@upstatephil The bigger the surgery, the more hardware that gets installed and possibly rods or longer rods than a surgery of fewer levels. The big surgery may be a future option if you get to where you do really need it as long as you are healthy enough to be able to go through the trauma of surgery at a future age and with good enough bone quality, etc. I know that is a tough decision, and you'll have to feel your way through it, but I do agree with your assessment. I think I would do the same. Certainly do discuss this when you follow up with your surgeon and ask any and all questions you have at that time, and about what future decision could be made and the window of opportunity to do that if you go with a smaller surgery now. Ask what could happen and if the spine condition will progress after a lesser surgery. Also ask the risks of the different choices. They may have told you this already, but would the bigger surgery carry more risks?