It is very common for patients to tell me when they are presented with the option of seeing a spinal surgeon that they “do not want to have spine surgery.” In most cases, these patients are correct. No one should want spinal surgery; however, there is a small group of patients whose quality of life is significantly compromised from their spinal condition. In these circumstances, surgery can be considered as a last resort. Spinal surgery is only one of the many treatment options available to patients. A majority of patients we see never need to have surgery. Frequently, physical therapy, rehabilitation and pain management will be effective treatments for the bulk of the spinal pathologies we encounter. We believe that conservative methods should be exhausted and, only when patients have exhausted these treatments, surgical treatment be considered.