I am now requring prevention as part of treatment. We have started looking at wellness as fundemental part of spine treatment. I find that less invasive surgery is already very much improving as a treatment option when patients are in better condition. Again, I treated a patient with lumber stenosis also with a pacemaker,defibulator, mechanical heart valve using new techniques as this would not have been possible 5 years ago.The advances for patients with stenosis or herniated disc is very much different then just a few years ago.