We are all on a sliding scale of risk vs. potential benefit. Doing MISS is a no brainer if you are a good candidate and stand a reasonable chance of success. The farther you are down the road of degeneration, failed conservative treatment, failed MISS, etc... the less likely you are to find success with the less invasive, minimally invasive, non-invasive treatments. At some point, it becomes wishful thinking.
While MISS is lower risk than bigger, open procedures, they are not risk free. There is also risk involved in not addressing mechanical issues in a timely manner.
The bottom line is that needing to have this discussion means you are in trouble. We have very few options and they all suck. We are just looking for the option that sucks less.
Mark
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