I think how much trust a patient needs to have to move forward with spinal surgery on the neck and back region given all the bad press regarding spinal surgery. A lot of this is actually good as patients should be cautious on making any decision. There are real risk and surgery gives less then perfect results. However, there is a window after which results are less certain if chronic weakness and pain are treated with narcotics and excessive nerve blocks. Know your options and research on the Internet as well. Education is a fundamental goal in my practice with all patients.