New emerging Gore Matrix: Basis of stitchless spine surgery under local anesthesia

T of back pain, sciatica, and claudication has changed due to understanding of anatomy, physiology of pain generators leading to change in access, philosophy, and equipment. I have tried to summarize what was the traditional past, why change is necessary and what has changed, and how the change is incorporated in Gore matrix for diagnosis and gore system for treatment in back pain, sciatica, and claudication by proposing spine surgery as stitchless and under local anesthesia in awake and aware patients.