LESS™ is not a variation of existing spine surgery. It is a fundamentally different approach designed to restore function, preserve anatomy, and treat patients earlier. Traditional spine surgery evolved like cardiothoracic surgery, treating advanced disease with large reconstructive procedures that carry high risks, high costs, and permanent disruption of normal anatomy. Minimally invasive spine surgery (MISS) attempted to improve this by reducing incision size. However, it did not change the operation itself. The same problems remain: Removal of normal anatomy Reconstruction using interbody cages and rigid fixation with pedicle screws Dependence on imaging rather than direct visualization This approach often leads to adjacent segment breakdown due to excessive rigidity and direct injury to the facet above from screw placement. To compensate, large spine companies have invested heavily in robotics and navigation systems to improve screw accuracy. While helpful, these technologies add significant cost and complexity while reinforcing traditional reconstructive surgery rather than advancing it. The result is a system optimized for performing the same surgery more precisely, instead of asking whether it is the right surgery. We chose a different path. Inspired by interventional cardiology and dentistry, LESS™ was built on the belief that early intervention prevents disease progression and avoids complex reconstruction. Founded in 2008 by Harvard-trained Professor Dr. Kingsley R. Chin, LESS™ redefines spine surgery at its core. Instead of focusing on smaller incisions, LESS™ focuses on doing the fundamentals right: Direct midline decompression with full visualization Preservation of normal anatomy at all costs Maintenance of motion rather than defaulting to rigid fixation Instead of destabilizing the spine with full laminectomies, LESS™ favors hemilaminectomies to preserve the lamina and spinous processes. This is achieved through: Endoscopic LESS invasive decompression (ELID™) Mini-open LESS Rx retractor approach Both approaches are designed to preserve the facet joints and maintain structural integrity. When anatomy must be replaced, LESS™ restores function rather than reconstructing the spine: Axiomed® viscoelastic disc replacement preserves motion InSpan® replaces interspinous and supraspinous ligaments FacetFuse™ preserves facets during fusion while leaving the disc intact MISS optimizes for imaging. LESS™ optimizes for patient outcomes. LESS™ is guided by the REP Principles: Restore function Early diagnosis and treatment Preserve anatomy and motion Where MISS lacks a unifying philosophy, LESS™ is built on one. This philosophy has led to the development of a new category: Interventional Spine Surgery. It bridges interventional pain management and traditional reconstructive spine surgery, creating a middle ground focused on earlier treatment, less disruption, and better outcomes. Today, the healthcare system is moving in the same direction LESS™ anticipated: Procedures shifting to outpatient ambulatory surgery centers Increasing demand for lower cost, higher value care Growing interest in motion preservation technologies Recognition of the limitations of rigid fixation LESS™ is aligned with this shift. It enables safer, more efficient procedures, reduces unnecessary complexity, and supports scalable innovation in spine care. Closing Statement LESS™ is not about doing surgery through smaller incisions. It is about doing the right surgery, at the right time, with the least disruption to the patient.