There are different types of back surgery which Dr. I’d like you to chime in on. Let’s take this graphic remark and walk it through it maybe you can also tell me which one is the most common one, but take the first one for us okay. > So there’s… there’s several different kinds of back surgery so diskectomy laminectomy fusion and artificial discs or four broad categories that would happen for patients who presented with a herniated disc, for example, and with either back pain or leg pain. The type of surgery or select oftentimes depends on patient’s symptoms so if you have back pain that more pushes us towards a fusion back pain comes from either the discs or the facet joints and I said — we’re gonna take 3D image let’s show that to our viewers right now and let’s see exactly what you’re telling us in terms of that surgery and do we have that let me take that graph that 3D image up there we go okay doctor why don’t you tell us right what that is — So if we look at this so here we have our disc okay so this is this is a disc this is the back part of your spine so your spinous process is back here and these are part of your four set joints okay so these are the joints that are in the back here we have the cauda equina okay and this is essentially what causes the nerve roots to kind of come down and they branch out and here is an l4 nerve root and that’s a nerve root that comes out from in between the discs and the bones in your back. So a surgery that would be appropriate for this patient that we see in the graphic for example would be something like a micro laminectomy and a micro diskectomy with the goal of decompressing this nerve because the most common symptom this patient would be complaining of is leg pain, so that would be pain that’s coming from the nerve and shooting down the leg so the sciatica as we talked about before. If this patient also had back pain it could be because this nerve certainly is is affected that would more cause leg pain but the back pain would more be because the disc is damaged and the bones are rubbing against one another. So as we have patients who have arthritis and their hips and knees and we all know somebody who’s had a hip replacement ereplacementparts.