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Acquisitions - Additional Information (Detail) - USD ($) shares in Millions			3 Months Ended
	Jan. 31, 2019	Apr. 30, 2018	Mar. 31, 2019	Mar. 31, 2018	Feb. 06, 2019	Dec. 31, 2018
Business Acquisition [Line Items]
Goodwill			$ 71,177,000			$ 72,401,000
Consideration for the asssets acquired	$ 6,400,000
Options Medical Founder [Member]
Business Acquisition [Line Items]
Share based compensation, grant of restricted stock units	25,478
Share based compensation, grant fair value of restricted stock units	$ 1,400,000
Share based compensation, vesting rights of RSUs	33.33%
Spinal Kinetics [Member]
Business Acquisition [Line Items]
Business acquisition date		Apr. 30, 2018
Business acquisition conversion of shares into net cash subject to adjustments		$ 45,000,000.0
Fair value of the consideration transferred		76,600,000
Goodwill		17,612,000
Acquisition related costs			0	$ 1,500,000
Revenue from acquisition			3,100,000
Net loss from Acquisition			$ 4,000,000.0
Spinal Kinetics [Member] | Global Spine [Member]
Business Acquisition [Line Items]
Goodwill					$ 17,600,000
Spinal Kinetics [Member] | Maximum [Member]
Business Acquisition [Line Items]
Future milestone payments		$ 60,000,000.0

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