In this presentation Mr. Jeremy Fairbank, from the Nuffield Centre in Oxford, United Kingdom, presents the findings of the to-date largest comparison multi-center prospective study on surgical versus nonsurgical treatment of low-back pain. The lead investigator of this unparalleled study provides a first-hand report of the scope of this undertaking, as well as a discussion on limitations and surprising findings encountered along the way. The study found that patients with back-pain without structural spinal deficiencies or encroachment of nerves may be better and more safely served with a dedicated nonoperative treatment using cognitive behavior therapy, a combination of reeducational efforts and physical strengthening. From the Series:Symposium on Low Back Pain