Spine Surgery

Back and neck pain affects millions of people across India, and most cases respond well to non-surgical treatment. But when pain is severe, persistent, or associated with nerve compression causing weakness or numbness in the arms or legs, a spine specialist assessment is the right next step. Spine surgery in Chennai may be considered when conservative treatment does not provide adequate relief or when there is significant nerve compression or another structural problem requiring surgical intervention.

At Bharath Orthopaedics in Chennai, Dr. Bharath Loganathan provides orthopaedic spine care covering conservative management, pain interventions, and surgical treatment for common spine conditions. His orthopaedic training included extensive spine case exposure during residency and senior residency at Grant Medical College and JJ Group of Hospitals, Mumbai, as well as clinical spine management during his tenure as assistant professor at SRM Medical College, Chennai. He approaches spine care the same way he approaches joint care: conservative treatment first, surgery only when it is genuinely the best option.

Common Spine Conditions Treated

Spine pain takes many forms. Understanding the underlying condition is the foundation of effective treatment.

Lower Back Pain

The most common musculoskeletal complaint seen in orthopaedic practice. Most cases result from muscle strain, poor posture, or degenerative changes in the lumbar spine. The majority resolve with physiotherapy, pain management, and activity modification. A small proportion require further investigation and intervention when nerve involvement is present.

Disc Prolapse (Slipped Disc)

The intervertebral discs act as cushions between the vertebrae. When the outer layer of a disc tears, the inner material can press against a nearby nerve root. In the lower back, this causes sciatica, a sharp pain radiating from the buttock down the leg. While disc herniation is the most common cause of sciatica, it can also result from spinal stenosis, spondylolisthesis, or in some cases piriformis syndrome compressing the sciatic nerve. In the neck, it causes pain and tingling in the arm. Most disc prolapses settle with conservative management. When neurological symptoms are significant or persistent, surgical intervention may be required.

Spinal Stenosis

Stenosis refers to narrowing of the spinal canal, reducing the space available for the spinal cord and nerve roots. This typically develops gradually with age and causes leg pain, heaviness, or cramping that worsens with walking and improves with sitting or leaning forward. Conservative management is appropriate in mild to moderate cases. Severe or progressive cases may require surgical decompression.

Spondylolisthesis

A condition in which one vertebra slips forward over the one below it, causing instability, back pain, and sometimes nerve symptoms. Grades of severity determine whether physiotherapy and bracing are sufficient or whether surgical stabilisation is needed.

Degenerative Disc Disease

A gradual breakdown of the intervertebral discs over time. Associated with ageing, it can contribute to chronic back pain, reduced flexibility, and in some cases, nerve root compression. Management focuses on maintaining function and managing pain.

Vertebral Compression Fractures

Most commonly seen in patients with osteoporosis. A vertebra weakens and collapses, causing sudden severe back pain. Treatment includes pain management, activity modification, and in selected cases, minimally invasive procedures such as vertebroplasty or kyphoplasty to stabilise the fractured vertebra.

Spinal Infections and Tumours

Rare but important causes of spine pain that require thorough investigation. Fever, unexplained weight loss, or pain that is constant and worsens at night should always prompt a specialist review to rule out these causes.

When is Spine Surgery Recommended?

Spine surgery is not the first step for most patients. The decision to recommend surgery is made after careful assessment of the specific condition, the degree of neurological involvement, and whether an adequate trial of conservative treatment has genuinely been completed.

Surgery is considered when:

• Significant neurological symptoms are present, including leg or arm weakness, numbness affecting daily function, or loss of bladder or bowel control (which requires urgent assessment)
• Severe or progressive nerve compression is confirmed on MRI imaging
• Conservative treatment including physiotherapy, pain management, and nerve block injections has not provided adequate relief after an appropriate period
• Imaging findings and clinical symptoms are consistent, confirming that surgery will address a clear structural cause

Surgery is not recommended for back pain alone without neurological involvement or imaging evidence of a surgically correctable cause.

Surgical Procedures Available

Microdiscectomy

A minimally invasive procedure to remove a portion of a herniated disc that is pressing on a nerve root. Performed through a small incision using a surgical microscope. Most patients experience immediate relief of leg or arm pain after the procedure and recover within 4 to 6 weeks.

Laminectomy (Decompression Surgery)

The lamina, a portion of the vertebra forming the roof of the spinal canal, is removed to relieve pressure on the spinal cord or nerve roots. Performed for spinal stenosis causing significant symptoms. Relief of leg symptoms is typically good, though back pain improvement varies.

Spinal Fusion

Two or more vertebrae are joined together using bone graft and fixation hardware to stabilise a painful or unstable segment of the spine. Used for spondylolisthesis, degenerative instability, and some fracture cases. Recovery is longer than decompression alone, typically 3 to 6 months for full functional recovery.

Vertebroplasty and Kyphoplasty

Minimally invasive procedures for vertebral compression fractures. Bone cement is injected into the collapsed vertebra to stabilise it and reduce pain. Kyphoplasty also uses a balloon to partially restore vertebral height before cement injection. Both are day-case or short-stay procedures.

Foraminotomy

Enlargement of the foramen, the opening through which a nerve root exits the spinal canal, to relieve nerve root compression. Often combined with other decompression procedures.

Non-Surgical Spine Treatment Options

For most patients, the right starting point is not surgery. A structured conservative management programme addresses the majority of spine conditions effectively.

Physiotherapy and Exercise

A targeted physiotherapy programme addresses muscle weakness, postural imbalances, and movement patterns that contribute to spine pain. Core strengthening, flexibility work, and ergonomic guidance form the foundation of conservative spine care.

Pain Management

Anti-inflammatory medication, muscle relaxants, and in some cases nerve pain medication are used to manage symptoms while the spine heals. Long-term daily use of NSAIDs is not recommended without medical supervision.

Epidural Steroid Injections

A corticosteroid is injected into the epidural space around the affected nerve root to reduce inflammation and relieve radiating leg or arm pain. Effective for many patients with disc prolapse or nerve root compression, providing temporary symptomatic relief that can last weeks to months and allows physiotherapy to be engaged more effectively. Epidural steroid injections do not alter the underlying structural problem or prevent long-term disease progression. They are a management tool, not a cure.

Activity Modification

Identifying and modifying activities that aggravate the spine, combined with guidance on safe movement patterns for daily tasks, reduces the mechanical load on the spine and supports recovery.

Preparing for Spine Surgery in Chennai

If surgery is recommended, preparation involves a full medical assessment including blood tests, cardiac evaluation where needed, and MRI or CT imaging of the relevant spine region. Any blood-thinning medications should be discussed with your surgeon as some need to be paused before the procedure.

Pre-operative physiotherapy to strengthen supporting muscles before surgery is recommended for procedures such as spinal fusion, as stronger muscles support the spine during recovery and contribute to better post-surgical outcomes.

Patients receive detailed pre-operative education about what to expect during the procedure and the first weeks of recovery.

Recovery After Spine Surgery

Recovery timeline depends on the procedure performed.

Microdiscectomy patients typically begin walking on the day of or day after surgery. Return to work depends heavily on occupational demands. Desk-based workers can often return within 2 to 4 weeks. Patients in physically demanding jobs involving lifting, bending, or prolonged standing typically require 8 to 12 weeks before returning to full work duties.

Laminectomy patients have a similar early recovery to microdiscectomy for uncomplicated cases. Return to full activity typically takes 6 to 8 weeks.

Spinal fusion recovery is longer. Walking begins within 1 to 2 days of surgery but return to full normal activity takes 3 to 6 months. A structured physiotherapy programme is essential during this period.

Vertebroplasty and kyphoplasty patients typically go home the same or following day with significant pain improvement within the first week.

Regardless of the procedure, physiotherapy after spine surgery is one of the most important factors in long-term outcome.

Red Flags that Need Urgent Assessment

Seek immediate medical attention if you experience:

• Loss of sensation in the groin, inner thighs, or buttocks (saddle anaesthesia), which is often the earliest sign of cauda equina syndrome before bladder or bowel control is affected. This combination with back or leg pain is a surgical emergency requiring same-day assessment
• Progressive leg or arm weakness developing over hours or days
• Back pain following a significant fall or accident, particularly in older adults with known osteoporosis
• Severe, constant back pain that does not change with position and is associated with fever or unexplained weight loss

These symptoms require same-day or emergency assessment.

Why Choose Bharath Orthopaedics for Spine Care in Chennai

Dr. Bharath Loganathan brings 20+ years of orthopaedic experience including spine case management from his training and academic career at Grant Medical College and JJ Group of Hospitals, Mumbai, and his academic tenure at SRM Medical College, Chennai. His approach to spine care mirrors his approach to joint care: thorough assessment, conservative treatment as the first line, and surgery only when the clinical evidence clearly supports it.

It is important to note that while general orthopaedic surgeons routinely manage non-surgical spine conditions and perform common decompression procedures such as microdiscectomy and laminectomy, complex spinal surgeries including multi-level fusion and major deformity correction are typically performed by fellowship-trained spine subspecialists. Patients with complex or high-risk spine conditions will be assessed individually and referred to an appropriate specialist when that is in the patient’s best interest.

Bharath Orthopaedics is recognised by Outlook as the Best Robotic Joint Replacement Centre in Chennai. The clinic’s patient care pathway covers assessment, diagnosis, treatment planning, and post-operative rehabilitation under one team.

Clinic locations are available in Kilpauk, Purasaiwalkam, and other areas of Chennai.

If you have back or neck pain that has not improved with rest and basic pain management over two to three weeks, or if you have nerve symptoms in your arm or leg, a consultation will give you a clear diagnosis and a treatment plan.

Read more about physiotherapy for knee and joint pain as part of musculoskeletal rehabilitation. For appointments, visit our contact page.

Read also Knee & Hip Replacement Surgeons in Chennai.