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License and Consulting Agreements - Additional Information (Detail) - USD ($)
$ in Thousands
 1 Months Ended 3 Months Ended 12 Months Ended
Dec. 12, 2013
Dec. 15, 2010
Sep. 30, 2015
Aug. 31, 2014
Oct. 31, 2013
Nov. 30, 2012
Nov. 30, 2010
Sep. 30, 2010
Jan. 31, 2010
Jun. 30, 2009
Feb. 28, 2009
Dec. 31, 2007
Sep. 30, 2014
Dec. 31, 2010
Sep. 30, 2010
Dec. 31, 2015
Dec. 31, 2014
Dec. 31, 2013
Research and Development Arrangement, Contract to Perform for Others [Line Items]                                    
Royalty rate       7.00%                            
Royalty rate, amended       8.50%                            
Royalty obligation per year       $ 200                            
Royalty accrual reversal                         $ 1,700          
Intangible assets                               $ 74,716 $ 78,001  
Amortization of acquired intangible assets                               6,100 6,200 $ 11,600
Provision for excess and obsolete inventory                               2,156 3,539 11,652
Payments to acquire asset agreement                               0 0 750
In-process research and development                               98 102 0
Issuance of common stock for acquired technology (less than $1.0 million)                               0 102  
OsseoScrew License Agreement [Member]                                    
Research and Development Arrangement, Contract to Perform for Others [Line Items]                                    
Milestone payments             $ 1,500         $ 3,600            
Additional milestone payments $ 300                     $ 2,500            
Stock issued for asset agreement             $ 1,000             $ 1,000        
Intangible assets                           2,500        
Cash payment                           $ 1,500        
Intangible assets, amortization period                           7 years        
Number of shares of Common stock   452,488                                
Reversal of accrual for milestone payments                                   600
License Agreement with Helix Point, LLC [Member]                                    
Research and Development Arrangement, Contract to Perform for Others [Line Items]                                    
Stock issued for asset agreement                     $ 400              
Intangible assets               $ 200             $ 200      
Cash payment                     $ 200              
Distribution Agreement with Parcell Spine, LLC [Member]                                    
Research and Development Arrangement, Contract to Perform for Others [Line Items]                                    
Additional milestone payments                 $ 1,000                  
Stock issued for asset agreement                 1,000                  
Cash payment                 $ 500           $ 500      
Intangible assets, amortization period                             7 years      
Amortization of acquired intangible assets                                   900
Provision for excess and obsolete inventory                                   $ 2,600
Distribution Agreement with Parcell Spine, LLC [Member] | Research and Development Arrangement [Member]                                    
Research and Development Arrangement, Contract to Perform for Others [Line Items]                                    
Stock issued for asset agreement                             $ 1,000      
Distribution Agreement with Parcell Spine, LLC [Member] | Development Milestone Payments [Member]                                    
Research and Development Arrangement, Contract to Perform for Others [Line Items]                                    
Addition in intangible assets                             1,500      
License Agreement with R Tree Innovations LLC [Member]                                    
Research and Development Arrangement, Contract to Perform for Others [Line Items]                                    
Stock issued for asset agreement         $ 200 $ 200   500                    
Intangible assets         500 500   1,300             $ 1,300      
Cash payment         $ 300 $ 300   $ 800                    
Intangible assets, amortization period           7 years                        
Number of shares of Common stock           367,044                        
Asset Purchase Agreement [Member]                                    
Research and Development Arrangement, Contract to Perform for Others [Line Items]                                    
Stock issued for asset agreement                                 $ 100  
Stock issued for asset agreement, shares                                 72,992  
Payments to acquire asset agreement     $ 200                           $ 200  
In-process research and development                               $ 300 $ 300  
Issuance of common stock for acquired technology, shares     72,992                              
Issuance of common stock for acquired technology (less than $1.0 million)     $ 100                              
License Agreements [Member]                                    
Research and Development Arrangement, Contract to Perform for Others [Line Items]                                    
Stock issued for asset agreement, shares                   260,000