For two geriatric patients with similar pain symptoms and spinal conditions, Konstantinos Margetis, MD, Assistant Professor of Neurosurgery, Chief of Neurosurgery at Mount Sinai St. Luke’s, and Director of Spine at Mount Sinai-Union Square, took different approaches. He considered each patient’s risk factors and comorbidities when deciding between an open spinal fusion—the gold standard—and a minimally invasive one.