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Spine Surgery - Procedure, Diagnosis, and Treatment

Visit Pristyn Care to undergo safe and effective spine surgery. At Pristyn Care, we work with some expert and experienced orthopedic surgeons who have ample experience in performing various surgeries, including spine surgery. Book an appointment now.

Visit Pristyn Care to undergo safe and effective spine surgery. At Pristyn Care, ... Read More

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  • What is Spine Surgery?

    Spine surgery is a surgical procedure that is performed to relieve a person from pain because of spinal problems. It helps in stabilizing spinal joints and vertebral bones caused due to herniated discs, spinal abnormalities, bone spurs, spine injuries, or spinal tumors. Spine surgery is also known as Endoscopic Spine Surgery (ESS), Minimally Invasive Spine Surgery (MISS), and Arthroscopic Spine Surgery. These advanced techniques do not really affect the nearby muscles and tissues of the spine. Therefore, the pain and recovery duration is lesser compared to traditional spine surgery. 

    • Disease name

    Spinal Laminectomy/Spinal Decompression

    • Surgery name

    Spine Surgery

    • Duration

    4 to 8 Hourse

    • Treated by

    Neurosurgeons

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    Types of Spine Surgery

    Various types of spine surgery are as follows:

    • Cervical disc replacement: During this procedure, a surgeon removes damaged disc portions or the entire disc and replaces it with a bone graft or artificial parts. The common benefits of this surgery include more mobility, quicker recovery, improved function, and lower risk of future pain.
    • Discectomy: This surgery involves the removal of a portion of a herniated or bulging disc that is pressing on spinal nerves, causing pain and other symptoms.
    • Foraminotomy: During this surgical procedure, a surgeon widens the area around the bones in the spinal column. This surgery helps in relieving the pressure on compressed spinal nerves.
    • Spinal laminectomy: A laminectomy surgery involves removing all or part of the lamina (the back part of the bone that covers your spinal canal). The aim of this surgery is to decrease compression to the spinal cord. Laminectomy is a common spinal stenosis treatment.
    • Microdiscectomy: It is a minimally invasive procedure in which a surgeon removes pieces of a herniated or ruptured disc to relieve back pain.
    • Lumbar discectomy: A lumbar discectomy is spine surgery involving an injured disc in the patient’s lower back region. There are two types of lumbar discectomy: minimally invasive arthroscopic discectomy and open spine surgery. Open spine surgery is the more common procedure for a herniated disc in the lumbar area.
    • Vertebroplasty/ Kyphoplasty: A kyphoplasty treats a compression fracture. The surgeon uses a balloon and special cement to stabilize the bone. The procedure restores some height to the compressed vertebrae (bones that form your spinal column).
    • Foraminotomy: This surgery enlarges the space where spinal nerves exit the spinal canal, relieving nerve compression caused by conditions like spinal stenosis or foraminal stenosis.
    • Artificial Disc Replacement: This surgery involves replacing a damaged or degenerated spinal disc with an artificial disc, allowing for continued motion at the affected spinal level.

    Spinal fusion: Spinal fusions permanently connect two or more vertebrae. You may need a spinal fusion to treat spinal instability, scoliosis, or a herniated disc. During a spinal fusion, the surgeon connects two adjacent vertebrae in order to avoid pain caused by their movement against each other. The surgeon uses small screws and rods to connect the vertebrae, and they are then left to heal and fuse together naturally. The physician may also take a small bone graft from another part of your body to help the vertebrae fuse.

    Are you going through any of these symptoms?

    Traditional vs MISS Surgery

    Traditional spine surgery refers to the long-standing, conventional approach  used to treat various spinal conditions. It involves making a large incision and dissecting through surrounding muscles and tissues to access the affected area. It has been used for many years and is suitable for complex spinal conditions. The procedures usually require extensive tissue disruption, longer incisions, and longer hospital stays, but they generally yield favorable outcomes.

    Minimally invasive spine surgery (MISS), on the other hand, is a newer technique that utilizes advanced instruments and specialized techniques to perform spinal procedures with smaller incisions and minimal disruption to surrounding tissues. The goal of MISS is to minimize muscle and tissue damage, reduce postoperative pain, speed up recovery, and enable a faster return to normal activities. It involves making small keyhole incisions and employing tools such as endoscopes and microscopes to access and treat the affected area. MISS can be used for various spinal conditions, including herniated discs, spinal stenosis, and spinal instability.

    The advantages of minimally invasive spine surgery include reduced blood loss, lower infection risk, decreased postoperative pain, smaller scars, and shorter hospital stays. Patients often experience faster recovery and can resume their daily activities sooner. However, it is important to note that MISS may not be suitable for all spinal conditions or patients, and traditional open surgery may still be necessary in complex cases.

    The decision between traditional and minimally invasive spine surgery depends on factors like the specific spinal condition, its severity, the patient’s overall health, and the surgeon’s expertise. A surgeon first evaluates the individual’s condition comprehensively to determine the most appropriate surgical approach.

    When is Spine Surgery Required?

    Several factors can lead to the spine surgery, including: back and cervical pain, traumatic injury, and a fracture or loss of function due to spinal cord injury).The pain can result from a variety of degenerative bone and muscle conditions. The following are a few reasons why an orthopedic surgeon may recommend spine surgery-

    • Degenerative disk disease, like spinal arthritis, spinal stenosis
    • Herniated disc with associated complications like sciatica
    • Spinal instability
    • Bone spurs and tumors
    • Scoliosis 

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    When Should I Consider Back Surgery?

    A doctor usually recommends back surgery in the following conditions:

    Pain in arms and legs: The spine consists of bones known as vertebrae, and the spinal cord runs through the center of these vertebrae. Some nerves travel between each vertebra and affect different areas of your body. If these nerves in the lower back get  damaged, you are likely to experience radiculopathy or pain that radiates to your arms and legs.

    The most common causes of radiculopathy are herniated discs and bone spurs. When your disc herniates, the soft inner layer pushes through the outer layer and presses on the surrounding nerves. You can have pain in either your arms or legs, depending on which nerves it presses on.

    Bone spurs form because of osteoarthritis in the spine. Osteoarthritis wears down the cartilage between the bones, and as a result, the bones rub together and form bone spurs.Surgery for radiculopathy is effective because it relieves the pressure on the nerves. So, if you have constant pain that radiates, it’s time to see a spine surgeon.

    Constant Back Pain: If you have constant severe back pain, a doctor will  likely suggest back surgery. Most of the time, back pain is acute, and it lasts anywhere from a few days to less than 12 weeks, and there is no loss of function or symptoms that linger. However , chronic back pain continues for at least 12 weeks or longer, even after you’ve had treatment for the initial injury. There are different treatment options for back pain that include:

    • Physical therapy
    • Steroid shots
    • Epidural injections
    • Anti-inflammatory medications
    • Lifestyle changes

    If you’re still experiencing constant pain despite these treatments, you’ll need to see a spine doctor to discuss surgical options that will give you the back pain relief you need.

    Experiencing reduced mobility: Constant back pain can also affect your ability to move normally. Chronic back pain often prevents you from taking hikes or playing sports. You may also find it limits your mobility at work, prevents you from doing your job, or affects your ability to work in certain industries.

    If you’ve had to change your life completely because of back pain, then you must undergo spine surgery. Spine surgery can often reduce your pain, increase your mobility, and give you back control of your life.

    Numbness or weakness in your legs: Having numbness or weakness in your legs is not a symptom to ignore for a long period. Conditions like spinal stenosis or narrowing of the spine can cause numbness and weakness. Spinal stenosis typically occurs with age and can happen in any part of your spine, but it most commonly occurs in your lower back or lumbar area.

    If you have lumbar spinal stenosis, you will  likely notice trouble walking long distances. You are likely to experience pressure on your back. 

    Usually, you won’t have many symptoms at first, but as the condition worsens, you can develop symptoms like

    • Constant numbness and weakness in your legs
    • Loss of sensation in your feet
    • Burning pain that runs down your legs

    Numbness and weakness can also be caused by disc herniation, tumors, or infections of the spine. If you have ongoing numbness or weakness in your legs, you’ll need to see a spine doctor for a thorough evaluation of your spine.

    Spinal Deformity That’s Progressing: Spinal deformities result from abnormal curvature or rotation of the spine, and the most common spinal deformity in adults is scoliosis.

    Scoliosis in adults often results from wear and tear to the back because of age or past back surgeries. You can have a minor curvature that continues to progress over time and eventually causes deterioration to your vertebrae and compresses organs like the lungs. If you’re already being treated for scoliosis and are feeling worsening symptoms of pain, numbness, weakness, and back stiffness, talk to a doctor about your surgical options.

    Spinal Fracture: Severe back injuries can result from car accidents, a fall from a significant height, or a sporting event, and many times, a severe back injury results in a spinal fracture. In some cases, automobile accidents cause extension fractures which occur when vertebrae tear apart. You can also get a transverse process fracture where the spine bends or rotates sideways.

    Treatment depends on the severity of the fracture, and it often takes up to 12 weeks to heal. You may require physical therapy and need to wear a back brace. However, sometimes conservative treatments aren’t enough, and you can often have lingering pain, along with numbness and tingling. If you have a spinal fracture, talk to a surgeon right away. There are minimally invasive options like laser spine surgery that can fix the damage and speed up the recovery process

    Diagnostic Tests for Spine Disorders

    Few diagnostic tests to understand the severity of the condition and identify any underlying health condition that may complicate the surgery. Some common diagnostic tests are as follows:

    • X-ray: X-rays can help study the structural anatomy of the hard tissues of the spine to diagnose spine dislocation, kyphosis, scoliosis, bone spurs, disc space narrowing, vertebral body fracture, spinal collapse, or erosion.
    • Magnetic resonance (MR) imaging: MRIs help diagnose aberrations of the soft tissue components of the spine, such as the spinal cord and nerves.
    • Computed tomography (CT) scan: CT scans provide a detailed view of both hard and soft tissues of the spine to diagnose abnormalities of the vertebrae, spinal cord, spinal nerves, and other soft and hard tissues.
    • Bone Scan: For older patients or those at risk of osteoporosis, a bone scan (DEXA scan) may be performed to assess bone health and risk of fractures.

    How to Prepare For Spine Surgery?

    Spine surgery requires preparation on both physical and mental levels. The doctor is likely to provide the patient with all required guidance depending on the severity of the damage. However, here are a few points that may come in handy for anyone planning spine surgery: 

    • Gather all necessary information about spine surgery: The key to preparation for any surgery is being well informed about it. Talk to the healthcare provider and the medical staff, and acquire all important information about the procedure, medicines, cost, and anything that comes to your mind. The more well-informed a person is about the surgery, the better he/ she is likely to do postoperatively.
    • Continue to move: It is tough to live with constant back pain. Even then, a doctor usually recommends being physically active as much as possible. Going stagnant may add to complications during the surgery. Stay physically active, and try to achieve a healthy weight. This can speed up the recovery process and enhance blood circulation too.
    • Avoid anti-inflammatory drugs: You must avoid taking drugs like ibuprofen, naproxen, and aspirin before the surgery. Blood thinners can increase the risk of complications during the surgery. If you are taking any over-the-counter pills, you must inform your doctor.
    • Keep realistic expectations: The surgery is not a guaranteed cure for the condition. Although it improves the injury symptoms to a great extent, a lot also depends on the person’s dietary and lifestyle habits.

    What is the Procedure of Spine Surgery?

    Endoscopic spine surgery is a specific type of spine surgery. It  is a minimally invasive procedure for treating spinal conditions. It involves the use of an endoscope, which is a thin, flexible tube with a camera and light source at its tip.

    Prior to endoscopic spine surgery, a doctor recommends a comprehensive evaluation, including a physical examination and diagnostic tests. A surgeon explains the procedure, discusses the associated risks and benefits, and addresses any questions you may have before the procedure. The surgery is performed under the influence of general anesthesia, rendering you unconscious throughout the procedure. In some cases, local anesthesia with sedation may be used instead.

    During the surgery, a surgeon makes small incisions, usually less than an inch in length, near the affected area of the spine. Through these incisions, specialized instruments and a small endoscope is inserted. The endoscope helps in providing real-time visual images of the surgical site on a monitor, enabling the surgeon to observe the affected area, including the spinal discs, nerves, and surrounding tissues, without the need for a large incision. 

    Using the endoscopic instruments, the surgeon assesses and prepares the target area. This may involve removing a small portion of the bone or soft tissue to reach the spinal structures causing compression or instability. The specific steps usually depend on the purpose of the surgery, such as decompression, fusion, or disc herniation repair.

    Once the surgeon has gained access to the affected area, they carry out the necessary treatment or repair. This may include removing herniated or damaged disc material, repairing a disc, fusing vertebrae together, removing bone spurs, or performing other corrective procedures. After completing the necessary surgical steps, the surgeon removes the instruments and closes the incisions. Typically, the small incisions can be closed using sutures or adhesive strips, often without the need for stitches.

    Following the surgery, a healthcare provider takes you to a recovery area, where you are monitored as you regain consciousness from anesthesia. Pain medication and supportive measures may be provided to manage any discomfort. The length of your hospital stay will depend on the extent of the surgery, and you may be discharged on the same day or after a short period of observation.

    After endoscopic spine surgery, a doctor usually prescribes a rehabilitation program to aid in the recovery of strength, flexibility, and mobility. This may involve physical therapy and specific exercises. Your surgeon provides instructions for postoperative care, including any restrictions or limitations on activities, and schedules follow-up appointments.

    Benefits of Minimally Invasive Spine Surgery (MISS)

    The benefits of MISS are as follows:

    • Lower risk of complications: In traditional spinal surgery, a surgeon makes a large incision to reach the affected area of the spine. The possibility of complications is high, including excessive bleeding and the possibility of infection in open surgery.  In minimally invasive surgery, small incisions are made so there is less opportunity for complications. Moreover, because the incisions are smaller, there is a lower chance of blood loss. Also, ue to less potential for complications, minimally invasive spinal surgery can be performed in an outpatient facility.
    • Decreased Risk of Muscle Damage: Minimally invasive spine surgery helps in supporting and stabilizing the spine. While open surgery results in pulling muscles away from the affected area of the spine, which can result in damage to muscle and soft tissue.  Minimally invasive surgery does not involve the cutting of muscles or the pulling of muscles to the same extent.  Therefore, there is a lower chance of damage to the muscle and surrounding area.
    • Faster recovery: Due to the smaller incision, recovery time of minimally invasive spine surgery is significantly low as compared to major surgery.  Moreover, with little to no muscle damage, patients after spinal surgery can often be discharged much quicker. In many cases, patients are discharged within a day of the procedure.  Therefore, recovery time is quick and much easier.
    • Less painful process: Spinal procedures are usually performed to help relieve compression of the spinal nerves that causes pain in the patient’s back, arms, legs, or other areas of the body.  Traditional, open surgery can cause significant  discomfort and pain because it involves a larger incision. Patients who undergo minimally invasive spinal surgery often suffer less pain throughout each aspect of the procedure.  They may also experience less postoperative pain, reducing the need for pain medications post-surgery.

    What are the Risks and Complications of Spine Surgery?

    Like any surgical procedure, spine surgery also carries certain risks and complications. The potential complications of spine surgery include:

    • Infection: There is a chance of infection caused by bacteria or fungal organisms. A doctor usually suggests antibiotics to the patient before, during, and often after the surgery to lessen the risk of infections.
    • Pseudarthrosis: It is a condition in which there is not enough bone formation, and a spinal fusion does not completely heal. In such cases, a second surgery may be required to obtain a solid fusion. The chances of patients of pseudarthrosis are high in patients who smoke.
    • Nerve damage: There is a chance of nerve or blood vessel damage during the surgery. However, these complications are very rare.
    • Blood clots: There is a rare chance of the formation of blood clots in the legs (deep vein thrombosis) after surgery. They pose a significant danger if they break off and migrate to the lungs.
    • Bleeding: In some cases, a certain amount of bleeding is expected, but this is not typically significant.
    • Pain at graft site: In some rare instances, patients experience persistent pain at the bone graft site.
    • Recurring symptoms: In some cases, patients may experience a recurrence of their original symptoms.

    Some long-term complications involved in spine surgery are as follows:

    • Spinal instability and pain due to implant screws loosening
    • Non-union of the spinal bones that were fused together
    • Implants breaking due to excessive forces on the spine
    • Injury and degeneration to the facet joints 
    • Spinal muscle injury

    What is the Average Cost of Spine Surgery In India?

    The average cost of spine surgery in India typically ranges from around INR 1,40,000 to INR 3,70,000. This is the average cost of surgery, the final cost can vary depending on various factors, including:

    • Type of spine surgery
    • Cost of medication
    • Choice of the hospital
    • The severity of the spinal condition
    • Cost of diagnostic tests
    • A consultation fee of an orthopedic surgeon
    • Type of anesthesia
    • Patient’s age and overall health condition
    • Insurance coverage

    What to Expect After Spine Surgery?

    Recovery and results after spine surgery can vary depending on the type of surgery performed, the specific spinal condition being treated, and how well they follow postoperative instructions. Here are some general guidelines to follow after spine surgery:

    • After spine surgery, take good care of the spine. Begin with short walks and gradually increase the distance and time. 
    • Moderate exercise enhances muscle toning and builds strength. Some of the exercises to do after spine surgery include core-strengthening exercises, upper and lower extremity exercises, breathing exercises, etc. However, avoid twisting, lifting, and bending. If you have had a spinal fusion, avoid lifting weights. 
    • Eat a well-balanced diet rich in fruits and vegetables. Since you will be less active physically, do not load the body with high calories and fatty foods. Healthy eating is crucial for a smooth recovery.
    • Follow the advice of the healthcare provider for bathing and incision care. Typically, doctors recommend keeping the surgical site clean and dry for 3-4 days. Avoid getting into the bathtub or the swimming pool until the doctor deems fit.
    • Take medicines for pain management after the surgery as recommended by the doctor and make sure there are no gaps. Do not take any medicine without informing your doctor.
    • Wear a postoperative brace if the surgeon prescribes one. The brace provides support to the neck and back and limits movements of the spinal levels. 
    • Ask your surgeon what is the best position to sleep in without hurting the back, and try to follow it. Ideally, the following tips help relieve the stress from the back and the adjacent body parts.
    • Place a pillow under the knees or the back to keep the hips slightly bent, Don’t get up suddenly from the bed. Use the ‘log roll method.’ While getting up, push your arms and legs rather than exert pressure on the waist or back.

    FAQs about Spine Surgery

    When can I resume daily activities after spine surgery?

    If you undergo minimally invasive spine surgery, you can resume your normal activities within 6-8 weeks, including bending, lifting, and twisting movements. However, some spine surgeries like spine fusion procedures may take longer recovery time depending on the location and severity of the condition.

    How long does spine surgery take?

    The duration of a spine surgery depends on the complexity. But in most cases of minimally invasive spine surgery, the duration is approximately 1-2 hours.

    How long do I have to stay in the hospital after spine surgery?

    You may have to stay in the hospital for a day or two after your spine surgery. However, the exact duration depends on factors like the type of surgery performed, the complexity of the procedure, the patient’s overall health, and their response to surgery.

    Are there any risks involved in spine surgery?

    Like any other surgery, there are certain risks associated with endoscopic spine surgery or MISS, such as:

    • Infections at the surgical site
    • Allergic reactions to given anesthesia
    • Blood clotting
    • Pain and discomfort
    • Paralysis
    • Stroke

    For how long shall I need physiotherapy after spine surgery?

    Rehabilitation and physiotherapy for recovery after spine surgery begin right after you are discharged from the hospital. Your rehabilitation period may last 4-6 weeks or even longer, depending on the severity of the condition and the nature of the surgery performed.

    What is the most common spine surgery?

    The most common type of spine surgery is spinal decompression and fusion. In this surgery, pressure is taken off the pinched nerves to make the spine stable. The surgeon relieves the stress from the spinal cord and then stabilizes it by using hardware to anchor the bones in the spine. 

    Who needs spinal surgery?

    In cases of traumatic injury (a fracture or loss of function due to spinal cord injury) and in situations where a patient is losing the ability to use an arm or a leg, surgery is often needed on an urgent or emergent basis. 

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    Dr. Kamal Bachani
    32 Years Experience Overall
    Last Updated : March 30, 2024

    Types of Spine Surgery

    Spinal laminectomy/ spinal decompression

    It is generally performed for spinal stenosis patients. The surgeon removes bony spurs or walls compressing the spinal column to relieve the nerve pressure.

    Vertebroplasty/Kyphoplasty

    Vertebroplasty and kyphoplasty are performed to fix compression fractures due to osteoporosis. The surgeon injects a glue-like bone cement that hardens and strengthens the vertebrae.

    Discectomy (or Microdiscectomy)

    It is a slipped disc surgery that is performed to remove a herniated disc compressing the nerve root and spinal cord. It is often performed in conjunction with laminectomy.

    Foraminotomy

    This is performed to widen the spinal column where the nerve root exits the spinal canal in case it has narrowed due to aging.

    Nucleoplasty

    Nucleoplasty, also called plasma disk decompression is a minimally invasive laser surgery in which the surgeon uses a plasma laser device to reduce the disk size and treat mild disk hernia.

    Spinal fusion

    The surgeon removes the spinal disc and fuses the adjacent vertebrae together using bone grafts or metal implants to allow the fusion of vertebrae together via the bone grafts, for example, ACDF surgery (Anterior cervical discectomy and fusion), TLIF surgery (Transforaminal Lumbar Interbody Fusion).

    Artificial disk replacement

    For people with severely damaged vertebral discs, the surgeon removes the disc and replaces it with a synthetic implant to help restore vertebral height and movement.

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    • VR

      Vipin rawat

      3/5

      After having spine surgery, my brother recovered quickly and had a great experience with him. Would strongly advise

      City : MUMBAI
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      Nilesh Aswale

      4/5

      I had surgery with Dr. Chintan Rohit for a gap in my neck. After three months of rest, I'm completely cured and grateful for his excellent care. Thank you, Dr.

      City : MUMBAI
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      Ram Rajput

      5/5

      It was an excellent experience. I was suffering from severe pain in my neck, and after visiting Dr. Chintan Rohit, Hegde got relief the very next day, and he even identified the correct problem.

      City : MUMBAI
    • SM

      Savita Medepalli

      4/5

      As a physician and a person, Surya Prakash Rao is one of the best doctors I have encountered thus far. The Anterior Cervical Decompression and Fusion (ACDF) condition affects my father. Prior to meeting Surya Prakash Sirwevisited numerous hospitals, all of which misled us.

      City : HYDERABAD
    • AV

      Abhishek Verma

      3/5

      It's an excellent Doctor with state-of-the-art technologies and facilities, making it a dream come true for spine surgery patients!

      City : BANGALORE
    • PG

      pasam gopi

      3/5

      Excellent surgeon performing spine surgery. He will do spine surgery with extreme caution and grace. The spine surgery that my wife, L4 L5, underwent was quite successful. We recommend him as a competent spine surgeon in Hyderabad.

      City : HYDERABAD