What It Does: Removes a slipped disc fragment through a small tube and camera. Commonly Used For: Slipped disc, sciatica.

What It Does: Removes a slipped disc fragment under an operating microscope. Commonly Used For: Slipped disc, sciatica.

What It Does: Removes bone and thickened ligament to widen the canal in the lower back. Commonly Used For: Canal stenosis, neurogenic claudication.

What It Does: Removes the back of the vertebrae in the neck to free the spinal cord. Commonly Used For: Cervical myelopathy, some spinal tumours.

What It Does: Frees the spinal cord in the mid-back. Commonly Used For: Thoracic disc, stenosis, tumours.

What It Does: Removes a neck disc from the front and fuses the level with a cage. Commonly Used For: Cervical radiculopathy, cervical myelopathy.

What It Does: Removes a lower-back disc and fuses the level with a cage, screws and rods. Commonly Used For: Spondylolisthesis, instability with stenosis.

What It Does: Stabilises the spine with screws and rods. Commonly Used For: Fracture, instability, tumours, C1–C2 instability.

What It Does: Removes tumours inside the cord or in the spinal bones, and relieves cord pressure. Commonly Used For: Spinal tumour, vertebral body tumours.

What It Does: Removes tumours inside the cord's covering but outside the cord. Commonly Used For: Spinal meningioma, schwannoma.

What It Does: Releases a spinal cord that is abnormally fixed at its lower end. Commonly Used For: Tethered cord.

What It Does: Performs suitable operations through smaller incisions with less muscle disturbance. Commonly Used For: Selected disc, stenosis and fusion operations.

How It Is Done: Camera and instruments through a tube, typically under 1 cm. Often Suited To: Selected slipped discs and some stenosis.

How It Is Done: Small incisions with tubes or retractors; muscles spread rather than cut. Often Suited To: Selected decompression and fusion operations.

How It Is Done: Small to moderate incision with an operating microscope. Often Suited To: A wide range of disc, stenosis, tumour and cord operations.

Spine surgery is an operation on the bones, discs, joints, nerves or spinal cord of the neck, mid-back or lower back. It is used to relieve pressure on a trapped nerve or the spinal cord, remove a slipped disc fragment, stabilise an unstable or injured spine, or remove a tumour.

Spine surgery is considered when a problem seen on the MRI matches your symptoms and is causing disabling pain, weakness or loss of function that has not improved with non-surgical treatment, usually after about 6–12 weeks, or when nerve function is getting worse. It is needed urgently for cauda equina syndrome, rapidly worsening weakness or spinal cord compression.

Yes, in most cases. Most back and neck pain improves with time, staying active, physiotherapy, exercise and pain-relieving medicines. A 2024 review in the CMAJ found that new episodes of back pain improved on average by about half within six weeks. Surgery is for specific problems such as a trapped nerve, spinal cord compression or instability.

No. Most people with a slipped disc and sciatica improve without surgery. When surgery is and is not needed is explained on the slipped disc page.

For most patients planned spine surgery is safe, but every operation carries risk. Possible complications include nerve injury, a spinal fluid leak, infection, bleeding, blood clots, recurrence of a disc herniation and persistent pain. The level of risk depends on the condition, the operation, your age and your general health.

Permanent paralysis after planned spine surgery is uncommon. Temporary numbness or weakness can occur as an irritated nerve settles. The risk is higher in operations on the spinal cord itself or in complex deformity and tumour surgery, which is why intraoperative nerve monitoring is used for these operations.

There is no single figure; it depends on the condition and the main symptom. Surgery tends to work best for leg or arm pain caused by a trapped nerve that matches the MRI, and for relieving spinal cord compression. It is less predictable for back pain alone. Ask your surgeon what improvement to expect for your specific problem.

Minimally invasive spine surgery (MISS) performs suitable operations through smaller incisions, spreading the muscles rather than cutting them. Which operations it suits, and its limits, are explained on the minimally invasive spine surgery page.

Endoscopic spine surgery uses a thin camera and instruments passed through a small tube. Its commonest use is removing a slipped disc fragment; see endoscopic discectomy for who it suits, how it compares with microdiscectomy, and recovery.

Almost all neurosurgeons and some orthopaedic surgeons are trained as spine surgeons. Neurosurgical training centres on the brain, spinal cord and nerves, which is particularly relevant to operations on the spinal cord and its covering, such as spinal cord tumours and tethered cord. What matters most is the surgeon's regular experience with the specific operation you need.

Neck pain from spondylosis alone rarely needs surgery. Surgery is considered when arm pain or weakness from a trapped nerve (cervical radiculopathy) does not settle, or when the spinal cord is compressed (cervical myelopathy), causing clumsy hands or unsteady walking. Common operations are ACDF and cervical laminectomy.

Spinal fusion joins two or more vertebrae so they heal into one solid bone, using screws, rods and often a cage. It is used for instability, slipped vertebrae and some fractures and deformities. Fusing one or two levels usually causes little noticeable loss of overall movement, because the rest of the spine continues to move.

Only if the spine is unstable or the operation itself would make it unstable. Most disc operations and many decompressions do not need screws or rods. Fusion with spinal instrumentation is used for conditions such as spondylolisthesis with instability, fractures, some tumours and C1–C2 instability.

Most spine operations are done under general anaesthesia. Some endoscopic disc operations can be done under local anaesthesia with sedation. The choice depends on the operation, its length and your health, and is discussed with the anaesthetist before surgery.

A single-level discectomy often takes around one to two hours. Decompression and fusion operations usually take longer, depending on the number of levels, and spinal cord and tumour operations can take several hours. Your surgeon can give an estimate for your operation.

It depends on the operation. After endoscopic or micro-discectomy, many patients go home the same day or within two days. After decompression the stay is typically two to four days, and after fusion about three to five days. Spinal cord and tumour surgery may need a longer stay and rehabilitation.

Most patients are helped to walk within a day of spine surgery, often the same day after disc surgery. Early walking is encouraged because it helps recovery and reduces the risk of blood clots. Walking distance is then increased gradually over the following weeks.

As a general guide, desk work is often possible two to four weeks after disc surgery, three to six weeks after decompression and four to eight weeks after fusion. Heavy manual work usually needs longer, often around three months after fusion. Your surgeon will advise based on your operation and your job.

You can usually drive once you can sit comfortably, turn to look behind you and brake firmly without pain, and are no longer taking medicines that cause drowsiness. This is often two to six weeks after surgery, depending on the operation. Check with your surgeon before driving.

Yes. Age alone is not a reason to avoid spine surgery. Many older people have operations such as lumbar decompression for canal stenosis to improve walking. What matters is overall health, heart and lung fitness, bone strength and the expected benefit, which are assessed before surgery.

Emergency surgery may be needed for cauda equina syndrome (back pain with saddle numbness or bladder or bowel changes), rapidly worsening leg or arm weakness, spinal cord compression from a tumour, infection or bleeding, and unstable spine fractures. These need same-day hospital assessment and an urgent MRI.

The cost of spine surgery in Pune varies with the operation, the number of levels, any implants such as screws, rods or cages, the hospital and room category, the length of stay and the rehabilitation needed. Ask the hospital for a written estimate before planned surgery.

Most health insurance policies in India cover medically necessary spine surgery, subject to the policy's terms, sub-limits and waiting periods for existing conditions. Check your cover with your insurer or the hospital's insurance desk before admission.

Spine surgery in Pune is performed by neurosurgeons and orthopaedic spine surgeons. Dr Jaydev Panchawagh, MS (General Surgery) and MCh (Neurosurgery), is a consultant neurosurgeon in Pune with 27 years of independent neurosurgical practice and more than 3,000 spine surgeries. Clinic: 102, Bhagyatara Society, Erandwane, Pune 411004.

Bring your MRI and other scan images (not only the reports), previous treatment records, a list of your current medicines including blood thinners, and a note of your main symptoms and when they started. It also helps to bring a family member to discuss options.