I just return from an advanced spine meetings and want to report my observations.Patients should understand the best improvements after surgery still fall far short of a 100 percent. Even with new technologies, the number of patients with less then 70 percent improvement of their back or leg pain is still the challenge for surgeons. I always spend extra time making sure I explain realistic goals. Unfortunately, we do not have a perfect solutions for back or leg pain due to spinal pathology. Patients going to centers with claims of 90 to 100 results should be very wary!