Often times, I find that there is a lot of confusion amongst patients that read articles on the Internet or in the newspapers about minimally invasive surgery. As spine surgeons, we want to perform smaller incisions so that recovery will be less eventful. Be assured patient outcomes is still the gold standard. I still see a great deal of failed back surgery because the primary cause of compression by bone or disc has not been completely removed. I have performed well over a thousand revisions surgeries and continue to be amazed that the primary pathology is not removed during surgery. In many cases , the patients still have leg pain or weakness most often from the Lumbar 5 nerve root which is still the primary cause of failed back surgery. Patients should not be confused that removal of compression and some type of stabilization implant will be necessary for real results. Laser is just a cutting tool and addressing the above has not changed by using laser during the procedures.The amount of failed back surgery due to claims of small incision as outpatients procedures for complex spinal pathology still amazes me each day. Buyer beware still applies!