The other thing is is that with patients who do have other pathologies, it may require more extensive surgeries. For instance, if you have a big cyst that comes off a joint, it can look just like you have a ruptured disc from the standpoint of symptoms and signs, symptoms being what hurt, how you tell the doc it hurts and signs being things that are on exam and only with the imaging do you see that it's a big cyst and that may require a more extensive surgery even including excision of the cyst and maybe stabilization of the joint there, which might be even including an instrumented fusion. But not all cysts required instrumented fusion. And then after that we're talking about a lot of things that are less common, although sometimes you'll see a patient who has what's called stenosis where the bone has grown, made things tight, the patient's been doing really well and starts to have a lot more leg pain. There isn't a ruptured disc. There isn't a cyst, but things are real tight. And it depends on how many levels of stenosis you have as to whether a surgery for that it's going to last an hour or it's going to last three hours, and so that becomes then more complex and very much more individualized to the patient.
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