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Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019
Components Of Income Tax Expense Benefit [Line Items] |  |  |
Cash paid related to taxes | $ 4,800 | $ 500 | $ 8,100
Net increase in valuation allowance | 26,200 |  |
Unremitted foreign earnings | $ 50,000 | 53,700 |
Minimum percentage of income tax benefit | 50.00% |  |
Gross unrecognized tax benefit | $ 3,500 | 4,600 |
Net interest and penalties on unrecognized tax benefits | (400) | (5,400) | (100)
Accrued interest and penalties related to unrecognized tax benefits | 800 | 1,200 |
Income taxes | 24,884 | $ (2,885) | 1,413
Internal Revenue Service [Member] |  |  |
Components Of Income Tax Expense Benefit [Line Items] |  |  |
Income taxes |  |  | $ (1,800)
Minimum [Member] |  |  |
Components Of Income Tax Expense Benefit [Line Items] |  |  |
Decrease in unrecognized tax benefits, exclusive of interest and penalties | 400 |  |
Maximum [Member] |  |  |
Components Of Income Tax Expense Benefit [Line Items] |  |  |
Decrease in unrecognized tax benefits, exclusive of interest and penalties | 1,100 |  |
State [Member] |  |  |
Components Of Income Tax Expense Benefit [Line Items] |  |  |
Operating loss carry forwards, net of tax | $ 32,300 |  |
Operating loss carryforwards, expiration year | 2027 |  |
State [Member] | Spinal Kinetics [Member] |  |  |
Components Of Income Tax Expense Benefit [Line Items] |  |  |
Operating loss carry forwards, net of tax | $ 20,900 |  |
Federal [Member] |  |  |
Components Of Income Tax Expense Benefit [Line Items] |  |  |
Operating loss carry forwards, net of tax | $ 17,500 |  |
Operating loss carryforwards, expiration year | 2026 |  |
Research and development credits | $ 2,200 |  |
Foreign Tax Authority |  |  |
Components Of Income Tax Expense Benefit [Line Items] |  |  |
Operating loss carry forwards, net of tax | $ 125,000 |  |
Operating loss carryforwards, expiration year | 2022 |  |

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