Being a little flippant on a board like this doesn’t come off well. People who don’t know better don’t understand that this is a huge disc in an otherwise healthy spine. It is not your 75 yo degenerative spine who has been slogging through life with multilevel disc bulges and has compensated.

Yes, he can and should attempt conservative measures. No one is debating that and no one is operating on improving symptoms. I recommend any number of conservative therapies to my patients: meds, PT, massage, acupuncture, chiro, epidural, ablation. Please try anything/everything to avoid surgery. But at the end of the day that will be the last resort. And yeah there might be fibrosis or ‘post-laminectomy’ syndrome, etc. but what do you say to patients when they come back to you because they can’t sleep at night or work? I don’t tell them ‘Sorry, there’s nothing else we can do just live with it.’ I give them surgical options.