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Income Taxes - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | 12 Months Ended
--- | --- | ---
Mar. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2019 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Components Of Income Tax Expense Benefit [Line Items] |  |  |  |  |  |
Corporate income tax rate |  |  |  | 21.00% | 35.00% | 35.00%
Additional income tax expense benefit |  | $ 8,300 |  |  |  |
Tax cuts and jobs act of 2017 change in tax rate deferred tax assets and liability expected to reserve in future |  |  |  |  | $ 8,600 |
Change of intention for foreign earnings |  |  |  |  | 0 | $ 1,300
Tax cuts and jobs act of 2017 change in provisional income tax benefit |  |  |  |  | 300 |
Impact of the Tax Act | $ (600) |  |  | $ (560) | 8,347 |
Cash paid related to taxes |  |  |  | 15,600 | 3,300 | 4,400
Change in estimate, increase in net income |  |  |  |  |  | $ 2,400
Change in estimate, increase in earnings per share |  |  |  |  |  | $ 0.13
Net increase in valuation allowance |  |  |  | 2,700 |  |
Unremitted foreign earnings |  | 335,700 |  | $ 50,400 | 335,700 |
Minimum percentage of income tax benefit |  |  |  | 50.00% |  |
Gross unrecognized tax benefit |  | 22,500 |  | $ 21,400 | 22,500 |
Net interest and penalties on unrecognized tax benefits |  |  |  | 1,400 | 2,300 | $ 2,100
Accrued interest and penalties related to unrecognized tax benefits |  | $ 5,300 |  | 6,700 | 5,300 |
Income taxes |  |  |  | 9,074 | $ 29,100 | $ 15,527
Scenario, Forecast [Member] |  |  |  |  |  |
Components Of Income Tax Expense Benefit [Line Items] |  |  |  |  |  |
Income taxes |  |  | $ (2,000) |  |  |
Minimum [Member] |  |  |  |  |  |
Components Of Income Tax Expense Benefit [Line Items] |  |  |  |  |  |
Decrease in unrecognized tax benefits |  |  |  | 3,300 |  |
Maximum [Member] |  |  |  |  |  |
Components Of Income Tax Expense Benefit [Line Items] |  |  |  |  |  |
Decrease in unrecognized tax benefits |  |  |  | 3,800 |  |
State [Member] |  |  |  |  |  |
Components Of Income Tax Expense Benefit [Line Items] |  |  |  |  |  |
Operating loss carry forwards, net of tax |  |  |  | 49,000 |  |
State [Member] | Spinal Kinetics [Member] |  |  |  |  |  |
Components Of Income Tax Expense Benefit [Line Items] |  |  |  |  |  |
Operating loss carry forwards, net of tax |  |  |  | 35,200 |  |
Foreign Jurisdictions [Member] |  |  |  |  |  |
Components Of Income Tax Expense Benefit [Line Items] |  |  |  |  |  |
Operating loss carry forwards, net of tax |  |  |  | 159,500 |  |
Federal [Member] |  |  |  |  |  |
Components Of Income Tax Expense Benefit [Line Items] |  |  |  |  |  |
Operating loss carry forwards, net of tax |  |  |  | 24,400 |  |
Research and development credits |  |  |  | $ 1,600 |  |

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