The use of hardware in spinal procedures is very confusing. Patients need to have this explained in a way so they embrace the concept when necessary to stabilize the spine. Many patients with severe stenosis with leg pain have collapse of bone around the exit of the nerve roots and these devices keep the bone away from the the nerve when patients are walking.The goal is a much better quality of life after surgery which usually means less pain when standing or walking. Certainly, not all patients require these device when there is a less severe form of stenosis.