Out-of-state? Free MRI review + telehealth consult before you travel4.9 ★ · 619 Google reviewsBoard-certified — American Board of Orthopaedic SurgeryMinimally invasive, same-day spine surgery in Beverly HillsCall (424) 217-7463
Out-of-state? Free MRI review + telehealth consult before you travel4.9 ★ · 619 Google reviewsBoard-certified — American Board of Orthopaedic SurgeryMinimally invasive, same-day spine surgery in Beverly HillsCall (424) 217-7463
Neck and low-back surgery does not have to mean a big open fusion — most problems can be solved through small, muscle-sparing approaches that keep the spine moving.
Cervical and lumbar surgery covers operations on the two most commonly treated regions of the spine: the neck (cervical) and the lower back (lumbar). These are the areas where discs herniate, nerves get pinched, and the canal narrows most often, and they are where the right surgical approach makes the biggest difference in how someone recovers.
Dr. Melamed's philosophy is to solve the actual problem with the least disruption possible. Rather than defaulting to a large open fusion, he leads with minimally invasive and motion-preserving techniques — muscle-sparing biportal endoscopic decompression to free a pinched nerve, and artificial disc replacement to treat a worn disc while keeping the segment mobile. Fusion still has a clear role when there is genuine instability or deformity, but it is a deliberate choice, not the automatic answer. He offers this care from the Beverly Hills office, in the greater Los Angeles area, and gives honest second opinions when patients want to be sure surgery is truly needed.
At first, neck and lower-back pain can be annoying but minor, presenting as stiffness after a long day or upon waking up in the morning. Then, it becomes trouble sleeping, difficulty exercising, or even pain shooting into your arms or legs. In fact, back or neck pain affects roughly 4 out of 5 Americans at some point. Once it happens, recurrence becomes far more likely.
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 or 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.
Surgery is considered when a clear structural problem — a herniated disc, stenosis, a pinched nerve, or an unstable segment — matches your symptoms and has not responded to a fair trial of non-surgical care, or when there is progressive weakness or spinal cord involvement that should not wait. The most important step is matching the right operation to the right person. Dr. Melamed reviews your imaging in detail because the same scan can point one patient toward a simple decompression, another toward disc replacement, and only a few toward fusion. If surgery is not the right call, he will say so.
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:
Timely care is important, as persistent nerve compression can lead to permanent damage if left untreated.
Minimally Invasive Spine Surgery Techniques
For most nerve-compression problems in the neck or lower back, Dr. Melamed uses muscle-sparing techniques: small incisions and a high-definition endoscope to remove the disc fragment, bone spur, or thickened ligament crowding the nerve, without cutting through the muscle the way open surgery does. When a worn disc is the problem and the segment is otherwise stable, artificial disc replacement swaps it for a mobile implant that preserves motion.
When instability or deformity is present, a fusion or stabilization is planned carefully and performed as minimally as the anatomy allows. In every case the aim is the same — relieve the nerve or cord, restore stability only where it is truly needed, and protect the surrounding muscle and healthy segments.
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.
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.
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 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
Because muscle is spared rather than cut, recovery from a minimally invasive decompression or disc replacement is usually faster and more comfortable than traditional open surgery. Many patients go home the same day or after a short stay, walk soon afterward, and build back toward full activity over the following weeks under Dr. Melamed's guidance. Throughout, the plan is opioid-sparing, relying on multimodal pain control rather than defaulting to narcotics. When a fusion is necessary, recovery is more gradual because bone needs time to heal, and Dr. Melamed sets honest expectations up front.
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.
Why Dr. Melamed Prefers Muscle-Sparing Surgery
✓Minimally invasive, muscle-sparing techniques whenever possible
✓Motion-preserving options like artificial disc replacement over fusion where appropriate
✓Smaller incisions and less soft-tissue disruption than open surgery
✓Often outpatient or short-stay, with quicker return to walking
✓Opioid-sparing recovery plans
✓Honest second opinions on whether surgery is truly needed
Common Conditions Requiring Spine Surgery
Cervical radiculopathy
Cervical/lumbar stenosis
Herniated disc
Pinched nerve
Degenerative disc disease
Sciatica
Spondylolisthesis
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.
Other conditions that may require surgical treatment include:
Spinal deformities, such as scoliosis: Curvature of the spine that may compress nerves
Often not. Most neck and low-back problems are nerve-compression issues that a muscle-sparing decompression can solve, and worn discs can frequently be treated with motion-preserving disc replacement. Fusion is reserved for genuine instability or deformity. Dr. Melamed reviews your imaging to determine which approach actually fits your case.
How is minimally invasive spine surgery different from open surgery?
Traditional open surgery detaches and retracts muscle to reach the spine, which adds pain and lengthens recovery. Minimally invasive techniques use small incisions and an endoscope to reach the same target while preserving the muscle. The problem is addressed just as directly, but with less collateral disruption and usually a quicker recovery.
Can I get a second opinion before deciding on surgery?
Yes, and it is encouraged. Dr. Melamed provides honest second opinions and will tell you plainly if a less-invasive option or non-surgical care is the better path. The goal is the right treatment for you, not surgery for its own sake.
How soon will I be walking after surgery?
After a minimally invasive decompression or disc replacement, many patients are up and walking the same day and return to light activity within days to a couple of weeks. A fusion takes longer because bone must heal. Your exact timeline depends on your specific procedure, which Dr. Melamed reviews with you.
Second opinions welcome
Not sure if surgery is the answer? Neither are we — until we've seen your MRI.
Send your imaging for a personal review with Dr. Melamed. Many patients learn a smaller, muscle-sparing option is on the table.
