So steroid injections, then if the patient still is not bitter, that patient may ultimately come to surgery. If it’s simply a ruptured disc, it may be an outpatient surgery that takes an hour, hour and a half to do where you take those pieces of disc out away from a nerve root. And think of it as like having a rock in your shoe. You want to get the rock out, but you don’t want to destroy the shoe and you don’t want to destroy the foot. The analogy here being that the foot is the nerve and the shoe is the bone integrity of the spine and modern techniques of operating have really made this marvelous procedure done with microscopes, sometimes done with endoscopes and there’s no real advantage of one over another. The incisions for the small microdiscectomy are hardly bigger than the ones with the scopes. Some people are not as fast though with the scopes and like those so called mini open procedures and they’re many, many practitioners who do small approaches are many approaches for this as an a simple outpatient procedure. In fact, it’s almost not so much done as an inpatient procedure as it was 20 years ago.
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