Myles Luszczyk,D.O.

Myles Luszczyk, D.O.

Specialties

  • Fracture Care
  • Spine (Back and Neck)

Locations

  • Bettendorf, Iowa
  • Davenport, Iowa

Background & Training

Hometown

St. Catharines, Ontario, Canada

Undergraduate Studies

University of Western Ontario, Bachelor of Science in Kinesiology

Medical School

Midwestern University – Chicago College of Osteopathic Medicine, Doctor of Osteopathic Medicine

Residency

Michigan State University – Pontiac Regional Medical Center, Orthopedic Surgery

Fellowship

University of Washington – Harborview Medical Center

Professional Memberships

American Academy of Orthopedic Surgeons
American Osteopathic Academy of Orthopedic Surgeons
American Osteopathic Association

Areas of Expertise

Cervical, Thoracic and Lumbar Spine Surgery
Spinal Stenosis
Spondylolisthesis
Disc Herniations
Knee Arthroscopy
Minimally Invasive Spine Surgery
General Orthopedics

Physician Team

John Tryon, PA-C, Physician Assistant
Candace G., LPN, Patient Coordinator

4.9 based on 489 reviews

Patient Reviews

Joshua Workman
April 11, 2026
Google

I recently had to have emergency back surgery and I want to express how thankful I was to have Dr.Myles Luszczyk and his team there to do the procedure. We are very lucky to have a surgeon of his caliber in the Quad Cities.

Ross Ketelsen
April 8, 2026
Google

As always very caring and does the best to provide best care.

Bobbie Ojeda
March 11, 2026
Google

Dr. Luszczyk is a great guy who explains all that you need to know

Joel Chapman
March 11, 2026
Google

Dr. Myles was very thorough, honest, and straightforward in my Surgical consultation. I have confidence that my surgery will go well.

Christopher Steuer
March 5, 2026
Google

Very thorough and does an excellent job not only explaining your issues but showing you with technology what and where they are. No pressure and gives you the choice for your care. Excellent disposition and truly cares for his patients.

Jody Schroeder
March 5, 2026
Google

The staff was very professional and very nice. The building in Bettendorf Iowa is beautiful. And Dr. Miles very professional and explained my medical situation very well.

Kenneth Quinn
February 26, 2026
Google

ORA has helped immensely with what originally was diagnosed as Bursitis but ultimately became a lower back surgery situation. As an avid hunter it was important to me to be able to get around but that was slowly getting cut short. I did the physical therapy which innitally helped some but that too slowly became an issue of the past. That's when I started seeing Dr. Myles Luszczyk in preparation for what would end up being lower back surgery. Dr. Luszczyk was the answer to a prayer. He prepared me for quite a journey. He was very straight forward about what that journey could and could not entail in a very direct but caring manner. There were no punches pulled by him in his description and his question at the end was, "are you prepared for this". Dr. Luszczyk, of course was exactly right in his explanations and descriptions and in the end performed what I would call a miracle. Although ORA has helped alot my greatest gain was meeting with Dr. Luszczyk and being cared for by him. I, with no hesitation, would highly recommend Dr. Luszczyk to anyone for back problems and especailly if surgery was called for I don't believe that you could find a better person to take care of your problem along with a caring and gracious attitude. I in no way regret being attended to by Dr. Luszczyk.

Joe Puck
February 24, 2026
Google

Dr. Luszczyk is extremely knowledgeable and very thorough with his work. He comes very highly recommended by people who have had back surgery performed by him. Excellent bedside manner, and all around normal good guy!

MARK WALLENFELSZ
February 21, 2026
Google

I was very impressed with every aspect of this consult.

Tracy Johannsen
February 19, 2026
Google

Dr. Miles is always a pleasant person but will let you know what you need to do to stay healthy.

Jane Dilworth
February 18, 2026
Google

Dr. Luszczyk is so personable and down to earth. He made my appointment almost enjoyable, LOL. Explained what was going on with me and the options for my situation. I would go back to him if I needed him in a minute. hope i dont but you never know.

Mark Payne
February 18, 2026
Google

Dr Luszczyk was very professional and listened to all my concerns regarding my back pain. He explained in detail what the MRI showed. Thank you

Cindy Montoya
February 7, 2026
Google

Dr Myles is the best! He listens to you and explains everything so you can understand what is going on. Only doctor at ORA that I trust!!

Larry Roberson
January 14, 2026
Google

Very pleasing

Larry Squire
January 14, 2026
Google

Very pleasant, conscientious, and straightforward. Enjoyed the appointment, and it was very educational.

Cheryl Proulx
January 14, 2026
Google

Dr. Myles performed complex cervical and lumbar spine surgery as well as scoliosis repair for me. He is a truly brilliant surgeon—highly skilled, meticulous, and compassionate. Thanks to his expertise, my outcome has been life-changing. I am profoundly grateful for his care and will remain forever thankful for what he has done for me.

Patient
January 14, 2026
Healthgrades

Dr. Myles performed complex cervical and lumbar spine surgery as well as scoliosis repair for me. He is a truly brilliant surgeon—highly skilled, meticulous, and compassionate. Thanks to his expertise, my outcome has been life-changing. I am profoundly grateful for his care and will remain forever thankful for what he has done for me.

Vitals Guest
January 14, 2026
Vitals

Dr. Myles performed complex cervical and lumbar spine surgery as well as scoliosis repair for me. He is a truly brilliant surgeon—highly skilled, meticulous, and compassionate. Thanks to his expertise, my outcome has been life-changing. I am profoundly grateful for his care and will remain forever thankful for what he has done for me.

Kathy fuller
January 12, 2026
Google

The Dr listen to me and help is an extremely scary life threading issue and respond for my life. I am the doctor is with us to help those in need.

Patient
January 6, 2026
Healthgrades

Kind attitude -well done explanation - I think He is thoroughly competent-

Patient
January 5, 2026
Healthgrades

Kind attitude -well done explanation - I think He is thoroughly competent-

Michael Jacobs
January 3, 2026
Google

Down to earth doctor.

timothy loudrock55
December 19, 2025
Google

I was very fortunate to be seen by Dr luszczyk. He was my second opinion and I believe he saved me from a surgery that would have taken my ability to live a better life without the surgery. I will go on with the pain .take it as long as I can. What a outstanding Dr. The best. Thank you for caring.

Jeff Ruiz
December 17, 2025
Google

Very nice doctor and explained everything to me. Very patiently

Kris Craddick
December 17, 2025
Google

I enjoyed meeting Dr. Myles. Great personality and personable. He was very helpful and informative about decision regarding my health issues. 😊

Vitals Guest
December 16, 2025
Vitals

Very informative I like the way Dr Myles explained everything Left feeling assured of reaching the problem with help other than surgery unless all else fails.

Jamie Walker
December 14, 2025
Google

Trusting a spine doctor is not an easy decision. After a year of intense pain and countless questions, I did a lot of homework, and after meeting with Dr. Luszcyk, I knew he was the right choice. Within about 30 seconds, he was able to accurately diagnose my condition and clearly outline a treatment plan, which ultimately did require surgery. His bedside manner, care, compassion, and honesty are truly something to be thankful for. Now, three weeks post-surgery, I know without a doubt that I made the right decision.

Steve Wolf Cole
December 10, 2025
Google

Dr. Luszczyk took time to listen to my problems and explain in plain language what could be done

Tracey Sulzberger
December 9, 2025
Google

Such a wonderful experience! His bedside manner is one of the best! Being a RN and a patient, I can say this is a rare quality today. Both professional and personable and really listens to your concerns and answers questions in a way that you can understand. 10 stars!

Pennie Engler
November 25, 2025
Google

He is so thorough and truly cares about his patients health and makes sure they heal properly.

patricia thomas
November 19, 2025
Google

Dr. Myles has seen me for my back surgery last May. I feel better and that surgery has helped me. Now yesterday I was again seen by Dr. Myles for problems with my right arm, hand etc. I again will be having surgery in 6 months because I’m having surgery for a knee replacement as well. Dr. Myles is caring, thorough & will explain all aspects of my cervical surgery. I am thankful that Dr. Myles & staff can take good care of me & the public. I highly recommend Dr. Myles & Dr. Rossi who is the surgeon to replace my knee.

Brian Miller
November 19, 2025
Google

Very nice Dr! Straight shooter

Patient
November 13, 2025
Healthgrades

Dr. Luszczyk was phenomenal as was the rest of his staff. As soon as he walked in the room I felt at ease. Very personable and professional. He took time to listen, to access, and to educate me. He was honest and thorough, which I greatly appreciated. I was very satisfied with my visit and I will definitely recommend him to others.

Carl Jorgensen
November 12, 2025
Google

Dr. Luszczyk was very welcoming to me. We talked about my cervical spine issues. He was very clear explaining my condition. At this time my symtoms are minimal and surgery was not recommended at this time. Due to some other health issues I would be a risk. He recommended that I wait until symtoms increase to where I need to have surgery done. Very clear with me and my risks. Thanks much.

Patient
November 12, 2025
Healthgrades

Dr. Luszczyk was phenomenal as was the rest of his staff. As soon as he walked in the room I felt at ease. Very personable and professional. He took time to listen, to access, and to educate me. He was honest and thorough, which I greatly appreciated. I was very satisfied with my visit and I will definitely recommend him to others.

Rick Darling
November 5, 2025
Google

Felt great to finally talk to somebody who seemed like they really knew what was going on with my back. Thanks, Doc.

Ellen Martin
October 24, 2025
Google

Dr Myles is prepared to give it all for his patients. During my initial meeting with him, he was ready to give me all the time I needed to become comfortable with the idea of having major surgery. And for some reason, I needed considerable time to come to terms with it. Not for a minute did I feel rushed. It gave me a lot of confidence in my future with Dr Myles.

Kathy Kilen
October 17, 2025
Google

Dr. Myles spent significant time explaining my condition and listening to our concerns. The timely surgery and care I received from him and his team was outstanding! Not only did I experience relief from nerve pain, I felt heard and included throughout the process. We appreciate his person-centered care and expertise!

Michele Dekeyrel
October 15, 2025
Google

I felt very comfortable talking with Dr. Myles. He was informative, and very funny. I was very nervous going in, but feel much more confident after talking with him.

Deborah Varsel
October 9, 2025
Google

I had a great visit with Dr Luszczyk regarding my lower back pain. He had my previous MRIs and explained to me what was going on with my spine. And he set up a plan for my recovery. The Dr is very pleasant and knowledgeable.

Vitals Guest
October 1, 2025
Vitals

I recently had an office visit with “Dr Myles” and his staff. My appointment was on time and his nursing staff was very friendly and compassionate about my spinal problems. Having been a patient of Dr Myles for over 12 years I cannot praise him enough for his for his previous operation on my cervical spine saving me from total paralysis. During my recent visit for new back issues, his assessment of my problem was not perform surgery but seek other methods of relief which are working. I cannot say enough about my respect for this man, his skill and caring attitude.

Kimberly Darling
September 16, 2025
Google

Dr. Myles did a triple cervical fusion on me in 2022. He was my second opinion doctor and was so patient when explaining what was going to happen and what could happen, etc. It went perfectly. I was surprised at how quickly I recovered and how well my neck moved. He has a wonderful support staff and John Tryon is the physician’s assistant and was super. I’ve seen John and the rest of the staff a lot in the past few years. I have quite a bit of arthritis in my neck, and I tend to not behave myself, so I will probably need to have another fusion at some point in the future. Dr. Myles will be the surgeon, no worries there.

Kelly DeLaughter
September 16, 2025
Google

Very personable Surgeon. He explained and showed me on my films why he could not help me surgically with the tremendous effects of arthritis on my spine. Not what I wanted to hear but I am glad he didn't sugar coat it. I would recommend Dr. Myles.

danielle walker
September 10, 2025
Google

My 1st appt was yesterday and Dr Myles was so sympathetic to me and the results of my MRI he explained and showed me in detail what I’m facing. He was kind, gentle, and I know that if I decide the surgical route that I will be in good hands

D C
September 7, 2025
Google

I went to see Dr. Luszczyk for a surgical consult due to my foraminal stenosis in my neck. He checked my symptoms and found something peculiar. He told me he could do surgery but didn't think it would help me. He said I needed to see a neurologist on an academic level instead. He was right. My neurologist discovered I have a rare, hereditary neuromuscular disease. My course of treatment completely changed . I'm grateful for Dr. Luszczyk's honesty and skill for being able to discern symptoms that were overlooked by other physicians.

Charles Lotspeich
September 4, 2025
Google

Very personable and down to earth doctor. Explains thing very well and clearly.

Mary Lou Smith
August 30, 2025
Google

Unbelievable communicator. Compassionate and down to earth

Deb Smull
August 27, 2025
Google

Saw Dr. Myles for clarification and options for my Thoracic back pain. He was so kind, honest and explained everything to me so that I understand my situation. I highly recommend him!

Patient
August 25, 2025
Healthgrades

I went to see Dr. Luszczyk for a surgical consult due to my foraminal stenosis in my neck. He checked my symptoms and found something peculiar. He told me he could do surgery but didn't think it would help me. He said I needed to see a neurologist on an academic level instead. He was right. My neurologist discovered I have a rare, hereditary neuromuscular disease. My course of treatment completely changed . I'm grateful for Dr. Luszczyk's honesty and skill for being able to discern symptoms that were overlooked by other physicians.

Michael Crane
August 13, 2025
Google

Dr. Myles is the best Spinal surgeon around. We are lucky to have him here in the Quad Cities, as he should probably be at Mayo.

Myles Metzger
August 13, 2025
Google

As usual, it was very good!

Emily Reid
July 31, 2025
Google

I am very thankful for Dr. Luszczyk for many reasons. I first met Myles when he had to treat my son’s badly broken femur due to a very bad car accident. Dr. Luszczyk was amazing from the moment we met in the ER to the year long recovery. My son is doing fantastic because of Dr Myles!!! I am now the patient and I couldn’t have imagined having any other Dr. treating me for my cervical issues. Highly recommend.

Candace Geurtsen
July 1, 2025
Google

The best of the best!

Patient
June 29, 2025
Healthgrades

Just his kind demeanor and honesty in spite it not being good news.

Patient
June 26, 2025
Healthgrades

Kindness overload. Such a fantastic dr. Very explanatory. Took time to tell you what he could and couldn't do

Don Shaw
June 25, 2025
Google

Good

Hope Brimmer
June 18, 2025
Google

Very precise and clear, and caring.

Caitlin Crane
June 17, 2025
Google

Myles was extraordinary and I hope he is still working down the road when I will end up having surgery.

Jennifer Peden
May 28, 2025
Google

Myles was fantastic! He was very clear about what needed to be done. I especially appreciated that he was very direct. He didn't pull any punches! Yet he is kind and very detailed!

Cheryl Arp
May 21, 2025
Google

Dr. Luszczyk did an excellent job pointing out areas on the MRI and explaining them. He told me that surgery might not solve my problem . I appreciated his honesty! He was very easy to talk with and welcomed questions.

Diane Quiram
May 20, 2025
Google

Myles explained in simple terms what I had in October and what I have now. Helped determine option I need to take now. He doesn’t sugar coat anything but gives you the facts in a caring manner. I know I’m in good hands with Myles.

M
May 9, 2025
Google

Great at explaining everything and you can tell he really cares.Nice personality.

Teresa Leedle
April 19, 2025
Google

I just met with Dr Myles Luszczyk for the first time and felt very comfortable with him and feel like I’m in great hands! He’s got a great bedside manner! I’m thankful I chose him to go to!

Ernie Sivia
April 17, 2025
Google

Dr Luszczyk is amazing. His care and concern is truly amazing. He helps you feel at ease even when facing surgery

Wayne Perkins
April 16, 2025
Google

Dr. Luszczyk was extremely attentive to my situation. He spent an exorbitant amount of time, listening, and giving input and finally a diagnosis and what the plan of action would be. There was never any pressure to commit to surgery. His main concern was that I understood the situation and what could possibly be done. I’ve never had a physician spend that much time with me and show so much empathy to my situation while being completely open and honest to the possible outcome

Laura Bebensee
April 12, 2025
Google

Was such a pleasure meeting this man. His sense of humor was top notch. He made me fill very comfortable as I was so nervous.i could tell he was very knowledgeable concerning my problem with my neck and shoulder and explained everything that would happen. He referred me to a shoulder surgeon as he thought most of my pain was coming from it. Thank you for making me fill welcome, Sincerely Laura Bebensee

Andrea Gutierrez
April 11, 2025
Google

I had a concern about my neck. He fit me in right away to make sure everything was healing properly with my spinal surgery. He is always so reassuring.

Vitals Guest
April 9, 2025
Vitals

Very professional with a great sense of humor. Took the time to answer all our questions and explain the options, whether we liked the answers or not. Clean and friendly environment.

Corbin Juers
April 2, 2025
Google

Very clean and professional with friendly staff. Dr. Luszczyk was very honest with me about what routes he would like me to take first. Surgery being my last option. Very to the point and knowledgeable.I was there less than an hour even though they looked pretty busy at the time.

Jennifer Boyd
March 26, 2025
Google

I would highly recommend Dr. Luszczyk to anyone who suffers from bone spurs, pinched nerve’s, and issues that radiates down the arm. I suffered for many years and now I feel like I have my life back.

Patient
February 20, 2025
Healthgrades

Myles is one of The most compassionate doctors I have ever been to. He listened to my every word and was very honest with me.

JOHN TYLER
February 19, 2025
Google

Doctor Luszczyk was very polite, very informative and all around great guy I would recommend anyone to him. His skills are impeccable. He took a botched surgery and straightened it out. A surgery that was only supposed to be an hour to little over 3 and did everything he could to help me, Thanks doc.

Patient
February 13, 2025
Healthgrades

Dr. Miles was incredibly compassionate and understanding and spent a lot of time with me explaining things in detail. I generally felt emotionally better after a visit, and understood with much greater clarity. What was going on with my condition. Although it was my first visit with him I was impressed With the kind of person a doctor he was. The world would be a better place if as many healthcare professionals was nice and understanding as Dr. Miles was.

richard gott
February 13, 2025
Google

My visit was nice everything well explained

Patient
February 12, 2025
Healthgrades

Dr. Miles was incredibly compassionate and understanding and spent a lot of time with me explaining things in detail. I generally felt emotionally better after a visit, and understood with much greater clarity. What was going on with my condition. Although it was my first visit with him I was impressed With the kind of person a doctor he was. The world would be a better place if as many healthcare professionals was nice and understanding as Dr. Miles was.

Keith Sanders
February 5, 2025
Google

Very professional. told me as it is. He’s a surgeon and I hope I don’t have to see him again because if I do that, that means I’m having surgery but if I do, I know he’ll do a great job.

Patient
January 30, 2025
Healthgrades

I met Dr. Luszczyk for the first time on Jan. 28th for the first time to discuss some up coming surgery.I found him very knowledgeable and personable. He was straight to the point on the subject that we were discussing which I really appreciated. He also had a great sense of humor but again stayed on track with the pros and cons of the surgery. He told me that he did have a hectic schedule and was the most sought out surgeon in his field which I no doubt can believe and understand why.I would recommend Dr. Luszczyk to any with no reservations.

Kenneth Quinn
January 29, 2025
Google

I met Dr. Luszczyk for the first time on Jan. 28th for the first time to discuss some up coming surgery. I found him very knowledgeable and personable. He was straight to the point on the subject that we were discussing which I really appreciated. He also had a great sense of humor but again stayed on track with the pros and cons of the surgery. He told me that he did have a hectic schedule and was the most sought out surgeon in his field which I no doubt can believe and understand why. I would recommend Dr. Luszczyk to any with no reservations.

Patient
January 29, 2025
Healthgrades

I met Dr. Luszczyk for the first time on Jan. 28th for the first time to discuss some up coming surgery.I found him very knowledgeable and personable. He was straight to the point on the subject that we were discussing which I really appreciated. He also had a great sense of humor but again stayed on track with the pros and cons of the surgery. He told me that he did have a hectic schedule and was the most sought out surgeon in his field which I no doubt can believe and understand why.I would recommend Dr. Luszczyk to any with no reservations.

Vitals Guest
January 29, 2025
Vitals

I met Dr. Luszczyk for the first time on Jan. 28th for the first time to discuss some up coming surgery. I found him very knowledgeable and personable. He was straight to the point on the subject that we were discussing which I really appreciated. He also had a great sense of humor but again stayed on track with the pros and cons of the surgery. He told me that he did have a hectic schedule and was the most sought out surgeon in his field which I no doubt can believe and understand why. I would recommend Dr. Luszczyk to any with no reservations.

Vitals Guest
January 29, 2025
Vitals

Dr.Myles, was polite, professional, personable when we meant him during my appointment. I have had problems with my back & neck and he was the first surgeon to make me feel like I mattered. Dr. Myles I highly recommend you. Thank you and the staff.

Lisa Mengler
January 15, 2025
Google

Dr Myles was very concerned with me and took time to answer all my questions and concerns. I loved meeting him for the first time.

Bruce & Carol McNeely
January 1, 2025
Google

Dr. Luszczyk is a very talented and cautious surgeon. I so appreciate his kindness and willingness to take on such a surgical challenge to prevent me from quadreplelgia.

Kristy Smith
December 25, 2024
Google

Dr. Myles was absolutely amazing and recommend him to everyone!!!💜

David Rickertsen
December 17, 2024
Google

Very intelligent, thoughtful but also tells it like it is. We are lucky to have a surgeon of his talents in the ORA system.

Julie
December 13, 2024
Healthgrades

I was able to get in to see Dr. Miles after a friend of mine, referred me to him. With my situation, he suggested other treatments to help me instead of surgery. I appreciated his honesty and listened to my concerns.

Laura Curry
December 12, 2024
Google

I can’t praise Dr Myles enough. Before my fusion of L3-5, I was ready to give up. I had lost the ability to do any of my responsibilities. My surgery went great. Dr Myles has strict protocols to prevent infections and other possible complications from the surgery. I appreciated his confidence , frankness and personality.

Tom Luethye
December 11, 2024
Facebook

I would recommend all of the staff at ORA. They are very caring & dedicated to the care of their patients. Dr Myles Luszczyk has been awesome & the QC is blessed have him serving our area!

Kossi AGLEE
December 4, 2024
Google

Very good doctor, patient and he knows his job very well. Take time to explain deeply. Funny and professional.

Billie Tack
November 21, 2024
Healthgrades

I had my first visit last week. He reviewed my records and reviewed my scans with me. He explained things well and I was very comfortable asking questions. I had a repeat MRI today and will have a follow up appointment to review that test and develop a plan of care. I am impressed with ORA. Every staff member I have had contact with has been pleasant, helpful, and shown concern for my care.

Billie Tack
November 20, 2024
Healthgrades

I had my first visit last week. He reviewed my records and reviewed my scans with me. He explained things well and I was very comfortable asking questions. I had a repeat MRI today and will have a follow up appointment to review that test and develop a plan of care. I am impressed with ORA. Every staff member I have had contact with has been pleasant, helpful, and shown concern for my care.

Barb Willis
November 7, 2024
Google

His sense of humor had a relaxing affect on me, which was greatly appreciated since my pain level was quite high. But the part that was most impressive and appreciated was his intervention by checking if the pain may be more from the shoulder than the neck … and X-rays showed bone-on-bone! Referred me to a shoulder specialist!! Will deal with neck issues after shoulder issues are resolved. Amazing competence … thank you!

Thomas Waterman
November 6, 2024
Google

Dr. Luszczyk was highly responsive, clear and persuasive in explaining my options and interpreting my MRI. I strongly recommend him.

Linda Martin
November 6, 2024
Google

He is so comforting. And compassionate. He put me at ease even though I'll have a serious surgery.

Patrick Harris
October 22, 2024
Google

Awesome doctor and tells it how it is love the honesty.

Ricky Skelton
October 8, 2024
Google

Best doctor I have ever met. He was so kind and compassionate. Very knowledgeable. He will be doing my back surgery. Will come back and update with my experience.

Newt’s Auto Repair
October 8, 2024
Google

Myles and his team at ORA are professionals. Everything from hospitality to consideration for your feelings. Although Myles Luszczyk is upfront and honest when getting to the point. Myles leaves options on the table and even though the outcome might not always be what you want to hear, at least you know the probabilities of the outcome. I feel like I am in good hands when discussing my back issues with Myles.

Linda Sanders
October 1, 2024
Google

Very personable. Explained everything in detail. He helped me with my back pain.

Mary Morrison
October 1, 2024
Google

Dr. Myles is the most reassuring doctor in discussing orthopedic issues. He has a great sense of humor which was greatly appreciated. He discussed a path forward in addressing my situation.

Jane Heesch
September 25, 2024
Google

My experience was amazing! Dr. Myles was very knowledgeable about what I am going through as far as pain. He was also very helpful in explaining my situation and my options. He was extremely pleasant and took the time to get to know us personally and even told us about some of his background. I would highly recommend him to anyone and I look forward to meeting him again about my issues and my future as far as surgery and other options.