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Condensed Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Cash flows from operating activities    
Net loss $ (96,851) $ (129,221)
Adjustments to reconcile net loss to net cash from operating activities    
Depreciation and amortization 44,067 39,094
Inventory reserve expenses 19,347 24,013
Amortization of inventory fair value step-up 9,141 29,006
Amortization of operating lease assets, debt costs, and other assets 4,601 4,506
Provision for expected credit losses 2,059 905
Deferred income taxes 1,505 1,148
Share-based compensation expense 25,290 32,540
Gain/loss on disposal of fixed assets and instrumentation 2,853 2,092
Change in valuation of investment securities 7,121 (82)
Change in fair value of contingent consideration 6,210 (2,100)
Other 3,288 (1,419)
Changes in operating assets and liabilities, net of effects of acquisitions    
Accounts receivable 1,301 2,912
Inventories (9,820) (48,164)
Prepaid expenses and other current assets 1,410 925
Accounts payable (11,374) 4,244
Other current liabilities (2,870) (20)
Other long-term assets and liabilities (5,218) 562
Net cash provided by (used in) operating activities 2,060 (39,059)
Cash flows from investing activities    
Capital expenditures for property, plant, and equipment (25,209) (45,695)
Capital expenditures for intangible assets (1,136) (1,302)
Cash acquired in the SeaSpine merger   29,419
Other investing activities (100) (500)
Net cash (used in) investing activities (26,445) (18,078)
Cash flows from financing activities    
Proceeds from issuance of common shares 3,311 2,377
Payments related to tax withholdings for share-based compensation (4,947) (3,334)
Payments related to finance lease obligation (525) (483)
Borrowings under credit facility 40,000 70,000
Repayment of borrowings from credit facility (15,000)  
Payment of debt acquired from SeaSpine merger   (26,899)
Contingent consideration milestone payment (1,000) (920)
Payment of debt issuance costs and other financing activities (2,617) (699)
Net cash provided by financing activities 19,222 40,042
Effect of exchange rate changes on cash (40) 58
Net change in cash and cash equivalents (5,203) (17,037)
Cash, cash equivalents, and restricted cash at the beginning of period 37,757 50,700
Cash, cash equivalents, and restricted cash at the end of period 32,554 33,663
Components of cash, cash equivalents, and restricted cash at the end of period    
Cash and cash equivalents 30,054 33,663
Restricted cash 2,500  
Cash, cash equivalents, and restricted cash at the end of period $ 32,554 $ 33,663