I try to managed the expectations of my patient purposely using 60 to 70 percent improvement to be what should be expected after surgery. Many patients come to me with much too optimistic expectations. I also explain that most conditions represent natural aging and not a terrible condition such as cancer Their results should leave them feeling good about all of the newer spinal less invasive treatments.I strongly believe up to 90 percent do well with therapy,medication,injections, and other nonsurgical methods.There is no reason for spinal patients to not have hope as we live in a time where spinal specialist understand that procedure should be less invasive and offer many proven newer technologies , In fact , I give all my patients my home and cell number so as to force me to make sure that what is offered as a choice is totally understood. Should they have any confusion , I would rather know prior to surgery. I also will have to live with the results good or bad as they have direct access to me.I have tried to force a ckeck and balance approach. If there is a poor outcome , I will certainly be hearing from these patients.