Understanding Cervical and Lumbar Spine Surgery

Your spine has several regions. However, two areas are responsible for a large majority of painful spinal conditions. These include your cervical spine (neck) and lumbar spine (low back). These sections move the most, which means they also wear down the most.

Between each vertebra (spinal segment) sits a disc or soft cushion that acts like a shock absorber. Nerves exit the spine nearby and travel into your shoulders, arms, hips, and legs. When discs of joints deteriorate, they can pinch nerves and cause symptoms outside of just the back. When a disc bulges or collapses, or when joints become arthritic, these nerves can get pinched, leading to pain, numbness, and weakness. Spinal surgery is designed to relieve that pressure, stabilize the affected bones when needed, and restore comfortable movement.

Common Conditions Requiring Spine Surgery

Many spinal problems improve with rest, physical therapy, medications, or targeted injections. Surgery is usually considered only when symptoms persist, and imaging shows a clear structural cause. Today, these procedures are more common than in the past — spine operations in the United States (U.S.) increased from roughly 800,000 annually in 2013 to more than 1.1 million per year in 2022, with about 73% involving the cervical and lumbar regions.

Conditions that may require surgical treatment include:

• Herniated disc: A torn or bulging disc presses on a nerve, causing arm pain or sciatica 
• Degenerative disc disease: Age-related disc wear leads to chronic pain and stiffness
• Spinal stenosis: Narrowing around nerves produces leg heaviness and difficulty walking
• Spondylolisthesis: A slipped vertebra creates instability and nerve irritation
• Pinched nerves (radiculopathy): Numbness, tingling, or weakness in the arms or legs
• Spinal deformities, such as scoliosis: Curvature of the spine that may compress nerves

Signs You May Need Spine Surgery

While many episodes of neck or back pain may resolve on their own with rest and time, certain warning signs suggest a deeper problem. Surgery is usually considered only after conservative care options — such as physical therapy, non-opioid medications, or injections — have been tried without success.

You should seek a surgical evaluation if you notice any of the following signs:

• Pain lasting longer than 3 to 6 months
• Numbness or tingling in the arms or legs
• Muscle weakness (e.g., dropping objects, foot dragging)
• Difficulty walking or standing 
• Loss of coordination or balance
• Symptoms worsening despite treatment
• Changes in bowel or bladder control

Timely care is important, as persistent nerve compression can lead to permanent damage if left untreated.

Minimally Invasive Spine Surgery Techniques

Unlike more invasive methods, minimally invasive spine surgery techniques use small openings, specialized instruments, and often a tiny camera called an endoscope to reach the problem area while protecting surrounding muscles and tissues. Because less tissue is disturbed, patients typically experience:

• Less postoperative pain
• Lower infection risk
• Minimal blood clots
• Quicker return to normal everyday activities

Procedures such as endoscopic discectomy and microdecompression directly remove the structural pressure on a nerve without destabilizing the spine. An ultra-minimally invasive technique — known as biportal endoscopic spine surgery (BESS) — uses two tiny openings. One is for a small camera and the other for tiny instruments that allow for precise removal of disc fragments or bone spurs while preserving muscles, stability, and normal anatomy. 

Clinical research shows that minimally invasive lumbar procedures can deliver significant improvement in function and pain relief for 80% to 95% of patients, with satisfaction rates above 90%.

Common Cervical Surgery Procedures

Surgery in the cervical spine focuses on relieving pressure on nerves that travel into the shoulders, arms, and hands. Because these nerves control strength and sensation, treating compression early is important. Common cervical surgery procedures include:

• Cervical disc replacement: Removes a damaged disc and inserts a moving implant that preserves natural neck motion and reduces stress on nearby levels.
• Anterior cervical discectomy and fusion (ACDF): The worn disc is removed, and the vertebrae are stabilized to relieve nerve pressure when significant degeneration or instability exists.
• Posterior cervical foraminotomy: A small, targeted decompression from the back of the neck to free a pinched nerve without fusing the spine.

Clinical outcomes are overwhelmingly positive, with studies showing that about 96% of patients experience complete relief of nerve-related arm pain after minimally invasive ACDF surgery.

Common Lumbar Surgery Procedures

Lower-back surgeries are designed to relieve leg pain, restore walking ability, and stabilize unstable areas of the spine. When nerves in the lumbar spine are compressed, symptoms often travel down the legs or hips. Common lumbar surgery procedures include:

• Microdiscectomy: Removes the portion of a herniated disc pressing on a nerve. This is a common treatment for sciatica, and many patients notice improvement in leg pain soon after surgery.
• Lumbar laminectomy (decompression): Removes small amounts of bone and thickened tissue to create space for nerves, often improving walking and standing tolerance in spinal stenosis.
• Endoscopic decompression (including BESS): Uses tiny portals and a camera to precisely remove disc fragments or bone spurs while minimizing muscle disruption and recovery time.
• Lumbar fusion: Stabilizes vertebrae affected by instability, such as spondylolisthesis, using screws and spacers while the bone heals together.

What To Expect: From Consultation to Recovery

Care begins through a thorough evaluation, including a physical exam and imaging to identify the root cause of the problem. Non-surgical options will be reviewed first, and surgery may only be needed when these alternatives fail.

On the day of surgery, many minimally invasive procedures are performed on an outpatient basis or only require a short hospital stay. Depending on your procedure, you may be able to walk the same day, begin light activity within days, and gradually increase movement as you heal. Most people return to their normal activity levels within a few weeks, guided by rehabilitation to rebuild strength and support the spine.

Schedule Your Consultation With Dr. Melamed

Board-certified orthopedic spine surgeon Dr. Hooman Melamed focuses on helping patients restore comfort and mobility while avoiding unnecessary surgery whenever possible. Schedule your consultation today to learn about your options for cervical and lumbar surgery in Beverly Hills and take the first step toward lasting relief.