I review many failed back surgery cases and find a common theme. In most cases, patients do not have a precise vision of what to expect long-term after their surgery. All patients need to understand that most spinal surgeries are salvage procedures that only can partially solve such issues as pain or weakness. Not to be depressed by less then perfect results,as long as patients understand until we have biological solutions the patient results should target 70-80 percent improvement after surgery.Most spinal conditions represent natural aging and this is a factor that affects long-term results. My best patients are realistic and have reviewed and performed personal research prior to having a procedure. I think they need to use google or yahoo to help learn about alternatives and find Internet sites such as spineuniverse.com or look at the website of their physician to learn their credentials. Surgery in my practice is only considered after failure of all non- surgical options.