Two hundred seventy-four patients were reviewed 1-5 years after laminectomy for spinal stenosis or herniated disks. All patients were treated according to the Pennsylvania Plan Algorithm for Degenerative Disk Disease. Ninety to ninety-five percent of the patients noted good to excellent relief of their leg pain, whereas only 80% noted low-back pain relief. The majority returned to work within 4 months. This review demonstrates that by following an algorithm for the treatment of back and leg pain from degenerative disk disease, the surgical results can be extremely gratifying, assuming the goals are relief of leg pain, the operative findings are definite, and the preoperative surgical indications and patient selection are well developed.