Meet Dr. Sravisht "Chevy" Iyer
Dr. Sravisht Iyer is a spine surgeon specializing in minimally invasive procedures to treat cervical, thoracic, and lumbar spine conditions. He works closely with each patient to identify treatment options that prioritize durable long-term outcomes while minimizing postoperative pain and recovery time.
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Meet Atlas, Spine Care AI Assistant
Atlas is not a generic chatbot. Atlas is a specialized AI assistant trained exclusively on Dr. Iyer's extensive research, published papers, curated information from reputed sources, and patterns observed in his clinical practice, to provide evidence-based information tailored to spine care. In addition, Atlas can also provide personalized guidance to Dr. Iyer's patients.
300+ research papers
Peer-reviewed research articles and papers authored by Dr. Iyer
15+ years of data
Anonymized case data from more than a decade of surgeries by Dr. Iyer
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Personalized guidance to current patients
About Dr. Iyer
Leading the way in minimally invasive spine surgery and partnering with each patient for optimal outcome and faster pain relief
Dr. Iyer completed his undergraduate training in biomedical engineering at Johns Hopkins University where he was inducted into the Tau Beta Pi honor society. He subsequently attended Harvard Medical School receiving an MD with honors (Magna Cum Laude) and a specialized degree in Health Sciences in Technology with coursework at Harvard and MIT. He completed his orthopedic residency at Hospital for Special Surgery followed by fellowship at Rush University Medical Center.
Dr. Iyer has also had the opportunity to travel internationally to learn specialized techniques in spinal surgery including time spent with Dr. Oheneba Boachie-Adjei at the FOCOS Orthopedic Hospital in Accra, Ghana.
Dr. Iyer strongly believes in advancing the field of spine surgery. His research interest in spine surgery began in medical school where he published and presented award-winning research on the biomechanics of spine.
His work has been presented and honored at several national and international conferences and has since appeared in the pages of prestigious peer-reviewed journals including Spine, Neurosurgery and the Journal of Bone and Joint Surgery.
At HSS, he has received several honors, including: the HSS Academic Achievement Award, the Weill Cornell Medical Center Distinguished Housestaff Award, the Eduardo A. Salvati Resident Research Grant and the Lewis Clark Wagner Resident Research Award.
Dr. Iyer currently sees patients in New York City and Westchester.
B.S. Biomedical Engineering
Tau Beta Pi Honor Society
M.D. with Honors (Magna Cum Laude)
Health Sciences in Technology (HST) Program from Harvard-MIT
Spine Surgery Fellowship
Orthopedic Surgery Residency
> Attending Orthopedic Surgeon, Hospital for Special Surgery
> Research Director, Spine Service, Hospital for Special Surgery
> Co-Director, HSS Athletes Spine Program
> Associate Professor in Orthopedic Surgery, Weill Cornell Medical College
> Associate Attending Orthopedic Surgeon, NewYork-Presbyterian Hospital
Conditions Treated
Comprehensive care for a wide range of spine and orthopedic conditions
Neck & Arm Symptoms (Cervical Spine)
Low Back & Leg Symptoms (Lumbar Spine)
Spine Alignment & Deformity
Arthritis & Degenerative Conditions
Trauma & Injury
Procedures Performed
Comprehensive surgical care for the full range of cervical, thoracic, and lumbar conditions
Cervical Spine Procedures
Lumbar Spine Procedures
Thoracic Spine Procedures
Scoliosis & Deformity Procedures
What his patients say about Dr. Iyer
"Dr. Iyer is not only a great doctor but just a compassionate guy"
I have had some serious neck and shoulder pain for approximately 2 years and I tried everything from having 3 series of ablations and 2 Epidurals, numerous chiropractic visits and nothing worked. 2 weeks after having posterior cervical formatory surgery. I feel great. Dr Iyer is not only a great dr. But just a compassionate guy that I always felt comfortable with in making this decision of having surgery. Thank you again for allowing a chance to have my old life back
Antonio Cintron
"Amazing, brilliant and down-to-earth surgeon"
Dr. Iyer performed diskectomy on my back. My pain specialist, Dr. Hung recommended a MRI and knew that it was time for me to see a surgeon. Dr. Hung recommended Dr. Iyer. I was able to get an appointment with him within a week. My husband and I were thoroughly impressed with Dr. Iyer's knowledge, expertise and his bedside manner. He was very patient and compassionate. His level of empathy really resonated with me. He explained the procedure in detail and put me at ease. After my surgery, the same day I was able to come home. Any time I had a question or a concern, he would call me back promptly. I am very thankful to him for being such an amazing, brilliant and down-to-earth surgeon.
Divya Dodhia
"If they had a 10-star rating I would give a 10"
Where Do I begin? If they had a 10 Star Rating I would've given them 10. Dr. Iyer and his staff were great and continue to amaze me. This was my first time ever having Surgery I was very nervous and anxious but when It was time I was super confident and comfortable having Dr Iyer and his Team by my side. Suffering from back pain/back injury as a young male I regained my confidence, strength, mobility, and overall mental health after the surgery feeling at ease and "normal" again. I would definitely brag about and recommend Dr. Iyer and his Team to anyone suffering from Spinal Injuries, pain and complications.
Randy Mera
Arm Pain (Pinched Nerve)
A "pinched nerve," medically known as nerve compression or radiculopathy, occurs when too much pressure is applied to a nerve by surrounding tissues, such as bones, cartilage, muscles, or tendons. This pressure interferes with the nerve's ability to function correctly, leading to various symptoms. In many cases, a herniated disc or a bone spur can be the culprit in the spine. Symptoms typically include a range of sensations like pain, numbness, "pins and needles" (paresthesia), burning, or tingling in the affected area, which may radiate away from the source of the pressure (e.g., down the arm or leg). Muscle weakness in the distribution of the affected nerve is also a common sign.
While many pinched nerves respond well to conservative treatments like rest, physical therapy, and anti-inflammatory medications, it is important to seek medical advice for a proper diagnosis and treatment plan. For further reading and in-depth information from trusted sources, explore these educational links:
Educational Resources
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Balance Problems (Myelopathy)
Myelopathy is the clinical term for compression of the spinal cord itself. unlike a "pinched nerve" (radiculopathy) which affects the nerve roots exiting the spine, myelopathy affects the main bundle of nerves running through the spinal canal. In the neck, this is often called Cervical Spondylotic Myelopathy (CSM) and is typically caused by age-related wear and tear, such as spinal stenosis, large disc herniations, or ossification of ligaments that narrow the space available for the cord.
Because the spinal cord is the main communication highway between the brain and body, symptoms can be widespread and progressive. Patients often notice difficulty with fine motor skills (like buttoning shirts or handwriting), "heavy" or stiff legs, and balance issues (feeling unsteady or stumbling). Because the spinal cord does not heal easily, early diagnosis and treatment are crucial to prevent permanent nerve damage.
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Cervical Herniated Disc
A cervical herniated disc occurs when one of the discs in the neck ruptures or bulges, allowing its inner material to press on a nearby nerve. This can happen due to natural age-related wear (degenerative disc changes) or from an injury. When the disc material irritates a nerve, it can cause sharp or burning pain that radiates from the neck into the shoulder, arm, and even the hand.
Common symptoms include neck pain, numbness or tingling in the arm, weakness in the shoulder or hand, and pain that worsens with certain movements. While many patients improve with rest, physical therapy, posture correction, and anti-inflammatory medications, persistent or worsening symptoms may require advanced evaluation. In some cases, targeted injections or cervical spine surgery may be recommended to relieve pressure on the nerve.
Educational Resources
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Neck Pain
Neck pain is one of the most common spine-related symptoms, affecting people of all ages. The cervical spine supports the head, protects the spinal cord, and allows for motion — which means strain, posture, arthritis, or disc problems can easily lead to discomfort. Neck pain may be sharp or dull and may worsen with movement, prolonged sitting, phone or laptop use, or poor sleep posture.
In some cases, neck pain can also be accompanied by muscle tightness, headaches, shoulder pain, or tingling in the arms or hands if a nerve becomes irritated. While many cases improve with rest, posture correction, and physical therapy, persistent or radiating pain may indicate issues such as a cervical disc herniation, degenerative disc disease, or nerve compression. A proper evaluation helps identify the underlying cause and guide treatment.
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Whiplash
Whiplash is a neck injury caused by a rapid back-and-forth motion of the head — most commonly from motor vehicle collisions, but it can also occur during sports, falls, or any sudden impact. This abrupt motion strains the muscles, ligaments, and joints of the cervical spine, leading to pain and stiffness. Symptoms may appear immediately or develop gradually over 24–48 hours.
People with whiplash often experience neck pain, limited range of motion, headaches, shoulder or upper-back discomfort, dizziness, or fatigue. Most cases improve with rest, gentle stretching, physical therapy, and over-the-counter pain relief. However, persistent pain or neurological symptoms (numbness, tingling, or weakness) may indicate deeper injury requiring medical evaluation.
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Back Pain
Back pain is one of the most common medical problems, affecting eight out of ten people at some point in their lives. It can range from a constant, dull ache to a sudden, sharp pain that makes it difficult to move. Acute back pain comes on suddenly and usually lasts from a few days to a few weeks. It is often caused by a fall or heavy lifting. Chronic back pain is defined as pain that lasts for more than three months.
The back is a complex structure of bones, muscles, nerves, ligaments, and tendons. Pain can arise from any of these structures. Common causes include muscle or ligament strain, bulging or ruptured disks, arthritis, and osteoporosis. Risk factors include age, lack of exercise, excess weight, improper lifting, and smoking. Most back pain improves with home treatment and self-care, usually within a few weeks.
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Leg Pain
Leg pain can arise from many different sources, including nerve irritation, muscle strain, joint problems, or issues in the spine. When the pain originates from the lumbar spine (lower back), it often radiates down the buttock, thigh, or calf - a pattern known as radiculopathy or sciatica. This happens when a spinal nerve is compressed or inflamed due to a disc herniation, arthritis, stenosis, or muscular tightness.
Symptoms can include sharp or burning pain, numbness, tingling, or weakness in the leg. Some patients experience worsening pain when standing or walking, while others feel relief when bending forward or sitting. Treatment depends on the underlying cause and may include physical therapy, stretching programs, anti-inflammatory medications, activity modifications, or in more persistent cases, injections or surgical options. A proper diagnosis is key to determining the best treatment path.
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Lumbar Herniated Disc
A lumbar herniated disc, often called a "slipped" or "ruptured" disc, is a common cause of lower back and leg pain. It occurs when the soft, gel-like center (nucleus) of a disc in the lower back pushes through a tear in its tough outer layer (annulus). This bulging material can press on sensitive spinal nerves, leading to inflammation and pain. While aging and general wear and tear are the most common causes, improper lifting or sudden twisting movements can also trigger a herniation.
Symptoms typically include sharp pain in the lower back that radiates down into the buttocks, thigh, and leg (sciatica). Patients may also experience numbness, tingling, or weakness in the affected leg or foot. In most cases, symptoms improve within a few weeks with non-surgical treatments such as rest, physical therapy, and anti-inflammatory medication. Surgery is generally reserved for severe cases where pain persists or there is significant muscle weakness.
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Sciatica
Sciatica is a term used to describe pain which radiates from the low back or buttock into the leg. It is so called because pain is generally felt along the course of the sciatic nerve.
The sciatic nerve is the largest nerve in the human body. The sciatic nerve originates from several nerves in your lower back, much like small streams coming together to form a river. These nerves extend from the lumbar (lower) spine and come together between the muscles of each buttock to form the sciatic nerve. The sciatic nerve then travels down each leg before dividing into smaller branches. The sciatic nerve carries movement signals down to the muscles of the leg and sends pain, temperature, and other sensory signals up to the brain. Symptoms of "sciatica" radiate along the same path.
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Spinal Stenosis
Spinal stenosis is a condition characterized by the narrowing of the spaces within your spine, most commonly in the lower back (lumbar stenosis) and neck (cervical stenosis). This narrowing can put pressure on the spinal cord and the nerves that travel through the spine. It is typically a degenerative condition that develops gradually as a result of the aging process, often related to osteoarthritis.
As the space within the spinal canal becomes more restricted, it can compress nerve roots, leading to symptoms such as pain, numbness, tingling, and weakness in the back, neck, arms, or legs. A classic symptom of lumbar stenosis is pain or cramping in the legs when standing for long periods or walking, which is relieved by sitting or leaning forward. While some people have no symptoms, others may experience significant discomfort and limitations in their daily activities. Treatment usually starts with non-surgical options like physical therapy, medications, and injections. Surgery is considered when conservative methods fail to provide relief and quality of life is significantly impacted.
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Slipped Disc (Disc Herniation)
"Slipped Disc" is the common term for a disc herniation. Since this term is often used interchangeably with the specific cervical and lumbar conditions, this section serves as a helpful general overview.
A "slipped disc" is the common name for a medical condition called a disc herniation. Despite the name, the disc doesn't actually slip out of place. Instead, the soft, jelly-like center of the disc (nucleus) pushes out through a tear in the tough outer ring (annulus). This is similar to the filling of a jelly donut squeezing out. When this material protrudes, it can irritate or compress nearby spinal nerves, causing pain, numbness, or weakness.
While a slipped disc can occur anywhere in the spine, it is most common in the lower back (lumbar spine) and the neck (cervical spine). The condition is often the result of gradual, age-related wear and tear called disc degeneration, but it can also be caused by lifting heavy objects the wrong way or sudden twisting motions. Many patients find relief through non-surgical methods like physical therapy, rest, and medications.
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Instability
"Spinal Instability" (often called Segmental Instability) is a specific functional diagnosis where the vertebrae move more than they should, which is distinct from the permanent slippage seen in Spondylolisthesis.
Spinal/Segmental instability occurs when the structures that normally stabilize the spine - such as the discs, ligaments, and facet joints - wear down or become loose. Unlike a fixed deformity, this condition involves abnormal or excessive movement between two vertebrae when you move. It is often described as a "micro-motion" that creates pain when shifting positions, such as standing up from a chair or rolling over in bed.
Patients often describe a feeling that their back is "giving way," "locking," or feeling weak. The pain is typically mechanical, meaning it worsens with specific movements and improves when the spine is held still or supported (like when wearing a brace). Over time, the body may try to stabilize this excessive motion by growing bone spurs, which can eventually lead to spinal stenosis. Physical therapy focused on core stabilization is the primary treatment to help muscles compensate for the loose joints.
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Kyphosis
Kyphosis is a spinal condition characterized by an excessive outward curve of the upper back, often creating a rounded or "hunchback" appearance. While a slight curve in the thoracic spine is normal, kyphosis involves a curvature of 50 degrees or more. It can affect patients of all ages but is particularly common in adolescents (often as Scheuermann's kyphosis) and older adults (where it may be related to osteoporosis or fractures).
In addition to the visible rounding of the back, symptoms can include back pain, stiffness, and fatigue. In severe cases, the curve may progress to the point where it impacts balance or breathing. Treatment depends on the severity of the curve and the underlying cause, ranging from observation and physical therapy to bracing or, in rare cases, surgery to correct the deformity.
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Scoliosis
Scoliosis is a condition where the spine curves sideways, often forming an "S" or "C" shape rather than a straight line. In adults, scoliosis may be a continuation of a curve that began earlier in life, or it may develop gradually due to age-related degeneration affecting the discs and joints of the spine. Some people notice uneven shoulders or posture changes, while others experience back pain, stiffness, or fatigue from the spine working harder to stay balanced.
Symptoms depend on the degree of curvature and whether the nerves are affected. Mild scoliosis may only need observation and specialized exercises, while more significant curves can cause nerve irritation, difficulty standing upright, or progressive deformity over time. Treatment options include physical therapy, activity modification, non-operative pain management, and in select cases, surgery to realign and stabilize the spine.
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Cervical Spondylosis
Cervical spondylosis is the medical term for age-related wear and tear in the joints and discs of the neck. Over time, the discs may lose hydration, the vertebrae can develop bone spurs, and the spinal joints may become arthritic. These changes are extremely common and often part of the natural aging process. Many people have cervical spondylosis without symptoms, while others may experience neck stiffness, aching, headaches, or pain that radiates into the shoulder or arm.
Symptoms occur when inflammation, nerve irritation, or reduced space in the spinal canal leads to discomfort or neurological changes. Most cases improve with non-surgical care such as physical therapy, posture training, anti-inflammatory medications, and activity modifications. If nerve compression or spinal cord pressure develops, further evaluation or advanced treatment may be needed.
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Degenerative Disc Disease
Degenerative disc disease is a condition in which the spinal discs - the cushions between the bones of your spine - gradually lose height, flexibility, and water content over time. As the discs wear down, they may no longer absorb shock as well, which can contribute to neck or low back pain, stiffness, and sometimes radiating pain if nearby nerves are irritated. Despite the word "disease," this process is often a normal part of aging, and not everyone with disc degeneration will have pain.
When symptoms do occur, they may include pain with sitting, bending, or twisting, as well as episodes of flare-ups followed by periods of improvement. Treatment usually starts with non-surgical care: physical therapy, targeted exercises, activity modification, anti-inflammatory medications, and sometimes injections. Surgery is considered only if pain remains severe or if there is significant nerve compression affecting quality of life.
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Degenerative Spondylolisthesis
Degenerative spondylolisthesis occurs when one vertebra slips forward over the one below it as a result of age-related wear. Over time, the spinal discs may lose height and the joints in the back of the spine (facet joints) may become arthritic and loosen. This combination can allow the vertebra to shift forward, most commonly in the lower back at the L4-L5 level. Many people first notice symptoms such as low back pain, stiffness, or leg pain that worsens with standing or walking and improves with sitting or leaning forward.
When the slip compresses nearby nerves, it can lead to numbness, tingling, heaviness, or radiating leg pain (often similar to sciatica). Treatment usually begins with nonsurgical care such as physical therapy, posture training, core strengthening, anti-inflammatory medication, and sometimes injections. Surgery may be considered if pain persists despite treatment or if nerve compression significantly affects mobility or quality of life.
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Facet Arthropathy
Facet arthropathy refers to arthritis or wear-and-tear affecting the small joints located at the back of the spine, called facet joints. These joints help guide motion and provide stability. Over time, the cartilage inside them can wear down, and the surrounding structures may become irritated or inflamed. This can lead to localized back or neck pain, stiffness, and discomfort that worsens with standing, twisting, or leaning backward.
Facet joint pain can sometimes mimic other conditions - such as disc problems or muscle strain - so diagnosis often involves a physical exam, imaging, and occasionally targeted injections. Treatment typically includes physical therapy, posture correction, anti-inflammatory medications, activity modification, and in some cases, injections that reduce inflammation around the joint. Most people improve without surgery, but persistent symptoms related to spinal instability or nerve compression may require further evaluation.
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Fractures / Spinal Trauma
Spinal trauma refers to damage to the spine's vertebrae, ligaments, or disks, often resulting from sudden incidents like car accidents, falls, or sports injuries. These injuries can range from mild fractures that heal with bracing to severe dislocations or spinal cord injuries (SCI) that may cause permanent loss of function or paralysis. Immediate and specialized care is critical to stabilize the spine and prevent further damage to the spinal cord.
Treatment for spinal trauma depends on the severity and location of the injury. Stable fractures may be managed with immobilization and physical therapy, while unstable fractures or those compressing the spinal cord often require surgical intervention to realign the bones and relieve pressure on the nerves. Rehabilitation plays a vital role in recovery, helping patients regain strength and adapt to any lasting changes in function.
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Anterior Cervical Discectomy Fusion
Anterior Cervical Discectomy and Fusion, or ACDF, is a surgery performed through a small incision in the front of the neck to relieve pressure on a spinal nerve or the spinal cord. During the procedure, the damaged disc is removed, the nerve is decompressed, and a spacer is placed in the disc space. A small plate is often added to help stabilize the spine as it heals and fuses.
When is ACDF recommended?
ACDF is typically considered when neck or arm symptoms do not improve with nonsurgical care. It is most commonly used for conditions such as:
- Cervical herniated disc
- Cervical radiculopathy (pinched nerve causing arm pain)
- Cervical spondylosis with nerve compression
- Cervical spinal stenosis
- Progressive weakness or numbness in the arm
ACDF is usually recommended when pain persists despite physical therapy, medications, or injections, or when there is significant nerve compression causing neurological symptoms.
What does recovery look like?
Most patients go home the same day or after an overnight stay. Soreness in the front of the neck is normal for a few days. Many people return to light activities or desk work within 1–2 weeks, while more physically demanding work may require additional time.
Walking is encouraged early, but heavy lifting and strenuous activity are restricted for several weeks. The fusion itself takes several months to fully heal, and most patients steadily increase their activities during this time.
Success Rate
ACDF is one of the most reliable spine surgeries for relieving arm pain, numbness, and tingling caused by nerve compression. Many patients experience significant improvement within days to weeks. Neck pain also often improves, although results can vary. Long-term outcomes are generally strong when the surgery is performed for the right reasons and after conservative treatments have been tried.
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Cervical Disc Replacement
Cervical disc replacement is a motion-preserving surgery in which a damaged disc in the neck is removed and replaced with an artificial disc made of metal and/or medical-grade plastic. Instead of permanently fusing two vertebrae together, the artificial disc is designed to maintain some of the normal movement at that level of the spine.
Where ACDF creates a solid bridge of bone between two vertebrae, disc replacement aims to relieve pressure on the nerves and spinal cord while still allowing the neck to bend, rotate, and flex more naturally at that segment.
When is it recommended?
Dr. Iyer may consider cervical disc replacement when:
- A single (or sometimes two) cervical discs are worn out or herniated
- Symptoms such as arm pain, numbness, tingling, or weakness are caused by nerve compression from that disc
There may also be neck pain related to the diseased disc.
Non-surgical treatments (physical therapy, medications, injections, activity modification) have not provided adequate relief
The procedure is most often used for:
- Cervical disc herniation
- Cervical radiculopathy (pinched nerve in the neck causing arm symptoms)
- Selected cases of cervical myelopathy or degenerative disc disease, when the anatomy and overall neck alignment are appropriate for a motion-preserving option.
It is not suitable for everyone. Significant arthritis in the facet joints, spinal instability, marked deformity, osteoporosis, or multi-level disease may make fusion (ACDF) a safer or more reliable option.
What happens during surgery?
- The surgery is usually performed through a small incision in the front of the neck, similar to ACDF.
- The damaged disc is carefully removed to decompress the spinal cord and nerve roots.
- Bone spurs or herniated disc fragments are cleaned out to give the nerves more space.
- Instead of placing a bone graft and plate (as in ACDF), Dr. Iyer prepares the endplates and inserts a custom-sized artificial disc between the vertebrae.
- The device is secured so it can move in a controlled way, mimicking the motion of a healthy disc while maintaining stability.
Most patients go home the same day or after one night in the hospital, depending on their overall health and how they feel after surgery.
What does recovery look like?
Recovery after cervical disc replacement is often quicker than after a fusion, though every patient is different.
- Many patients notice immediate improvement in arm pain, though numbness and weakness may take longer to improve as the nerve heals.
- Neck soreness and muscle tightness are common for a few weeks.
- A soft collar may be used briefly, but many patients do not require a long period of bracing because the motion segment is supported by the artificial disc.
- Light activities (walking, gentle daily tasks) begin within days.
- Desk or sedentary work is often possible in 1–3 weeks, depending on comfort and job demands.
- More physical work, heavy lifting, or high-impact sports typically require 6–12 weeks or longer, guided by follow-up visits and imaging.
Dr. Iyer's team will provide a structured plan for activity progression, posture, and neck strengthening to help you return safely to your routines.
Expected Outcomes & Success Rate
For appropriately selected patients, cervical disc replacement has shown:
- High rates of pain relief in the arm and improvement in nerve symptoms
- Reduced neck pain when it is related to the diseased disc
- Preservation of motion at the treated level, which may help reduce stress on the discs above and below
- Durable results with many devices performing well in studies 10+ years after surgery
As with any spine surgery, there are risks: infection, nerve or spinal cord injury, swallowing or voice changes (usually temporary), device-related complications, or the possibility that symptoms do not fully resolve. Long-term, a small number of patients may need revision surgery if the disc wears out, shifts, or if new problems develop at other levels.
How this connects to your symptoms?
Cervical disc replacement may be discussed if you have:
- Neck & arm pain (cervical radiculopathy)
- Cervical disc herniation on imaging
- Symptoms that match the "Neck & Arm Symptoms (Cervical Spine)" group on this page and have not responded to non-surgical care.
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Cervical Foraminotomy
A cervical foraminotomy is a minimally invasive spine surgery designed to relieve pressure on a spinal nerve in the neck. Each nerve exits the spinal canal through a small opening called the foramen. When this opening becomes narrowed - often due to a herniated disc, bone spurs, or arthritic changes - it can compress the nerve and cause pain that radiates into the shoulder, arm, or hand.
During the procedure, the surgeon removes the bone spurs or soft tissue that are crowding the nerve root. Unlike fusion surgery, a foraminotomy preserves the natural motion of the spine because no implants or plates are used.
When is it recommended?
A cervical foraminotomy is typically considered when:
- A pinched nerve causes radiating arm pain, numbness, tingling, or weakness
- Conservative treatments (physical therapy, medications, injections) fail to provide relief
- Imaging shows foraminal stenosis, bone spurs, or a small lateral/foraminal disc herniation
- The pain consistently affects daily activities, sleep, or function
- It is often recommended for conditions such as:
- Cervical radiculopathy
- Foraminal stenosis
- Lateral cervical disc herniation
- Bone spurs compressing nerve roots
What happens during surgery?
- A small incision is made on the back of the neck, directly over the affected nerve.
- Using minimally invasive tools, the surgeon gently separates the muscles rather than cutting through them.
- Bone spurs, thickened ligaments, or herniated disc fragments that are narrowing the foramen are carefully removed.
- The nerve root is decompressed and given more room to exit the spine naturally.
- No implants, plates, or fusion materials are used, so motion at that level of the spine is preserved.
- Most patients are able to go home the same day.
What does recovery look like?
Recovery after cervical foraminotomy is typically smooth because the spine is not fused and the incision is small.
Most patients experience:
- Noticeable improvement in arm pain within days
- Mild soreness around the incision for a few days
- Return to light activity in 1–2 weeks
- Increased activity and strengthening at 4–6 weeks
- Gradual return to full function with guidance from follow-up visits
Neck mobility is usually maintained, and many patients resume normal activities sooner than with fusion procedures.
Expected Outcomes & Success Rate
Cervical foraminotomy has consistently strong outcomes for patients with nerve compression from bone spurs or lateral disc herniations.
Typical results include:
- Significant relief of arm pain in 80–90% of patients
- Improvement in numbness or tingling as the nerve heals
- Preservation of normal neck motion
- Low complication rates
- Durable long-term relief when performed for the right indications
How this connects to your symptoms?
A compressed nerve in the neck can cause more than just neck discomfort - it often produces radiating pain, numbness, tingling, or weakness that travels down the shoulder, arm, or hand. This pattern is called cervical radiculopathy and commonly results from narrowed foramina.
If you experience:
- Arm pain that worsens when turning or tilting the head
- Numbness or tingling in a specific pattern down the arm
- Weakness when lifting or gripping
- Pain that improves when placing your hand on top of your head
these symptoms may be caused by a nerve compressed as it exits the spine.
Cervical foraminotomy directly targets this type of nerve compression.
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Cervical Fusion
Cervical fusion is a surgery that permanently joins two or more vertebrae in the neck to improve stability, relieve pressure on nerves or the spinal cord, and correct deformity. During the procedure, bone graft material is placed between adjacent vertebrae, and metal implants (such as screws, rods, or plates) are used to hold the spine in proper alignment while the bones fuse together over time.
Unlike motion-preserving options such as disc replacement or foraminotomy, cervical fusion intentionally eliminates motion at the operated level to create a stable, solid segment of bone.
When is it recommended?
Cervical fusion is typically considered when:
- There is spinal instability (vertebrae shifting abnormally)
- There is significant cervical stenosis or spinal cord compression
- Severe degenerative cervical spondylosis results in nerve or cord pressure
- There are multiple levels of disc or joint degeneration
- A deformity (such as kyphosis) requires correction
- A nerve is compressed and decompression alone would leave the spine unstable
Conditions often treated with cervical fusion include:
- Cervical myelopathy
- Instability from severe arthritis or spondylolisthesis
- Multi-level degenerative disc disease
- Recurrent disc herniations
- Post-traumatic instability or fractures
- Cervical kyphosis or deformity
Fusion can be performed through the front (anterior), back (posterior), or both sides of the neck depending on the condition and alignment needs.
What happens during surgery?
- A small incision is made either in the front or back of the neck based on the surgical plan.
- Compressed nerves or the spinal cord are carefully decompressed by removing bone spurs, thickened ligaments, or diseased disc tissue.
- Bone graft material is placed between the vertebrae to help them grow together into one solid piece.
- Metal screws, rods, or plates are used to hold the spine in proper alignment while fusion occurs.
- Over several months, the bone graft and vertebrae heal together to create a stable, fused segment.
Most patients go home the same day or after a short hospital stay, depending on the number of levels fused and overall health.
What does recovery look like?
Recovery varies depending on how many levels are fused and whether the approach is anterior or posterior.
Most patients experience:
- Improvement in arm pain relatively early
- Gradual reduction in neck pain as tissues heal
- Soreness around the incision for a week or two
- Return to light daily activity in 2–4 weeks
- Return to desk or computer work in 2–6 weeks
- Restrictions on heavy lifting, strenuous activity, and high-impact exercise for 8–12 weeks
- Full fusion maturing over 3–12 months, depending on the number of levels and bone quality
A neck brace may be recommended for additional support during early healing.
Expected Outcomes & Success Rate
Cervical fusion has been performed for decades and provides reliable, long-term improvement for conditions involving instability or nerve/spinal cord compression.
Patients typically experience:
- Significant relief of arm pain and nerve symptoms
- Improvement in hand coordination, balance, and walking when spinal cord pressure is relieved
- Better neck alignment when deformity is corrected
- A stable, reliable spine at the fused levels
Risks include infection, nerve or spinal cord injury, difficulty swallowing or voice changes (usually temporary), failure of the bones to fuse, or stress on adjacent levels over time - though overall complication rates are low.
How this connects to your symptoms?
When the vertebrae in the neck are unstable or when arthritis, disc collapse, or bone spurs begin to compress nerves or the spinal cord, symptoms can include:
- Neck pain and stiffness
- Radiating shoulder or arm pain
- Numbness or tingling in the hands or fingers
- Weakness when gripping or lifting
- Problems with balance or coordination
- A feeling that the head is "heavy" or hard to support
Cervical fusion addresses these symptoms by stabilizing the spine and relieving pressure on nerve structures that control strength, sensation, and fine motor function.
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Cervical Laminoplasty
Cervical laminoplasty is a motion-preserving surgery used to relieve pressure on the spinal cord in the neck. Instead of removing spinal bones (as in a laminectomy) or fusing vertebrae together, laminoplasty creates more space for the spinal cord by "hinging open" the bone at the back of the spine (the lamina). The lamina is then held open with small plates or bone struts so the spinal canal remains enlarged.
This technique decompresses the spinal cord while maintaining motion at most levels, making it an important option for selected patients with cervical spinal stenosis or myelopathy.
When is it recommended?
Laminoplasty is typically recommended when:
- There is cervical myelopathy (spinal cord compression causing symptoms such as clumsiness, difficulty with coordination, or balance problems)
- Imaging shows multi-level spinal stenosis across several vertebrae
- Symptoms are caused primarily by compression from the back of the spine
- Non-surgical treatments have not helped or symptoms are progressing
Conditions commonly treated with laminoplasty include:
- Cervical myelopathy
- Multi-level cervical spinal stenosis
- Ossification of the posterior longitudinal ligament (OPLL)
- Congenital or age-related narrowing of the spinal canal
Laminoplasty is usually performed when multiple levels need decompression without the need to fuse the spine.
What happens during surgery?
- The surgery is performed through an incision on the back of the neck.
- Neck muscles are gently lifted to expose the lamina at several levels.
- A thin "hinge" is created on one side of each lamina.
- The opposite side is carefully opened, similar to opening a door, to create significantly more space for the spinal cord.
- Small plates or spacers are used to hold the lamina open, preventing it from closing.
- No fusion is performed, allowing most of the natural motion of the cervical spine to remain intact.
Most patients stay in the hospital for one to two nights, depending on comfort, mobility, and overall health.
What does recovery look like?
Recovery after laminoplasty varies based on the number of levels treated and the severity of preoperative symptoms.
Most patients experience:
- Gradual improvement in hand coordination, balance, and walking over weeks to months
- Some neck stiffness or muscle soreness for several weeks
- Return to light activities within 2–4 weeks
- Return to desk work in 2–6 weeks, depending on comfort
- Restrictions on heavy lifting and strenuous activity for 8–12 weeks
- Progressive neurological improvement over several months, as the spinal cord recovers
A soft or rigid collar may be used temporarily, depending on the surgeon's preference and the patient's activity level.
Expected Outcomes & Success Rate
Cervical laminoplasty is known for:
- Effective decompression of the spinal cord across multiple levels
- Improvement in myelopathy symptoms, particularly hand coordination, balance, and walking
- Preservation of spinal motion, since no fusion is performed
- Lower likelihood of adjacent-level stress compared with multi-level fusion
- Durable long-term results when performed for the right indications
Possible risks include post-operative neck pain or stiffness, nerve irritation, C5 weakness (usually temporary), or - in rare cases - insufficient symptom improvement depending on the severity of spinal cord changes before surgery.
How this connects to your symptoms?
Cervical laminoplasty is designed to address symptoms that arise when the spinal cord is compressed in the neck.
These symptoms may include:
- Difficulty with balance
- Trouble with hand coordination or dropping objects
- Numbness or tingling in the arms or hands
- Weakness in the arms or legs
- Feeling unsteady or "off balance" when walking
- Difficulty fastening buttons, writing, or performing fine motor tasks
These issues are typical of cervical myelopathy, a condition caused by spinal cord compression. Laminoplasty aims to create more room for the spinal cord so these symptoms can stabilize or improve over time.
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Laminectomy
A laminectomy is a surgery that relieves pressure on nerves or the spinal cord by removing a small portion of bone called the lamina from the back of the spine. The lamina forms part of the "roof" over the spinal canal. When bone spurs, ligament thickening, disc bulges, or age-related narrowing reduce the space available for the nerves, the result can be pain, numbness, tingling, or weakness.
By removing the lamina and clearing the compression, a laminectomy creates more room for the spinal nerves or spinal cord to move freely.
When is it recommended?
A laminectomy is usually recommended when:
- There is spinal stenosis (narrowing of the spinal canal)
- Leg pain, heaviness, or numbness worsens with standing or walking
- Symptoms improve when bending forward or sitting (classic stenosis pattern)
- MRI shows nerve compression not relieved by nonsurgical treatments
- There is weakness or loss of function caused by nerve pressure
- Daily activities become limited despite physical therapy, medication, or injections
Conditions commonly treated with laminectomy include:
- Lumbar spinal stenosis
- Lumbar disc herniation with severe canal narrowing
- Cervical or thoracic stenosis (in selected cases)
- Degenerative changes that compress multiple nerve roots
In the lumbar spine, laminectomy is often performed without fusion unless there is instability.
What happens during surgery?
- A small incision is made in the back of the spine at the affected levels.
- Muscles are gently moved aside to expose the lamina.
- The lamina is partially or fully removed to open the spinal canal.
- Thickened ligaments or bone spurs compressing the nerves are removed.
- If needed, disc fragments causing pressure may also be taken out.
- The nerves are carefully freed and allowed more space within the canal.
Most laminectomies are done through minimally invasive techniques when appropriate, depending on the number of levels involved.
What does recovery look like?
Recovery varies depending on age, overall health, and the number of levels treated.
Most patients experience:
- Early relief of leg pain or heaviness
- Mild soreness at the incision for a few days
- Return to light daily activities in 1–2 weeks
- Return to desk work in 2–4 weeks
- Restrictions on heavy lifting and strenuous activity for 6–12 weeks
- Gradual increase in walking and mobility as tolerated
Physical therapy may be recommended to restore flexibility, posture, and core strength.
Expected Outcomes & Success Rate
Laminectomy is one of the most effective surgeries for leg symptoms caused by spinal stenosis, especially heavy, tired, or painful legs that worsen with walking.
Patients typically experience:
- Significant improvement in leg pain and walking endurance
- Reduced numbness and tingling as the nerves recover
- Greater mobility and ability to stand upright
- Durable long-term results when stenosis is the main cause of symptoms
Possible risks include infection, dural tears, nerve irritation, or - in cases with pre-existing instability - the possibility of needing fusion later, though this is not common for well-selected patients.
How this connects to your symptoms?
Spinal stenosis narrows the canal where the nerves travel. When you stand or walk, the canal becomes even tighter, causing symptoms such as:
- Leg pain, heaviness, or fatigue
- Numbness or tingling down the legs
- Difficulty walking long distances
- Relief when bending forward ("shopping cart sign")
- Reduced endurance or balance issues
A laminectomy directly addresses these problems by opening the canal and removing the structures pressing on the nerves.
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Lumbar Fusion
A lumbar fusion is a surgery that permanently joins two or more vertebrae in the lower back to stabilize the spine, reduce painful motion, and relieve pressure on the nerves. During the procedure, the damaged disc or arthritic joints are removed, bone graft is placed between the vertebrae, and implants (such as screws and rods) hold the spine in position while the bones fuse together over time.
Lumbar fusion is performed through different approaches depending on the anatomy and goals of surgery - including posterior, anterior, lateral, or a combination of these.
When is it recommended?
Lumbar fusion is typically considered when:
- There is spinal instability, such as vertebrae shifting abnormally
- Movement between vertebrae is painful
- There is spondylolisthesis (vertebral slippage)
- There is degenerative disc disease causing chronic mechanical back pain
- A disc herniation has recurred more than once
- Severe facet arthritis leads to instability
- There is deformity or collapse that needs correction
- Spinal stenosis requires decompression that would otherwise destabilize the spine
Conditions often treated with lumbar fusion include:
- Degenerative spondylolisthesis
- Degenerative disc disease
- Instability from arthritis or prior surgeries
- Recurrent lumbar disc herniation
- Adult scoliosis or deformity (in some cases)
Fusion is usually recommended only after non-surgical treatments have not provided meaningful or lasting relief.
What happens during surgery?
Depending on the surgical plan, lumbar fusion may be performed through the back, side, or front of the spine.
Common steps include:
- Removing the diseased disc or arthritic joint surfaces
- Decompressing the nerves by removing bone spurs, thickened ligaments, or disc material
- Placing bone graft between the vertebrae to encourage fusion
- Using metal screws and rods (instrumentation) to stabilize the spine during healing
- In some approaches, placing an interbody cage in the disc space to restore height and alignment
Over several months, the bone graft and vertebrae gradually heal together into one solid bone.
Most patients stay in the hospital one to three nights, depending on the approach and number of levels fused.
What does recovery look like?
Recovery after lumbar fusion varies by age, activity level, and the number of levels fused.
Most patients experience:
- Early improvement in leg pain if nerve compression was present
- Back soreness that improves gradually over weeks
- Return to light activities in 2–4 weeks
- Return to desk/office work in 4–6 weeks, depending on comfort
- Restrictions on bending, twisting, and lifting for 8–12 weeks
- A progressive walking program beginning shortly after surgery
- Full fusion typically maturing over 6–12 months
Physical therapy is often recommended to rebuild strength, restore mobility, and support long-term back health.
Expected Outcomes & Success Rate
Lumbar fusion has been used for decades and provides reliable improvement for well-selected patients.
Common benefits include:
- Reduction in back pain caused by painful spinal motion
- Relief of leg symptoms if nerve compression was also present
- Improved spinal stability and alignment
- Durable long-term results when fusion is achieved
- Improved quality of life and ability to participate in daily activities
Potential risks include infection, nerve irritation, hardware problems, incomplete fusion (non-union), or adjacent segment wear over time—though overall success rates remain high when the right indication is present.
How this connects to your symptoms?
Lumbar fusion is typically considered when movement itself causes pain or when instability in the spine leads to symptoms such as:
- Mechanical low back pain that worsens with bending or twisting
- Leg pain from nerve compression
- Difficulty standing upright
- A feeling that the back "gives out" with motion
- Symptoms that improve only temporarily with rest or medication
When vertebrae shift, collapse, or degenerate, the surrounding nerves can also become irritated. Fusion stabilizes the affected segment and removes the painful motion, helping both back and leg symptoms to improve.
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Anterior Lumbar Fusion
Anterior Lumbar Interbody Fusion (ALIF) is a spine surgery performed through the front of the lower abdomen to stabilize the lower spine, restore disc height, and relieve pressure on the nerves. During the procedure, the damaged disc is removed and replaced with a spacer or interbody cage, which is packed with bone graft to encourage fusion.
The anterior approach gives the surgeon direct access to the disc without moving spinal nerves or back muscles, often allowing for a larger implant and improved alignment.
When is it recommended?
ALIF is typically recommended when:
- There is degenerative disc disease causing chronic low back pain
- The disc space has collapsed, contributing to nerve compression
- There is spondylolisthesis (slippage of one vertebra over another)
- Spinal alignment needs to be restored
- A larger interbody device is beneficial to support fusion and stability
- Previous posterior surgeries have failed or created scar tissue
Conditions commonly treated with ALIF include:
- Degenerative disc disease
- Degenerative spondylolisthesis
- Isthmic spondylolisthesis
- Spinal instability
- Recurrent disc herniation
- Lumbar deformity requiring disc height restoration
ALIF may be performed alone or combined with additional screws and rods from the back (a "360° fusion") depending on stability needs.
What happens during surgery?
A small incision is made in the lower abdomen, often just to one side of the midline.
- In coordination with a vascular surgeon, the abdominal blood vessels are gently moved aside to access the spine.
- The damaged disc is removed, creating space for the interbody cage.
- A cage packed with bone graft is placed between the vertebrae to restore height and alignment.
- Depending on the plan, screws or plates may be placed to secure the cage.
- Over time, the bone graft helps the vertebrae grow together into a solid fusion.
Most patients stay one to two nights in the hospital, depending on comfort and mobility.
What does recovery look like?
Recovery after ALIF varies depending on age, health, and whether additional fusion was performed through the back.
Most patients experience:
- Early improvement in leg pain if nerve compression was present
- Gradual reduction in back pain as the spine stabilizes
- Return to light activity within 2–4 weeks
- Return to desk work in 4–6 weeks
- Restrictions on bending, twisting, and lifting for 8–12 weeks
- A progressive walking program starting shortly after surgery
- Full fusion maturing over 6–12 months
Abdominal soreness is normal for several weeks, especially when moving from sitting to standing or getting out of bed.
Expected Outcomes & Success Rate
ALIF has strong outcomes in properly selected patients because the approach allows:
- Restoration of disc height and alignment
- Indirect decompression of nerve roots
- Placement of a large, stable implant for better fusion rates
- Avoidance of large incisions in the back muscles
Patients typically experience:
- Improvement in low back pain related to disc collapse
- Relief of nerve symptoms when nerve roots are decompressed
- Better posture and spinal alignment
- Durable fusion and long-term stability
Potential risks include blood vessel injury, nerve irritation, bowel or bladder changes, implant issues, or incomplete fusion, though these are uncommon in experienced hands.
How this connects to your symptoms?
Degeneration or collapse of a lumbar disc can cause low back pain, stiffness, and nerve irritation. When the disc height narrows, nerve roots may become compressed, leading to:
- Leg pain, numbness, or tingling
- Pain that worsens with sitting or bending
- Low back pain that improves when lying down
- Difficulty standing upright
- Symptoms that fluctuate with activity
ALIF restores the disc height, stabilizes the motion segment, and creates space for the nerves - helping reduce both back and leg symptoms.
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Lateral Lumbar Fusion
Lateral Lumbar Fusion -often called XLIF (Extreme Lateral Interbody Fusion) or LLIF (Lateral Lumbar Interbody Fusion) - is a minimally invasive spine surgery performed through the side of the body to access the lumbar spine.
Through a small incision in the flank, the surgeon moves the muscles aside and works between the abdominal muscles and the psoas muscle to reach the spine without disrupting back muscles or spinal nerves.
The damaged disc is removed and replaced with an interbody cage that restores height, supports alignment, and encourages fusion between the vertebrae.
When is it recommended?
Lateral lumbar fusion is typically recommended when:
- Disc degeneration or disc collapse contributes to back or leg symptoms
- There is spondylolisthesis (vertebra slipping forward)
- Nerves are compressed from loss of disc height
- There is coronal or sagittal spinal deformity requiring correction
- Restoration of disc height and alignment is a priority
- A minimally invasive approach is preferred
- Previous posterior surgery has created scar tissue
Conditions often treated with XLIF/LLIF include:
- Degenerative disc disease
- Degenerative spondylolisthesis
- Adult spinal deformity
- Instability from arthritis
- Recurrent lumbar disc herniations
- Adjacent segment disease
The procedure is often combined with additional screws and rods for stability.
What happens during surgery?
A small incision is made on the side of the waist.
- Muscles are gently separated - not cut - to create a narrow path to the spine.
- Specialized instruments safely navigate around the psoas muscle and nerves that control leg function.
- The damaged disc is removed through tubular instruments.
- A large interbody cage packed with bone graft is inserted to restore height and alignment.
- Depending on stability needs, screws and rods may be placed from the back in the same surgery or in a staged procedure.
Most patients stay in the hospital for one night, though some go home the same day depending on comfort and mobility.
What does recovery look like?
Recovery after a lateral fusion is often faster than traditional open back surgery because the approach avoids cutting major back muscles.
Most patients experience:
- Early improvement in leg symptoms if nerve pressure was present
- Side or flank soreness for a few days
- Return to light activities in 2–3 weeks
- Return to desk work in 3–6 weeks
- Restrictions on twisting, bending, or lifting for 8–12 weeks
- A progressive walking program beginning shortly after surgery
- Full fusion developing over 6–12 months
Physical therapy may be recommended once early healing is complete.
Expected Outcomes & Success Rate
Lateral lumbar fusion is known for:
- Excellent restoration of disc height
- Indirect decompression of nerves
- Ability to place large, stable implants
- Less disruption to back muscles
- Improved spinal alignment
- Strong fusion rates and lasting symptom relief
Most patients experience:
- Reduced back pain from disc collapse or instability
- Relief of leg pain and numbness
- Improved posture and mobility
- Durable long-term stability when fusion is achieved
Potential risks include nerve irritation (especially those controlling hip flexion), thigh numbness or weakness (often temporary), implant issues, vascular injury, or incomplete fusion.
How this connects to your symptoms?
Loss of disc height or vertebral slippage can narrow the spaces where nerves travel, leading to symptoms such as:
- Leg pain, numbness, tingling, or heaviness
- Back pain worsened by standing or activity
- Difficulty walking long distances
- Relief when sitting or leaning forward
- Postural changes or spinal imbalance
Lateral lumbar fusion helps by restoring the disc height, realigning the spine, and stabilizing the motion segment - reducing pressure on the nerves and improving both back and leg symptoms.
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Microdiscectomy
A microdiscectomy is a minimally invasive spine surgery used to remove part of a herniated lumbar disc that is pressing on a spinal nerve. The procedure is done through a small incision in the lower back, using magnification and specialized instruments to remove only the portion of disc material causing nerve compression.
Microdiscectomy is one of the most effective surgeries for relieving sciatica — pain that radiates down the leg due to nerve irritation from a lumbar disc herniation.
When is it recommended?
Microdiscectomy is typically recommended when:
- A lumbar disc herniation is causing leg pain, numbness, tingling, or weakness
- Symptoms persist despite conservative treatments such as physical therapy, medications, or injections
- Severe sciatica affects daily activities or sleep
- There is progressive neurological weakness
- Imaging clearly shows disc material compressing a nerve root
Conditions commonly treated with microdiscectomy include:
- Lumbar disc herniation
- Sciatica from nerve compression
- Recurrent disc herniations
- Radiculopathy (leg pain following a nerve's path)
Microdiscectomy is not meant to treat general low back pain — it specifically targets nerve compression from a herniated disc.
What happens during surgery?
- A small incision is made in the lower back, usually 1–2 inches long.
- Muscles are gently separated to expose the lamina and ligament.
- A small portion of bone or ligament may be removed to reach the nerve root safely.
- Using magnification, the surgeon identifies the herniated disc fragment pressing on the nerve.
- Only the problematic disc material is removed; the rest of the disc is preserved.
- The nerve root is freed and allowed more space to heal.
Most patients go home the same day.
What does recovery look like?
Most patients experience rapid improvement in leg pain - often within hours to days of surgery.
Typical recovery milestones include:
- Mild back soreness for several days to a few weeks
- Return to light daily activities in 1–2 weeks
- Return to desk work in 2–4 weeks
- Avoid bending, twisting, or lifting for 6–8 weeks
- Gradual increase in walking and gentle mobility exercises
- Physical therapy may begin once early healing is complete
Since only a small portion of the disc is removed, most people regain normal mobility quickly.
Expected Outcomes & Success Rate
Microdiscectomy is one of the most successful procedures in spine care, especially for nerve compression from disc herniation.
Patients typically experience:
- Immediate or rapid improvement in leg pain
- Gradual improvement in numbness or tingling as the nerve heals
- Restoration of daily function and walking ability
- Low complication rates
- Durable symptom relief if the underlying disc remains stable
Risks include recurrent herniation (in a small percentage of patients), dural tear, nerve irritation, or continued back discomfort - though serious complications are uncommon.
How this connects to your symptoms?
A lumbar disc herniation can place pressure on the nerve root, leading to symptoms such as:
- Sharp or burning leg pain
- Numbness or tingling in the leg or foot
- Weakness when lifting the foot or standing on toes
- Pain that worsens with sitting, bending, or coughing
- Relief when lying down or walking
Microdiscectomy directly removes the disc fragment that is irritating the nerve, helping these symptoms improve quickly.
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Thoracic Disc Herniation
Thoracic disc herniation surgery is performed to relieve pressure on the spinal cord or nerve roots in the mid-back (thoracic spine). Although disc herniations are far less common in the thoracic region than in the neck or lower back, they can be more serious when they occur because the spinal canal is narrower in this area.
Surgery involves removing the portion of the disc that is compressing the spinal cord or nerves. Depending on the location of the herniation, the surgeon may approach the spine from the side, front, or back, using minimally invasive or traditional techniques to safely access the disc.
When is it recommended?
Thoracic disc herniation surgery is considered when:
- Symptoms persist despite nonsurgical treatments such as physical therapy, medications, or injections
- There is myelopathy (spinal cord compression) resulting in gait problems, clumsiness, or coordination issues
- The herniation compresses the spinal cord significantly on imaging
- There is progressive or severe weakness, numbness, or difficulty walking
- Pain radiates around the chest or abdomen following a nerve's path
- Bowel or bladder control is affected (rare but concerning)
Conditions that commonly lead to this surgery include:
- Thoracic disc herniation with spinal cord compression
- Thoracic radiculopathy (nerve root compression)
- Thoracic myelopathy
- Disc herniations caused by trauma or degeneration
What happens during surgery?
The surgical approach varies depending on the location and direction of the herniated disc:
- Posterolateral / Transpedicular approach: From the back, removing part of the bone to reach and decompress the nerve or spinal cord.
- Lateral / Costotransversectomy approach: From the side, carefully removing a small portion of rib and bone to access the disc.
- Anterior (thoracoscopic or open) approach: From the front of the chest using minimally invasive or traditional techniques to safely reach central disc herniations.
Regardless of the approach:
- The herniated disc fragment is removed to relieve compression.
- The spinal cord or nerve roots are freed and given more space.
- For some cases, stabilization or fusion may be added if needed for support.
Most patients stay in the hospital for 1–3 nights, depending on the approach and symptoms before surgery.
What does recovery look like?
Recovery varies widely based on the patient's symptoms and the surgical approach.
Most patients experience:
- Improvement in leg symptoms, stability, and balance over weeks to months
- Reduction in chest or abdominal nerve pain caused by compression
- Mild or moderate soreness at the incision site
- Return to light daily activities in 2–4 weeks, depending on approach
- Gradual return to work in 4–8 weeks, customized to each patient
- Restrictions on bending, lifting, and twisting for 8–12 weeks
- Physical therapy is often recommended to rebuild strength, posture, and gait if myelopathy was present.
Expected Outcomes & Success Rate
When performed for the right indications, thoracic disc herniation surgery provides reliable improvement in symptoms caused by nerve or cord compression.
Patients typically experience:
- Improvement in walking stability and coordination
- Relief of nerve-related pain wrapping around the chest or abdomen
- Better leg strength and gait
- Prevention of further neurological decline
- Durable long-term outcomes
Risks vary by surgical approach and may include lung-related issues (for anterior approaches), nerve irritation, spinal cord risks, cerebrospinal fluid leaks, or persistent numbness. However, carefully selected patients generally see meaningful improvement.
How this connects to your symptoms?
Thoracic disc herniations can cause symptoms different from those of cervical or lumbar herniations. Depending on which nerve or part of the spinal cord is compressed, you may experience:
- Pain wrapping around the chest or abdomen
- Leg weakness or stiffness
- Balance problems or trouble walking
- Numbness or tingling in the torso or legs
- Difficulty with standing upright or maintaining gait
- Symptoms of myelopathy, such as clumsiness or poor coordination
Surgery helps by removing the disc material pressing on the spinal cord or nerve roots, allowing these symptoms to stabilize or improve.
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Scoliosis Surgery & Deformity Correction
Scoliosis and spinal deformity correction surgery is performed to straighten and stabilize the spine when the curvature or imbalance becomes severe enough to cause pain, nerve problems, difficulty standing upright, or progressive deformity.
During the procedure, the surgeon realigns the spine, places screws and rods to hold the corrected position, and performs spinal fusion to maintain the new alignment over time.
This surgery can be performed in the thoracic, lumbar, or cervical spine depending on the deformity. It is a highly customized operation, planned using imaging, alignment goals, and the patient's symptoms.
When is it recommended?
Deformity correction surgery is usually considered when:
- The spinal curve continues to progress over time
- There is significant back pain not relieved by nonsurgical treatments
- The curve causes imbalance, making it difficult to stand upright
- The patient develops nerve symptoms, such as leg pain or weakness
- Lung or abdominal function is affected by severe curvature
- Physical appearance or posture is significantly impacted
- Daily activities become limited
Common conditions treated with deformity correction include:
- Adult degenerative scoliosis
- Long-standing scoliosis that progresses with age
- Kyphosis or forward-bending deformity
- Spinal imbalance (sagittal or coronal)
- Neuromuscular scoliosis
- Deformity due to arthritis, fractures, or prior surgeries
What happens during surgery?
Because scoliosis and deformity correction vary widely, the details depend heavily on the type and location of the curve. In general:
- A surgical approach is chosen - typically from the back of the spine (posterior), though anterior or lateral approaches may also be used if needed.
- Screws are placed into several vertebrae to anchor the correction.
- Rods are inserted and gradually maneuvered to straighten the spine and restore proper alignment.
- Areas of compression are decompressed if nerves are pinched.
- Bone graft is added to allow the vertebrae to fuse together in the corrected position.
- Advanced monitoring and imaging are used throughout the procedure to ensure safety and accuracy.
Depending on the extent of correction, patients may stay in the hospital several days for early recovery and mobilization.
What does recovery look like?
Recovery after scoliosis or deformity correction varies significantly based on age, curve severity, and the number of levels fused.
Most patients experience:
- Improvement in posture and alignment immediately after surgery
- Back soreness and stiffness that gradually improve over weeks to months
- Return to light activity in 4–6 weeks
- Return to desk work in 6–12 weeks
- Restrictions on bending, lifting, and twisting for 3 months or more
- Progressive return to daily activities and walking
- Full fusion and strengthening developing over 6–12 months
Physical therapy is often recommended to restore mobility, balance, and endurance.
Expected Outcomes & Success Rate
Deformity correction surgery provides meaningful improvement for properly selected patients:
- Straighter, more balanced posture
- Reduced back pain caused by deformity
- Relief of nerve symptoms when present
- Improved ability to stand upright and walk longer distances
- Better quality of life and physical function
- Durable, long-term stability through spinal fusion
As with all major spine surgeries, risks may include infection, nerve irritation, blood loss, hardware issues, or incomplete correction - but outcomes are generally strong when performed for clear indications.
How this connects to your symptoms?
Spinal deformity can cause a wide range of symptoms depending on severity:
- Back pain from muscle fatigue or uneven loading
- Leg pain or numbness from pinched nerves
- Difficulty standing upright or leaning forward to maintain balance
- Postural changes that worsen over time
- Fatigue from the spine working harder to support the body
- Abnormal gait from imbalance
- Trouble with daily activities such as walking, stairs, or prolonged standing
Deformity correction surgery addresses the underlying structural problem, aiming to reduce pain, improve posture, relieve nerve compression, and restore a more natural spinal alignment.
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