NuVasive, Inc. NUVA delivered third-quarter 2021 adjusted earnings per share (EPS) of 32 cents, registering a 41.8% decline from the year-ago adjusted EPS of 55 cents. The figure also lagged the Zacks Consensus Estimate by 40.7%.The one-time adjustments include expenses associated with certain business transition costs and amortization expenses, among others.GAAP loss per share of 42 cents also shows a huge decline from the year-ago EPS of 11 cents.Total RevenuesRevenues in the third quarter totaled $270.8 million, down 8.3% year over year on a reported basis as well as at constant exchange rate or CER. The top line missed the Zacks Consensus Estimate by 7.03%.The year-over-year decline in revenues was driven by COVID-related headwinds, healthcare staffing shortages and limited NuVasive Specialized Orthopedics product availability due to a company ship hold.Geographical & Segmental DetailsIn the reported quarter, U.S. Spinal Hardware business revenues declined 10% year over year to $145.1 million.Revenues from the U.S. Surgical Support business were $60.5 million in the third quarter, down 13% year over year. This downside was primarily attributed to the impact of NuVasive clinical services experiencing a reduction in case volumes due to COVID-19. During the quarter, the drop in surgical volume also resulted in lower net sales of biologics and other products.NuVasive, Inc. Price, Consensus and EPS Surprise NuVasive, Inc. price-consensus-eps-surprise-chart | NuVasive, Inc. QuoteIn the quarter, the company’s international business was impacted by COVID-led headwinds. However, NuVasive’s core Spine business grew double digits year over year, led by the Asia Pacific, Europe and Latin America regions.Margin DetailsIn the reported quarter, gross profit fell 13.5% year over year to $182.2 million. Gross margin contracted 407 basis points (bps) to 67.3%.Selling, general and administrative expenses declined 0.1% year over year to $146.1 million, whereas research and development (R&D) expenses climbed 14.7% year over year to $23.4 million.Overall adjusted operating profit was $12.7 million, down 71.1% from the year-ago figure. Adjusted operating margin saw a 1019-bp contraction year over year to 4.7%.Financial DetailsThe company exited third-quarter 2021 with cash and cash equivalents of $234.6 million compared with $204.1 million at the end of second-quarter 2021.Cumulative net cash provided by operating activities at the end of third-quarter 2021 was $144.8 million compared with the prior-year period’s $113.2 million.2021 GuidanceNuVasive has lowered its financial outlook for full-year 2021, taking into account year-to-date performance as well as unanticipated variability in elective surgical volumes due COVID-led impact and healthcare staffing shortages.The company currently expects to report revenues in the range of $1.13−$1.14 billion, compared to the July-announced guidance of $1.19-$1.21 billion. The Zacks Consensus Estimate for the same is pegged at $1.19 billion.Adjusted earnings per share are projected in the range of $1.73−$1.83, compared to the prior outlook of $2.25-$2.35. The Zacks Consensus Estimate for the same is pegged at $2.24. Adjusted operating margin is estimated in the range of 12.5% to 12.9% (down from the previous range of 14.4% to 14.9%).Our TakeNuVasive exited the third quarter of 2021 with lower-than-expected results. The year-over-year decline in earnings and revenues is disappointing. Top-line growth was hampered by COVID-led impact, healthcare staffing shortages and limited NuVasive Specialized Orthopedics product availability. The year-over-year decline in Surgical Support and Spinal Hardware segmental revenues in the United States does not bode well. A decline in gross profit and contraction of both margins are other downsides. A lowered full-year guidance raises further concerns.On a positive note, an increase in short-term cash level looks impressive. The commercial launch of the Pulse platform during the reported quarter buoys optimism. Further, double-digit growth in NuVasive’s core Spine business across the Asia Pacific, Europe and Latin America regions raises investor confidence.Zacks Rank and Key PicksNuVasive currently carries a Zacks Rank #4 (Sell).Some better-ranked stocks in the broader medical space that have announced quarterly results are Bio-Rad Laboratories, Inc. BIO, Laboratory Corporation of America Holdings or LabCorp LH and West Pharmaceutical Services, Inc. WST.Bio-Rad, carrying a Zacks Rank #2 (Buy), reported third-quarter 2021 adjusted EPS of $3.71, which beat the Zacks Consensus Estimate by 61.3%. Revenues of $747 million outpaced the consensus mark by 11.3%. You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.LabCorp reported third-quarter 2021 adjusted EPS of $6.82, surpassing the Zacks Consensus Estimate by 42.9%. Revenues of $4.06 billion surpassed the Zacks Consensus Estimate by 13.4%. It currently carries a Zacks Rank #2.West Pharmaceutical reported third-quarter 2021 adjusted EPS of $2.06, which surpassed the Zacks Consensus Estimate by 13.2%. Revenues of $706.5 million outpaced the Zacks Consensus Estimate by 3.2%. It currently carries a Zacks Rank #2. More Stock News: This Is Bigger than the iPhone! It could become the mother of all technological revolutions. Apple sold a mere 1 billion iPhones in 10 years but a new breakthrough is expected to generate more than 77 billion devices by 2025, creating a $1.3 trillion market. Zacks has just released a Special Report that spotlights this fast-emerging phenomenon and 4 tickers for taking advantage of it. If you don't buy now, you may kick yourself in 2022.Click here for the 4 trades >>Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free report Laboratory Corporation of America Holdings (LH): Free Stock Analysis Report BioRad Laboratories, Inc. (BIO): Free Stock Analysis Report NuVasive, Inc. (NUVA): Free Stock Analysis Report West Pharmaceutical Services, Inc. (WST): Free Stock Analysis Report To read this article on Zacks.com click here.