Chief, Neuro Spine Surgery & Additional Director, Neurosurgery, Artemis Hospitals, Gurgaon, India
Part 13 of 13 in Making Spine Surgery 100% Safe
When Is Spine Surgery Actually Needed? Signs You Shouldn't Ignore
August 6, 2026
Spine surgery is needed when back or neck pain comes with nerve compression, a tumour, infection, deformity, an unresponsive fracture, or spinal stenosis, not simply because pain is present. Dr. S. K. Rajan, Chief and Unit Head, Orthopaedics and Spine Neurosurgery at Artemis Hospitals, Gurgaon, explains that most patients who consult for spine surgery in India do not actually need an operation.
Why Most Back Pain Does Not Need Surgery
Dr. S. K. Rajan notes that most back pain is muscular in origin and resolves within six to eight weeks of medicine. He is direct about a common misconception: a bad-looking MRI does not automatically mean a patient needs spine surgery. Many patients travel long distances seeking spine surgery in India without a clear surgical indication, and simple back or leg pain alone is often not sufficient grounds for an operation.
The Genuine Warning Signs
According to Dr. S. K. Rajan, genuine indications for spine surgery include cervical spondylosis causing arm or neck pain and leg weakness, spinal tumours, spinal infections, spinal deformity, fractures from trauma or osteoporosis that do not respond to medicine, and spinal stenosis that prevents a patient from standing or walking for long periods, often accompanied by leg pain, tingling or burning that affects quality of life.
Why an Accurate Diagnosis Matters Before Considering Spine Surgery in India
Dr. S. K. Rajan explains that complications in spine care often arise not from the surgery itself but from errors at the diagnosis level or the doctor-selection level, before a patient ever reaches the operating table. He emphasises that if a clear cause for a patient's pain or weakness cannot be found, it is likely not a surgical case at all, which is why a thorough evaluation should always come before any decision about spine surgery in India.
Series index | What Is the O-Arm and How Does It Make Spine Surgery Safer? →
This article is based on a Jivo Masterclass session conducted by Dr. S. K. Rajan, Chief and Unit Head, Orthopaedics and Spine Neurosurgery, Artemis Hospitals, Gurgaon, India. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass — Dr. S. K. Rajan taught doctors across Africa on September 15, 2024.
FROM THE LIVE Q&A
Dr. Navala Gabriel
Do you have provisions for doing spine surgeries for children with neural tube defects?
Dr. S. K. Rajan
Yes, we have specialist spine surgeons and pediatric surgeons also, and I myself do a lot of spine surgery in children — whether they have neural tube defects such as meningocele, Chiari malformation, or tethering of the spinal cord which can cause weakness of the legs. In all those patients we do spine surgeries, also in children who've got scoliosis or hemivertebra deformities, or tumours of the spine. All those patients we have been tackling from the age of 6 months to 18 years of age.
Frequently Asked Questions
What about the cost of treatment, and the duration of treatment, for a spine problem?▼
The cost of surgery in our hospital for spinal problems can range anything from $3,500 for a discectomy and decompression to $5,500 or $6,000 for fixation of the spine at one level, and even up to $10,000 for more complicated cases — that's usually the range of costs patients most commonly have to bear. Most of these patients, who come walking because of pain in the neck, arm, or lower back going into the legs, usually stay in the hospital for about three to four days, and in the country for about two weeks.
Do you use intraoperative neuromonitoring?▼
Yes, we do use intraoperative neuromonitoring — we are one of the very few centres in the country who have been using this quite regularly. We were focusing on minimally invasive spine surgery and spine navigation in this talk because of limited time, but yes, we do have neuromonitoring available to us as well.
Do you have provisions for doing spine surgeries for children with neural tube defects?▼
Yes, we have specialist spine surgeons and pediatric surgeons also, and I myself do a lot of spine surgery in children — whether they have neural tube defects such as meningocele, Chiari malformation, or tethering of the spinal cord which can cause weakness of the legs. In all those patients we do spine surgeries, also in children who've got scoliosis or hemivertebra deformities, or tumours of the spine. All those patients we have been tackling from the age of 6 months to 18 years of age.
What are the genuine warning signs that indicate spine surgery may be needed?▼
Cervical spondylosis causing arm or neck pain with leg weakness, spinal tumours, infections, deformity, fractures unresponsive to medicine, and spinal stenosis that prevents standing or walking, often with leg pain, tingling or burning.
Does most back pain require surgical treatment?▼
No. Dr. Rajan notes that most back pain is muscular in origin and resolves within six to eight weeks of medicine.
If an MRI looks abnormal, does that automatically mean surgery is required?▼
No. A bad-looking MRI does not automatically mean a patient needs spine surgery; a clear cause for the pain or weakness must first be identified.
Where do complications in spine care most often originate?▼
Dr. Rajan explains they often arise not from the surgery itself, but from errors at the diagnosis level or the doctor-selection level, before a patient ever reaches the operating table.
In This Series: Making Spine Surgery 100% Safe
- 1.Making Spine Surgery 100% Safe
- 2.Cement Augmentation for Osteoporotic Spinal Fractures
- 3.Cost of Spine Surgery in India
- 4.Why an Integrated Spine Clinic Matters: Team-Based Spine Care
- 5.Intraoperative Neuromonitoring in Spine Surgery
- 6.Keyhole (Minimally Invasive) Spine Surgery Explained
- 7.Lumbar Canal Stenosis: Keyhole Surgery and Recovery
- 8.What Is the O-Arm and How Does It Make Spine Surgery Safer?
- 9.Pediatric Spine Surgery in India: Conditions Treated
- 10.Scoliosis Correction Surgery in India
- 11.Treating Spinal Tuberculosis in India
- 12.What Causes Spine Surgery Complications, and How They're Prevented
- 13.When Is Spine Surgery Actually Needed? Signs You Shouldn't Ignore