Are we operating on too many IVDP cases?

Are we operating on too many IVDP cases? This is a question I have been thinking about for some time. We frequently see patients with low back pain, an MRI showing a disc bulge/prolapse, and eventually a recommendation for surgery. But how consistently are established surgical indications being applied in everyday practice? An MRI finding is not, by itself, a surgical indication. There are situations where surgery is clearly necessary — and sometimes urgent. But there is also a large group of patients where the decision is less straightforward and adequate conservative management deserves a genuine opportunity.