The evolution of surgical treatment for symptomatic disk rupture of the human spinal column has progressed remarkably over the last 100 years. The correlation of symptomatology with pathophysiology, the development of imaging studies, and the refinement of surgical procedures over time have resulted in improved patient treatment with minimal morbidity. From the time of Keys' observation of an indentation of the spinal cord, to Dandy's confirmation that disks undergo traumatic degeneration rather than neoplastic growth, to the advent of spinal imaging and the subsequent development of the myriad of approaches to intervertebral disk pathology, the field has progressed tremendously.12, 19 This review has not considered the controversy surrounding the indications for and benefits of fusion. This issue merits a separate discussion. Historically and practically, it is a rich area for study. It should be interesting to follow the future innovations of the twenty-first century and to participate in the evolution of the effective treatment of ruptured disks of the human spine.