31, 2017 1,619 Accrued restructuring charges 528 Payments (1,115 ) Balance as of June 30, 2017 $ 1,032 Accrued restructuring charges 139 Payments (701) Balance as of September 30, 2017 $ 470

The Company and Basis of Pres29

The Company and Basis of Presentation - Additional Information (Details) $ in Thousands	Aug. 24, 2016	Sep. 30, 2017USD ($)segment	Dec. 31, 2016USD ($)
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Number of reportable segments | segment		1
Reverse stock split ratio	0.0833	0.0833
Working capital		$ 32,000
Cash		$ 15,437	$ 19,593

Select Condensed Consolidated30

Select Condensed Consolidated Balance Sheet Details - Accounts Receivable, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Balance Sheet Related Disclosures [Abstract]
Accounts receivable	$ 13,819	$ 19,870
Allowance for doubtful accounts	(516)	(1,358)
Accounts receivable, net	$ 13,303	$ 18,512

Select Condensed Consolidated31

Select Condensed Consolidated Balance Sheet Details - Inventories, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016
Balance Sheet Related Disclosures [Abstract]
Raw materials	$ 5,454	$ 7,301
Work-in-process	926	823
Finished goods	38,910	38,469
Inventory, gross, total	45,290	46,593
Less reserve for excess and obsolete finished goods	(15,543)	(16,500)
Inventories, net	$ 29,747	$ 30,093

Select Condensed Consolidated32

Select Condensed Consolidated Balance Sheet Details - Property and Equipment, Net (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 66,491		$ 66,491		$ 68,648
Less accumulated depreciation and amortization	(53,216)		(53,216)		(53,572)
Property and equipment, net	13,275		13,275		15,076
Depreciation	1,600	$ 1,600	$ 4,800	$ 5,600
Surgical instruments
Property, Plant and Equipment [Line Items]
Useful lives			4 years
Property and equipment, gross	53,116		$ 53,116		53,095
Machinery and equipment
Property, Plant and Equipment [Line Items]
Useful lives			7 years
Property and equipment, gross	5,492		$ 5,492		5,435
Capital leased assets, gross	2,100		$ 2,100		2,100
Computer equipment
Property, Plant and Equipment [Line Items]
Useful lives			3 years
Property and equipment, gross	3,512		$ 3,512		3,511
Office furniture and equipment
Property, Plant and Equipment [Line Items]
Useful lives			5 years
Property and equipment, gross	2,707		$ 2,707		2,695
Leasehold improvements
Property, Plant and Equipment [Line Items]
Various useful lives of leasehold improvements			various
Property and equipment, gross	$ 1,664		$ 1,664		3,467
Construction in progress
Property, Plant and Equipment [Line Items]
Property and equipment, gross					$ 445

Select Condensed Consolidated33

Select Condensed Consolidated Balance Sheet Details - Intangible Assets, Net (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2016
Finite-Lived Intangible Assets [Line Items]
Intangible assets, Gross	$ 32,835		$ 32,835		$ 32,362
Less accumulated amortization	(27,353)		(27,353)		(26,651)
Intangible assets, net	5,482		5,482		5,711
Amortization of intangible assets	200	$ 300	700	$ 900
Developed product technology
Finite-Lived Intangible Assets [Line Items]
Intangible assets, Gross	13,876		13,876		13,876
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			2 years
Intangible assets, Gross	5,738		$ 5,738		5,265
Trademarks and trade names
Finite-Lived Intangible Assets [Line Items]
Intangible assets, Gross	732		$ 732		732
Customer-related
Finite-Lived Intangible Assets [Line Items]
Useful lives			8 years
Intangible assets, Gross	7,458		$ 7,458		7,458
Distribution network
Finite-Lived Intangible Assets [Line Items]
Useful lives			8 years
Intangible assets, Gross	$ 4,027		$ 4,027		$ 4,027

Select Condensed Consolidated34

Select Condensed Consolidated Balance Sheet Details - Schedule of Intangible Assets, Future Amortization Expense (Details) $ in Thousands	Sep. 30, 2017USD ($)
Balance Sheet Related Disclosures [Abstract]
Remainder of 2017	$ 234
2,018	801
2,019	757
2,020	756
2,021	756
Thereafter	2,178
Total	$ 5,482

Select Condensed Consolidated35

Select Condensed Consolidated Balance Sheet Details - Accrued Expenses (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016
Balance Sheet Related Disclosures [Abstract]
Commissions and sales milestones	$ 4,378			$ 4,202
Payroll and payroll related	2,322			2,384
Litigation settlements	4,400			4,400
Globus related accruals				3,830
Accrued professional fees	1,605			3,093
Royalties	1,131			1,347
Restructuring and severance accruals	470	$ 1,032	$ 1,619	1,328
Accrued taxes	237			404
Guaranteed collaboration compensation, current	4,529			2,228
Accrued interest	361			387
Other	3,173			3,986
Total accrued expenses	$ 22,606			$ 27,589

Discontinued Operations - Addit

Discontinued Operations - Additional Information (Details)	Sep. 01, 2016USD ($)option	Nov. 30, 2016USD ($)	Sep. 30, 2017USD ($)	Sep. 30, 2016USD ($)	Sep. 30, 2017USD ($)	Sep. 30, 2016USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Repayments of lines of credit					$ 74,056,000	$ 110,840,000
Preliminary purchase price adjustments		$ 104,000
Revenues			$ 23,099,000	$ 26,711,000	75,456,000	93,158,000
Cost of revenues			8,587,000	10,849,000	28,417,000	31,651,000
Supply agreement [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Contracts revenue			2,300,000		9,100,000
Cost of contract revenues			$ 2,000,000		$ 7,800,000
International
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenues				1,400,000		8,900,000
Cost of revenues				1,800,000		8,900,000
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	$ 66,000,000
Globus facility agreement
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Maximum borrowing capacity	$ 30,000,000
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
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	$ 80,000,000
Supply commitment term	3 years
Supply agreement, number of annual options to extend | option	2
Supply obligation credit	$ 1,927,000
Supply obligation credit term	6 months
Interest expense, debt excluding amortization				2,144,000		7,194,000
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		$ 7,200,000

Discontinued Operations - Sched

Discontinued Operations - Schedule of Gain on Sale of Business (Details) - USD ($)	Sep. 01, 2016	Sep. 30, 2016	Dec. 31, 2016
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Net cash proceeds		$ 69,894,000
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	$ 80,000,000
Cash included in assets sold	(4,250,000)		$ (159,000)
Transaction costs	(5,960,000)
Net cash proceeds	69,790,000
Product supply obligation	(1,927,000)
Working capital adjustment	(2,295,000)
Carrying value of business and assets sold	(57,633,000)
Net gain on sale of business	$ 7,935,000

Discontinued Operations - Resul

Discontinued Operations - Results from Discontinued Operations (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Other income (expense):
Loss from discontinued operations, net of applicable taxes	$ (61)	$ (3,658)	$ (220)	$ (9,351)
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		40,146
Cost of revenues		11,469		19,694
Amortization of acquired intangible assets		555		1,291
Gross profit		6,019		19,161
Operating expenses:
Research and development		16		50
Sales and marketing		2,865		12,391
General and administrative	16	1,440	157	5,079
Amortization of acquired intangible assets		155		622
Restructuring expenses		4		620
Net gain on sale of business		(5,361)		(5,361)
Total operating expenses	16	(881)	157	13,401
Operating loss	(16)	6,900	(157)	5,760
Other income (expense):
Interest expense, net		(2,144)		(7,194)
Other income, net		243		1,892
Total other income (expense)		(1,901)		(5,302)
Loss from discontinued operations before taxes	(16)	4,999	(157)	458
Income tax provision	45	8,657	63	9,809
Loss from discontinued operations, net of applicable taxes	$ (61)	$ (3,658)	$ (220)	$ (9,351)

Discontinued Operations - Sch39

Discontinued Operations - Schedule of Assets and Liabilities Discontinued Operations (Details) - USD ($) $ in Thousands	Sep. 30, 2017	Dec. 31, 2016	Sep. 01, 2016
Current assets:
Total current assets of discontinued operations	$ 236	$ 364
Current liabilities:
Accrued expenses		3,830
Total current liabilities of discontinued operations	283	732
International operations | Discontinued operations, disposed of by sale
Current assets:
Cash		159	$ 4,250
Inventories, net		48
Prepaid expenses and other current assets	236	157
Total current assets of discontinued operations	236	364
Non-current assets:
Other assets	52	61
Total assets of discontinued operations	288	425
Current liabilities:
Accounts payable		43
Accrued expenses	283	689
Total current liabilities of discontinued operations	283	732
Total liabilities of discontinued operations	$ 283	$ 732

Discontinued Operations - Sch40

Discontinued Operations - Schedule of Non-Cash Adjustments from Discontinued Operations (Details) - International operations - Discontinued operations, disposed of by sale - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2016
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Depreciation and amortization	$ 1,024	$ 3,836
Provision for excess and obsolete inventory	15	151
Capital expenditures	$ 211	1,319
Interest expense related to amortization of debt discount and debt issuance costs		$ 2,052

Debt - MidCap Facility Agreemen

Debt - MidCap Facility Agreement (Details) - Amended credit facility with MidCap - USD ($)	8 Months Ended	9 Months Ended	12 Months Ended
	Aug. 31, 2018	Sep. 30, 2017	Dec. 31, 2017
Line of Credit Facility [Line Items]
Line of credit facility periodic payments maturity period		2018-08
Unamortized debt discount		$ 1,400,000
Line of credit | Maximum
Line of Credit Facility [Line Items]
Debt default, interest rate increase		5.00%
Forecast
Line of Credit Facility [Line Items]
Monthly term loan payments	$ 300,000		$ 200,000
Revolving credit facility
Line of Credit Facility [Line Items]
Maximum borrowing capacity		$ 22,500,000
Line of credit		$ 9,200,000
Interest rate		7.24%
Revolving credit facility | LIBOR
Line of Credit Facility [Line Items]
Interest rate description		LIBOR plus 6.0%
Basis spread		6.00%
Term loan
Line of Credit Facility [Line Items]
Maximum borrowing capacity		$ 5,000,000
Line of credit		$ 2,900,000
Floor on interest rate		9.50%
Interest rate		9.50%
Term loan | LIBOR
Line of Credit Facility [Line Items]
Interest rate description		("LIBOR") plus 8.0%
Basis spread		8.00%

Debt - Globus Facility Agreemen

Debt - Globus Facility Agreement (Details) - USD ($)	Sep. 02, 2018	Sep. 01, 2016	Dec. 31, 2016	Sep. 30, 2017	Sep. 30, 2016
Debt Instrument [Line Items]
Borrowings under lines of credit				$ 70,547,000	$ 94,241,000
Globus facility agreement
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 30,000,000
Unamortized debt discount				900,000
Line of credit | Globus facility agreement
Debt Instrument [Line Items]
Borrowings under lines of credit		$ 25,000,000	$ 5,000,000
Line of credit				30,000,000
Debt instrument, periodic payment				$ 800,000
Line of credit | Globus facility agreement | Maximum
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 | LIBOR | Globus facility agreement | Forecast
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 (Detail) $ in Thousands	Sep. 30, 2017USD ($)
Debt Disclosure [Abstract]
Remainder of 2017	$ 600
2,018	4,130
2,019	12,658
2,020	3,380
2021 and thereafter	21,666
Total	42,434
Add: capital lease principal payments	127
Less: unamortized debt discount and debt issuance costs	(2,296)
Total	40,265
Less: current portion of long-term debt	(3,037)
Long-term debt, net of current portion	$ 37,228

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) - USD ($) $ in Millions	1 Months Ended	3 Months Ended		9 Months Ended
	Jun. 30, 2017	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Loss Contingencies [Line Items]
Rent expense		$ 0.3	$ 1	$ 0.9	$ 2
Proceeds from landlord for tenant improvements	$ 0.5
Minimum
Loss Contingencies [Line Items]
Lease interest rate				7.60%
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, 2017USD ($)
Commitments And Contingencies Disclosure [Abstract]
Operating leases Remainder of 2017	$ 452
Operating leases 2018	1,656
Operating leases 2019	1,542
Operating leases 2020	1,584
Operating leases 2021 and thereafter	971
Total Operating leases	6,205
Capital leases Remainder of 2017	64
Capital leases 2018	68
Total Capital leases	132
Less: amount representing interest	(5)
Present value of minimum lease payments	127
Current portion of capital leases	$ (127)

Orthotec Settlement - Additiona

Orthotec Settlement - Additional Information (Details) - Orthotec LLC, litigation settlement $ in Thousands	Oct. 01, 2014USD ($)	Aug. 13, 2014USD ($)installment	Apr. 30, 2014USD ($)	Mar. 31, 2014USD ($)	Sep. 30, 2017USD ($)
Loss Contingencies [Line Items]
Judgment assessed by court for (against) company		$ (49,000)
Payments of settlement			$ 15,750	$ 1,750	$ 30,700
Number of quarterly installments | installment		28
Litigation settlement interest, quarterly installments, amount		$ 1,100
Litigation settlement, final installment amount		700
Litigation settlement, remaining outstanding balance including interest					$ 27,100
Beginning fourth quarter of 2014
Loss Contingencies [Line Items]
Settlement amount, remaining balance	$ 31,500
Litigation settlement interest, quarterly installments, amount		$ 1,100
Litigation settlement interest rate		7.00%
Litigation settlement payments, quarterly payment amount		$ 1,100
Final installment
Loss Contingencies [Line Items]
Number of quarterly installments | installment		1

Sale of Assets - Additional Inf

Sale of Assets - Additional Information (Details) - USD ($) $ in Thousands	May 05, 2017	Sep. 30, 2017
Sale Of Assets [Line Items]
Net gain on sale of assets		$ 856
Inventory and intellactual property | Third Party
Sale Of Assets [Line Items]
Agreement to sell assets, consideration payable in credit to future minimum royalties owed	$ 1,000
Net gain on sale of assets	$ 900

Net Loss Per Share - Computatio

Net Loss Per Share - Computation of Basic and Diluted Net Loss Per Share for Continuing and Discontinued Operations (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Numerator:
Loss from continuing operations	$ (3,076)	$ (10,063)	$ (11,129)	$ (16,220)
Loss from discontinued operations	(61)	(3,658)	(220)	(9,351)
Net loss	$ (3,137)	$ (13,721)	$ (11,349)	$ (25,571)
Denominator:
Weighted average common shares outstanding	13,954	8,623	11,400	8,554
Weighted average unvested common shares subject to repurchase	(16)	(63)	(51)	(49)
Weighted average common shares outstanding—basic	13,938	8,560	11,349	8,505
Effect of dilutive securities:
Effect of dilutive securities: conversion of preferred stock	0	0	0	0
Effect of dilutive securities: options	0	0	0	0
Effect of dilutive securities: warrants	0	0	0	0
Weighted average common shares outstanding—diluted	13,938	8,560	11,349	8,505
Net loss per share, basic and diluted:
Continuing operations, net loss per share, basic and diluted (in dollars per share)	$ (0.22)	$ (1.17)	$ (0.98)	$ (1.91)
Discontinued operations, net loss per share, basic and diluted	(0.01)	(0.43)	(0.02)	(1.10)
Net loss per basic and diluted share (in dollars per share)	$ (0.23)	$ (1.60)	$ (1)	$ (3.01)

Net Loss Per Share - Anti-Dilut

Net Loss Per Share - Anti-Dilutive Securities Not Included in Diluted Net Loss Per Share Calculated on Weighted Average Basis (Details) - shares shares in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive securities not included in diluted net loss per share (in shares)	7,812	665	7,060	668
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)	2,948	594	1,861	611
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)	16	63	51	49
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	1,013	8
Series A convertible preferred 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)	4,848		4,135

Stock Benefit Plans and Equit50

Stock Benefit Plans and Equity Transactions - Additional Information (Details)	Mar. 29, 2017USD ($)$ / sharesshares	Mar. 22, 2017USD ($)$ / sharesshares	Aug. 24, 2016	Sep. 30, 2017USD ($)$ / sharesshares	Sep. 30, 2016USD ($)	Mar. 30, 2017shares	Mar. 01, 2017$ / sharesshares	Dec. 31, 2016$ / shares	Oct. 04, 2016USD ($)shares
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Common stock reserved for future issuance				19,069
Reverse stock split ratio			0.0833	0.0833
Series A convertible preferred stock, shares issued				7,000
Exercise price of warrants (dollars per share) | $ / shares		$ 2
Warrant expiration period		5 years
Stockholder approval date				Jun. 15, 2017
Preferred stock, stated value per share | $ / shares				$ 0.0001				$ 0.0001
Wainwright Warrants
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Exercise price of warrants (dollars per share) | $ / shares							$ 2.50
Aggregate gross proceeds for private placement | $	$ 18,900,000
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Beneficial ownership limitation percentage				4.99%
Beneficial ownership, limitation option, percentage				9.99%
Beneficial ownership limitation notification period				61 days
Maximum | Certificate Of Designation
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Convertible preferred stock, percentage of shares issuable upon conversion	19.99%
Maximum | Wainwright Warrants
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Number of warrants issued (in shares)							471,600
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Percentage of outstanding voting stock acquired				50.00%
Common Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Issuance of common stock upon securities purchase agreement		1,809,628
Common stock purchase price share | $ / shares		$ 2
Common Stock | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Number of warrants issued (in shares)		9,432,000
Common Stock | Certain Directors and Executive Officers | Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Number of warrants issued (in shares)		1,175,000
Series A convertible preferred stock
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Series A convertible preferred stock, shares issued		15,245		7,797
Shares issued price per share | $ / shares		$ 1,000
Percentage of outstanding preferred stock shares	75.00%
Series A convertible preferred stock | Certificate Of Designation
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Preferred stock convertible to common stock	500,000
Preferred stock, stated value per share | $ / shares	$ 1,000
Series A convertible preferred stock | Certain Directors and Executive Officers
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Preferred stock convertible to common stock		1,175,000
Aggregate amount of convertible preferred shares purchased | $		$ 2,350,000
Series A convertible preferred stock | Common Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Preferred stock convertible to common stock		7,622,372		3,936,225
General and Administrative
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Share based compensations expenses | $				$ 1,400,000	$ 200,000
Selling and Marketing
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Share based compensations expenses | $				200,000	31,000
Research and Development Expenses
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Share based compensations expenses | $				100,000	18,000
Cost of Sales
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Share based compensations expenses | $				$ 12,000	$ 5,000
Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Common stock reserved for future issuance				3,458
Weighted-average grant-date fair value of stock options granted | $ / shares				$ 1.30
Unrecognized compensation expense for stock options and awards expected to be recognized | $				$ 3,700,000
Straight-line basis over a weighted average period				3 years 6 months
Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Common stock reserved for future issuance				1,130
Straight-line basis over a weighted average period				2 years 9 months 19 days
Unrecognized compensation expense for restricted stock and awards expected to be recognized | $				$ 2,600,000
Inducement Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Common stock reserved for future issuance						600,000			1,550,000
Maximum award to be deductible other than options | $									$ 1,000,000

Stock Benefit Plans and Equit51

Stock Benefit Plans and Equity Transactions - Summary of Stock Option Activity (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2017	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward]
Shares Outstanding, Beginning balance	1,155
Shares, Granted	2,686
Shares, Forfeited	(383)
Shares Outstanding, Ending balance	3,458	1,155
Shares, Options vested and exercisable	421
Shares, Options vested and expected to vest	3,096
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Weighted average exercise price, Outstanding, Beginning balance	$ 12.17
Weighted average exercise price, Granted	1.91
Weighted average exercise price, Forfeited	12.18
Weighted average exercise price, Outstanding, Ending balance	4.20	$ 12.17
Weighted average exercise price, Options vested and exercisable	17.91
Weighted average exercise price, Options vested and expected to vest	$ 4.44
Share-based Compensation Arrangement by Share-based Payment Award, Options, Additional Disclosures [Abstract]
Weighted average remaining contractual term, Outstanding, balance	8 years 11 months 8 days	7 years 9 months
Weighted average remaining contractual term, Options vested and exercisable	4 years 2 months 12 days
Weighted average remaining contractual term, Options vested and expected to vest	8 years 10 months 10 days
Aggregate intrinsic value, Outstanding, Beginning balance	$ 0
Aggregate intrinsic value, Outstanding, Ending balance	1,276	$ 0
Aggregate intrinsic value, Options vested and exercisable	10
Aggregate intrinsic value, Options vested and expected to vest	$ 1,113

Stock Benefit Plans and Equit52

Stock Benefit Plans and Equity Transactions - Summary of Information about Restricted Stock Awards, Restricted Stock Units and Performance-Based Restricted Units Activity (Detail) - Restricted Stock - $ / shares shares in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2017	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number of Shares [Roll Forward]
Shares, Unvested beginning balance	1,092
Shares, Awarded	357
Shares, Vested	(81)
Shares, Forfeited	(238)
Shares, Unvested ending balance	1,130	1,092
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value [Abstract]
Weighted average grant date fair value, Unvested beginning balance	$ 4.50	$ 7.48
Weighted average grant date fair value, Awarded	2.15
Weighted average grant date fair value, Vested	4.49
Weighted average grant date fair value, Forfeited	$ 2.30
Weighted average remaining recognition period, Unvested beginning balance	2 years 9 months 11 days	3 years 7 days

Stock Benefit Plans and Equit53

Stock Benefit Plans and Equity Transactions - Summary Common Stock Reserved for Future Issuance (Details)	Sep. 30, 2017shares
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Total shares reserved	19,069
Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Total shares reserved	3,458
Unvested restricted share awards
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Total shares reserved	1,130
Employee Stock Purchase Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Total shares reserved	451
Available For Future Grants Under the Inducement Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Total shares reserved	440
Series A Convertible Preferred Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Total shares reserved	3,686
Warrants to Purchase Common Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line items]
Total shares reserved	9,904

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($)	3 Months Ended	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2017	Dec. 31, 2016
Income Tax [Line Items]
Recognized tax benefit increase decrease in tax reserves	$ 35,000	$ 35,000
Unrecognized tax benefits	9,400,000	9,400,000	$ 9,300,000
Reasonably possible amount of unrecognized tax benefit that could reverse in the next twelve months	$ 2,800,000	$ 2,800,000
Effective income tax rate	0.30%	0.51%
Federal statutory income tax rate	35.00%	35.00%
Maximum
Income Tax [Line Items]
Unrecognized tax benefits increase (decrease)		$ 100,000

Related Party Transactions - Ad

Related Party Transactions - Additional Information (Details) - USD ($) $ in Thousands	Jul. 01, 2016	Aug. 13, 2014	Sep. 30, 2014	Apr. 30, 2014	Mar. 31, 2014	Sep. 30, 2017	Sep. 30, 2016
Orthotec LLC, litigation settlement
Related Party Transaction [Line Items]
Payments of settlement				$ 15,750	$ 1,750	$ 30,700
Judgment assessed by court for (against) company		$ (49,000)
Orthotec LLC, litigation settlement | HealthpointCapital, LLC
Related Party Transaction [Line Items]
Payments of settlement	$ 1,000					1,100
Judgment assessed by court for (against) company			$ (5,000)
HealthpointCapital, LLC
Related Party Transaction [Line Items]
Incurred expenses (less than $.1 million)						100	$ 100
Payable liability (less than $.1 million)						$ 100

Restructuring (Details)

Restructuring (Details) - USD ($) $ in Thousands	3 Months Ended				9 Months Ended
	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Restructuring Cost and Reserve [Line Items]
Restructuring expenses	$ 139	$ 528	$ 1,231	$ 1,605	$ 1,898	$ 1,778
2015 California manufacturing operations restructuring plan
Restructuring Cost and Reserve [Line Items]
Restructuring expenses				$ 1,600		$ 1,800
Employee severance | Severance liability and post employment benefits in connection with Globus transaction
Restructuring Cost and Reserve [Line Items]
Restructuring expenses	$ 100				$ 1,900

Restructuring - Rollforward of

Restructuring - Rollforward of accrued restructuring liability (Details) - USD ($) $ in Thousands	3 Months Ended				9 Months Ended
	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Sep. 30, 2016	Sep. 30, 2017	Sep. 30, 2016
Restructuring And Related Activities [Abstract]
Beginning balance	$ 1,032	$ 1,619	$ 1,328		$ 1,328
Accrued restructuring charges	139	528	1,231	$ 1,605	1,898	$ 1,778
Payments	(701)	(1,115)	(940)
Ending balance	$ 470	$ 1,032	$ 1,619		$ 470

Subsequent events - Additional

Subsequent events - Additional Information (Details) - USD ($) $ / shares in Units, $ in Millions	Oct. 02, 2017	Mar. 22, 2017	Oct. 31, 2017
Common Stock
Subsequent Event [Line Items]
Issuance of common stock upon securities purchase agreement		1,809,628
Common stock purchase price share		$ 2
Maximum | Common Stock
Subsequent Event [Line Items]
Number of warrants issued (in shares)		9,432,000
Subsequent Event | Common Stock | Securities Purchase Agreements
Subsequent Event [Line Items]
Proceeds from exercise of warrant			$ 1.7
Number of warrants issued (in shares)			900,000
Subsequent Event | Common Stock | Securities Purchase Agreements | Patrick Miles and Quentin Blackford
Subsequent Event [Line Items]
Common stock purchase price share	$ 2.26
Subsequent Event | Minimum | Securities Purchase Agreements | Patrick Miles and Quentin Blackford
Subsequent Event [Line Items]
Proceeds from issuance of common stock	$ 3.5
Subsequent Event | Minimum | Common Stock | Securities Purchase Agreements | Patrick Miles and Quentin Blackford
Subsequent Event [Line Items]
Issuance of common stock upon securities purchase agreement	1,549,116
Subsequent Event | Maximum | Securities Purchase Agreements | Patrick Miles and Quentin Blackford
Subsequent Event [Line Items]
Proceeds from issuance of common stock	$ 4
Subsequent Event | Maximum | Common Stock | Securities Purchase Agreements | Patrick Miles and Quentin Blackford
Subsequent Event [Line Items]
Issuance of common stock upon securities purchase agreement	1,769,912