I have reviewed several new technologies for less invasive surgeries on the spine. Most of us with years of experience know that there must be improvement in outcomes to justify their adoption into practice. I still see a number of failed results because basic principles are ignored. Most pain such as sciatica usually means there is blockage causing compression of a nerve root. Most surgeries must first solve this problem. Adding hardware such as screws or implants comes next. I see mostly failure decompressing L5 nerve root. A popular new approach using lateral implants cannot address L5 S1 levels. I do like this new technology but compression must not be forgotten at this level where many failures occur and may require revision surgery.

decompression of L 5 roots if primary cause of pain cannot be

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