22 July 2026

How Spine Surgery Works — What Happens and What to Expect

A close-up shot of a doctor’s hands explaining the anatomy of a spine through a model and holding a pencil in another hand.

Back surgery makes most people nervous, and understandably so. The spine houses the spinal cord and the nerve roots that control movement and sensation throughout the body. Operating near these structures sounds risky. The reality is that the most common spine operations — disc removal, decompression, single-level fusion — are among the more predictable in orthopaedic surgery when done by experienced surgeons for the right indications.

What makes the difference is matching the right operation to the right diagnosis. Spine surgery fails most often when it is done for the wrong reason, not because the technique is inherently unreliable.

The Most Common Spine Conditions That Lead to Surgery

1. Lumbar disc herniation: A disc between two vertebrae in the lower back bulges or ruptures, and disc material presses on a nerve root. The result is pain radiating down the leg (sciatica), sometimes with numbness or weakness. Most disc herniations resolve without surgery in six to twelve weeks. Surgery is indicated when conservative treatment fails, when weakness is progressing, or when the pain is severe and not improving.

2. Spinal stenosis: Narrowing of the spinal canal that compresses the spinal cord or nerve roots. Usually develops gradually as the facet joints and ligaments thicken with age. Causes leg pain and weakness that comes on with walking and is relieved by rest — classic neurogenic claudication. When lifestyle restriction is significant, surgery decompresses the nerves.

3. Spondylolisthesis: One vertebra slips forward over the one below. Causes back pain and often leg symptoms. When the slip is significant or unstable, surgery stabilises the spine.

4. Cervical disc disease: Similar to lumbar disc herniation but in the neck. Causes arm pain, hand weakness, or in severe cases, myelopathy — pressure on the spinal cord itself causing difficulty walking, hand clumsiness, and bladder symptoms. Cervical myelopathy is a surgical emergency — delaying operation risks permanent neurological deficit.

5. Spinal deformity (scoliosis, kyphosis): Abnormal curvature of the spine. Adults can develop degenerative scoliosis that causes pain and imbalance. Adolescents with progressive scoliosis may need surgical correction.

The Operations — What Each Involves

1. Microdiscectomy

For lumbar disc herniation. A small incision in the back over the affected disc level. A surgical microscope gives the surgeon magnified view. The ligamentum flavum is opened, the nerve root is gently moved aside, and the herniated disc material pressing on the nerve is removed.

The nerve is no longer compressed. In most patients, the sciatic leg pain resolves within days to weeks of surgery. The incision is a few centimetres. Hospital stay is one to two days. Patients can walk the same day as surgery.

2. Laminectomy / Decompression

For spinal stenosis. The lamina — the back wall of the vertebral canal — is removed or thinned to create more space for the compressed nerve roots. The key technical challenge is removing enough bone to relieve the compression without destabilising the spine. If decompression requires removing too much bone, fusion may need to be added.

3. Spinal Fusion

For spondylolisthesis, deformity, instability, or multi-level degenerative disease. The goal is to permanently join two or more vertebrae together, eliminating movement at the painful level. Bone graft — the biological material that eventually fuses the vertebrae — is placed between or around the vertebrae. Screws, rods, and cages provide immediate stability while the fusion heals over twelve months.

Multiple approaches:

TLIF (Transforaminal Lumbar Interbody Fusion) — from the back, placing a cage in the disc space through the foramen
PLIF (Posterior Lumbar Interbody Fusion) — from the back, through the central canal
ALIF (Anterior Lumbar Interbody Fusion) — from the front of the abdomen

4. Cervical Disc Surgery

ACDF (Anterior Cervical Discectomy and Fusion): The standard operation for cervical disc disease. A small incision in the front of the neck. The disc is removed, a cage filled with bone graft is placed, and a small plate is screwed to the vertebrae above and below to maintain stability. Hospital stay is one to two days.

Cervical Disc Replacement: An artificial disc replaces the removed disc, preserving motion at that level. Preferred over fusion in younger patients who want to maintain neck mobility and avoid adjacent segment disease. Available at India's top spine centres.

5. Minimally Invasive Spine Surgery (MISS)

All of the above operations can be performed through smaller incisions using tubular retractors that dilate rather than cut through the muscles. The same surgical goals are achieved but with less muscle trauma, less blood loss, shorter hospital stay, and faster recovery.

Endoscopic spine surgery — the most minimal approach — uses a thin endoscope through a tiny incision. For appropriate disc herniations and stenosis cases, some patients are discharged the same day. Available at Fortis FMRI and Medanta.

Robotic spine surgery — during fusion procedures, robotic guidance systems help place screws with greater accuracy. Particularly valuable for multi-level fusion where misplaced hardware risks nerve damage. Available at Fortis FMRI.

What Recovery Looks Like

Recovery varies significantly by procedure:

1. Microdiscectomy: Leg pain often resolves within days. Most patients walk on the day of surgery. Back to normal activity in two to four weeks. No long-term restrictions.

2. Laminectomy: Hospital stay two to three days. Recovery four to six weeks. Gradual return to normal activity.

3. Single-level fusion: Hospital stay three to five days. Recovery three to four months before fusion is solid, though most patients are mobile much sooner. Lifting restrictions for three months.

4. Multi-level fusion or deformity correction: Longer hospital stay, longer recovery. Six to twelve months for full fusion, though patients are active well before that.

Spine Surgery Hospitals in Prime Medical's Network

Fortis Memorial Research Institute, Gurugram (JCI, NABH, NABL) — Strong spine surgery department. Minimally invasive and robotic approaches. Complex deformity and revision surgery.

Artemis Hospital, Gurugram (JCI, NABH) — Prime Medical partner. Good spine department. Minimally invasive techniques.

Max Super Speciality Hospital, Saket, Delhi (JCI, NABH, NABL) — Robotic spine surgery available. Strong orthopaedic team.

Indraprastha Apollo Hospital, New Delhi (JCI, NABH) — Full spine programme. Cervical disc replacement available.

For patients from Addis Ababa, Dire Dawa, Kampala, Mbarara, Arusha, Dar es Salaam, or Banjul with disc, spine stenosis, or other spine conditions: share MRI scans and a description of symptoms with Prime Medical Solutions. A spine specialist reviews within 48 hours.

To book a consultation, call the number on our website.

Medical Disclaimer: Prime Medical Solutions is a facilitation and coordination partner and does not provide medical advice, diagnosis, or treatment. The content on this website, including text, graphics, and resources, is for informational purposes only and is not a substitute for professional medical advice. Always consult with a qualified physician or healthcare provider regarding any medical condition or treatment. Never disregard or delay seeking professional medical advice. Read our full Medical Disclaimer.