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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2015
Sep. 30, 2014
OPERATING ACTIVITIES:    
Net (loss) income $ (18,499) $ 16,838
Adjustments to reconcile net income to net cash provided by (used in) operating activities:    
Loss (income) from discontinued operations, net of tax 10,370 (948)
Depreciation and amortization 40,596 34,042
Non-cash impairment charges 0 600
Deferred income tax 32,578 (89)
Amortization of debt issuance costs 1,645 2,060
Non-cash interest expense 5,874 5,256
Payment of accreted interest (384) 0
Loss on disposal of property and equipment 124 505
Change in fair value of contingent consideration 359 (878)
Share-based compensation 11,788 11,234
Excess tax benefits from stock-based compensation arrangements (3,678) (1,207)
Changes in assets and liabilities, net of business acquisitions:    
Accounts receivable (9,206) (12,409)
Inventories (8,005) (23,791)
Prepaid expenses and other current assets 7,423 11,566
Other non-current assets 1,224 (2,203)
Accounts payable, accrued expenses and other current liabilities 9,348 4,528
Deferred revenue (185) 1,069
Other non-current liabilities (72) (5,229)
Net cash provided by operating activities of continuing operations 81,300 40,944
Net cash (used in) provided by operating activities of discontinued operations (12,209) 17,762
Net cash provided by operating activities 69,091 58,706
INVESTING ACTIVITIES:    
Purchases of property and equipment (20,314) (27,108)
Sale of property and equipment 1,438 0
Cash used in business acquisition, net of cash acquired (308,256) (235,000)
Net cash used in investing activities of continuing operations (327,132) (262,108)
Net cash used in investing activities of discontinued operations (7,060) (2,358)
Net cash used in investing activities (334,192) (264,466)
FINANCING ACTIVITIES:    
Borrowings under senior credit facility 545,000 385,000
Repayments under senior credit facility (448,750) (160,000)
Repayment of 2016 convertible notes (2,519) 0
Distribution to SeaSpine (47,013) 0
Payment of debt issuance costs (1,050) (3,110)
Proceeds from the issuance of common stock, net of issuance costs 219,888 0
Principal payments under capital lease obligations (553) (370)
Proceeds from exercised stock options 7,345 8,317
Excess tax benefits from stock-based compensation arrangements 3,677 1,207
Net cash provided by financing activities 276,025 231,044
Effect of exchange rate changes on cash and cash equivalents (3,347) (5,667)
Net increase in cash and cash equivalents 7,577 19,617
Cash and cash equivalents at beginning of period 71,734 120,614
Cash and cash equivalents at end of period $ 79,311 $ 140,231