It has been shown that most individuals over 60 years of age will present with abnormalities on a spinal MRI.  Approximately one-third of healthy adults will present with a protruded disc on a lumbar MRI.  As most of us get older, our spines look abnormal on advanced diagnostic imaging studies such as MRI and CT.  Not all of the abnormalities on these studies are associated with pain, however loss of function may be present without pian.  The decision to go ahead with back surgery or non-operative care should not be based solely upon imaging results.  This decision requires careful correlation of imaging results with the patient’s symptomatic history and neurological findings as well as the result of other available diagnostic studies.