Pain down the legs, heaviness of the legs on walking and symptoms such as pins and needles and numbess can be due to pressure on the nerves of the lumbar spine. MRI findings of focal compression on nerves can guide us to the type and level of surgery. Microscopic decompression can help relieve the symptoms. Sometimes additional nerve tests are required to exclude a problem with the nerves in the legs. The need to consider this operation and the other options such as injections should be discussed.