When do you need to undergo spinal surgery? Is undergoing one necessary? Dr. Chandril Chugh, American trained stroke and Aneurysm Specialist discusses all the factors that come up in all our minds.


If a patient comes up with lower back or neck pain, we observe him for a while and suggest maintaining physical activity, in case it resolves on its own. If the pain does not resolve on its own, you should see a doctor for further evaluation.

Spinal problems can also be treated in a non-surgical way as well. Options like physical therapy, exercises, medication, and sometimes spinal injections are also recommended before surgery is resorted to. If a patient is not responding to non-surgical options and still experiencing a lot of pain then, we recommend surgery, especially for those who go through a weakness in limbs due to spinal cord or nerve root compression.


Lumbar Decompression Surgery for Spinal Stenosis: Lumbar decompression surgery, also known as, lumbar laminectomy, is performed to correct the narrowing of the spinal canal, called spinal stenosis. The surgeon removes the lamina in the spine that is causing pain.  

A lumbar discectomy involves removing an injured disc in the lower back. An arthroscopic discectomy and an open spine surgery are both types of lumbar discectomy. Open spine surgery is more common.

Herniated Disc Surgery : In herniated disc surgery, the surgeon removes an injured part of the disc. In order to stop the pain from the disc, the surgeon may remove the disc and fuse the vertebrae together. Take the decision after getting a second opinion since spinal fusion makes it difficult to move the part that was operated on. The second opinion doesn’t hurt, ever. 

Spinal Fusion Surgery: As discussed above, it involves fusing two adjacent vertebrae together to avoid pain caused due to their movement against each other. The surgeon uses small screws and rods to fuse the vertebrae and then leave them to naturally heal and fuse. The surgeon can also use a bone graft from another part of the body to help the vertebrae to fuse.  


Recovery after discectomy is usually quicker, although you may feel numbness, pain, or weakness around the affected area.

When it comes to fusion surgery, it may take longer. It will take 3 to 4 months at least for the bones to recover and the process of healing will go on for a year. The length of surgery also depends upon your condition before surgery.


Anaesthesia risks: Spine surgeries are usually performed under general anaesthesia, intravenously to avoid pain during the surgery. Risks are rare but serious like death, heart attack, stroke, and brain damage. Complications may be caused because of other medical conditions. Please tell the medical team about tobacco use or if you or your other family members have ever had a reaction to anaesthesia. 

Bleeding: The surgeon employs techniques that minimise blood loss however, blood loss can still happen.  

Blood clots: After the surgery, the body’s clotting mechanism is super active to stop the bleeding caused by the surgery. Injury to the blood vessels around the affected site can cause clotting. Clots can occur during the first few weeks of surgery. Signs of a blood clot include swelling, tenderness or redness, and pain. 

Dural tear: It occurs when the thin protective covering around the spinal cord gets torn during the procedure. Most dural tears heal without incident. In case, the tear doesn’t heal the spinal fluid can leak out through the tear and can cause a spinal headache. If you feel a headache after surgery, tell your surgeon, chances are you might need a second surgery.  

Infection: The risk of infection after surgery is small. If the infection develops it is superficial, but it can spread to the deeper areas around the spinal cord and vertebrae. Common symptoms of infection include a red hot and swollen wound, pain, fever and chills, clear liquid or yellow pus coming out from the cut, a foul smell coming out from the wound site. Go to your doctor if you notice any of these symptoms.  


The complications mentioned are rare but still, you should ask the surgeon about the risks associated with the surgery. In fact, take a second opinion as well. Knowing the risks beforehand allows you to weigh the pros and cons of whether undergoing surgery would be right for you. Taking a second opinion is best when the first surgeon wants a confirmatory opinion before going for the second surgery. When this is the case, let the surgeon choose the surgeon as he would choose the one whose opinion he would value the most. If the surgeon is unable to explain to you why you need surgery, his explanation seems vague or your personal goals don’t match, when it comes to the treatment, you should surely take a second opinion. Taking a second opinion is important when the first surgery did not work and the doctor is recommending another one. If the first surgery is not beneficial, then the second one would be helpful in very specific circumstances.

Online second opinion services are also an option especially when the doctor you want to consult is at a distance. The doctors look at your X-ray scan, MRI reports and then provide a second opinion. But there is one drawback, they do not get to evaluate you and your condition in person.


  1. The surgeon should enlighten you about the pros and cons of undergoing surgery, and educate you about the process. He should describe to you what is technically possible about the potential benefits.
  1. Patients often ask about whether the orthopaedic surgeon or neurosurgeon should do their surgery. Each specialty has a different focus in training although both are equally trained to do the surgery. The orthopaedic surgeons are better suited for deformity and neurosurgeons are better in handling tumour cases. Both of these surgeons often work together in the operating room.  Your surgeon should be board certified in orthopaedic surgery or neurosurgery.
  1. Last but not least, the number of years of experience that the surgeon has in the field of spinal surgery. A surgeon more experienced is going to have a way better technique while handling such a case than the one who does a spinal surgery occasionally.

In a nutshell, never ignore the symptoms and never avoid taking a second opinion.