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1. Patients who chose surgery had a much greater degree of pain and disability than those who chose non-operative care (e.g. Oswestry 56.7 operation, 35.9 nonoperation) 2. Ultimately, 22% (48) of patients who initially chose non-operative management crossed over and had surgery. 3. Patients who had surgery had dramatic improvements in virtually all primary and secondary outcomes measures. 4. Patients treated with non-operative management also improved but not to the degree that surgery patients did. 5. The differences between surgery and non-surgery outcomes were highly significant. 6. Surgery was very safe with very few complications. Dural tear2%, recurrent hnp 7% at one year and 9% by two years. Mean op time 70 minutes with 50 ml average blood loss.

AANS/CNS Section on Disorders of the Spine and Peripheral Nerves Annual Meeting Barrow Neurological Institute