@rstark I’m glad to see you are researching this and watching medical presentations geared for surgeons. I did that too and you can learn a lot. I’m also happy to see this is a presentation from Cleveland Clinic as they are well respected and similar to Mayo. If you watch this and pause, you can try to look up some of the detailed information since it goes by pretty fast. One of the key takeaways is your disc must not be collapsed to use this device, so that seems to be an early intervention as opposed to years later with collapse and bone spurs. They don’t have a lot of data past 7 years. One point they made was less back pain because the spine moves better if not fused. A couple reasons I chose fusion was that my body reacts to foreign materials like metals which has been a problem with titanium. Some people are allergic to it. Bone quality matters for any spine surgery, but more when there are only screws holding an implant in place without any area that can anchor with bone growth. It sounds hopeful since you are a great candidate and with a second chance reoperation option as long as you are not too old for spine surgery or in poor health when that time comes. In making a decision, you weigh the pros and cons, and take your best shot. It’s always a decision where you knowledge of the future is limited, but you find out how you can help increase you chances of success.