Medical device maker NuVasive Inc (NUVA.O) estimated third-quarter revenue below its earlier forecast, sending shares down about 20 percent after the bell.
The company said "an unusually high" number of customers turned to competitors and it also faced pressure since many surgeon customers complained of increased delays and denials from insurance payers.
"(The spine surgery market) is pretty competitive and NuVasive has always relied on taking away market share away from Medtronic Inc," Northland Securities analyst Suraj Kalia said.
NuVasive competes with Medtronic Inc (MDT.N), Johnson & Johnson (JNJ.N) and Globus Medical Inc (GMED.N) in the market for implants and instruments used in spine surgeries.
Device makers that focus on the spine and hip replacement market have been hurt as patients postpone procedures in a weak economy.
"At the core (of the spine surgery market) there is very little product differentiation and products are severely overpriced," said analyst Kalia.
The company said it would update its 2012 forecast to reflect the impact of the delay in orders and loss of customers. NuVasive had forecast 2012 adjusted profit of about 97 cents per share, on revenue of about $625 million.
The company expects third-quarter revenue of about $147 million. It had earlier forecast revenue of about $155 million.
Analysts on average were expecting revenue of $153.6 million, according to Thomson Reuters I/B/E/S.
The company is expected to report third-quarter earnings on October 29.
Shares of the company, which have gained about 83 percent so far this year, fell 20 percent after the bell. They closed at $22.62 on the Nasdaq on Wednesday.
(Reporting By Vrinda Manocha and Vidya L Nathan in Bangalore; Editing by Supriya Kurane)