The inception of the Less Exposure Spine Surgery (LESS™) philosophy in 2008 by Professor Dr. Kingsley R Chin, marked a pivotal shift in the approach to spine surgery. This innovation was built on the realization that, while minimally invasive surgery (MIS) techniques, such as the use of his MANTIS MIS percutaneous pedicle screws he sold to Stryker MIS, offered reduced incision sizes, they also came with their own set of challenges. These included the potential for pedicle breaches, disruption of the adjacent normal facet complex leading to adjacent segment breakdown, and irritation caused by the bulkiness of screws beneath the multifidus muscles. Driven by the desire to overcome these limitations, Dr. Chin researched historical methodologies of spine fixation. He discovered earlier techniques, such as Dr. King's 1948 description of facet fixation using screws, Dr. Magerl's translaminar facet fixation method in 1984, and the Bouchard transfacet pedicular technique in 1959. These methods reported high fusion and clinical success rates greater than 90%, inspiring him to develop and patent FacetFuse™, a new direction in transfacet pedicle screw development, followed by InSpan, a screwless midline interspinous fusion technology, and a multitude of other patented modern innovations in less exposure spine surgery technologies. LESS™ emerged as a significant advancement over traditional MIS, focusing on reducing the collateral damage associated with surgery. Traditional MIS aimed to mimic the outcomes of open surgery with less invasive techniques but often resulted in unintended tissue damage and required additional radiation, whose effects could be cumulative over time. In contrast, LESS™ procedures prioritize a tailored approach, adapting to the patient's individual needs, health status, and body type. Performed in an outpatient setting, this approach aims to minimize risks and streamline the surgical process.  By focusing on reducing pain, blood loss, and recovery time, LESS™ represents a more patient-centered and efficient method of spine surgery, embodying the next step in the surgical care continuum. This evolution reflects a broader move towards procedures that are not only less invasive but also more attuned to the overall well-being and specific conditions of each patient, leading to safer and more effective outcomes in spine care.