Surgical Spine Care

Comprehensive surgical spine evaluation and treatment for cervical, thoracic, and lumbar spine conditions causing nerve compression, spinal instability, neurologic symptoms, and functional limitations.

cervical and lumbar mri

Most patients with neck pain or back pain do not require surgery. Many spine conditions improve with physical therapy, medication, injections, activity modification, or other conservative treatments.

However, some patients continue experiencing persistent pain, progressive neurologic symptoms, walking limitations, weakness, numbness, or significant functional decline despite appropriate non-surgical care. In these situations, surgical spine evaluation becomes important.

Dr. Garges provides surgical spine care in Webster, TX for patients throughout Clear Lake, League City, Nassau Bay, Friendswood, Pearland, Pasadena, and the greater Houston area.

As a board-certified orthopedic spine surgeon with fellowship training at the San Francisco Spine Institute and prior experience as chief of spinal surgery at UTMB, Dr. Garges evaluates both common and complex spine conditions involving the cervical, thoracic, and lumbar spine.

His approach focuses on careful surgical decision-making based on symptoms, neurologic examination, imaging findings, prior treatment response, and overall functional impact.

What Surgical Spine Care Involves

Surgical spine care involves evaluating whether structural problems within the spine are contributing to pain, neurologic symptoms, instability, or loss of function that may benefit from surgical treatment.

Spine surgery is not based on imaging findings alone. Many patients have disc degeneration, arthritis, spinal stenosis, or herniated discs visible on MRI scans without significant symptoms.

Determining whether surgery is appropriate requires correlating:

Patient symptoms
Physical examination findings
Neurologic function
Imaging studies
Functional limitations
Response to prior conservative treatment

Dr. Garges evaluates the entire clinical picture before discussing surgical recommendations.

The goal of surgical spine care is not simply treating MRI findings. The objective is relieving clinically significant nerve compression, stabilizing structural problems when necessary, and improving function when conservative treatment is no longer providing adequate relief.

Symptoms That May Require Surgical Spine Evaluation

Patients often seek surgical spine evaluation after symptoms begin significantly affecting mobility, work activities, sleep, or quality of life.

Symptoms vary depending on the location of spinal involvement and the severity of nerve or spinal cord compression.

Neck and Arm Symptoms

Cervical spine conditions may cause:

Persistent neck pain
Arm pain radiating from the neck
Shoulder blade pain
Numbness or tingling in the hands or fingers
Weakness in the arms or hands
Difficulty gripping or holding objects
Loss of hand coordination
Balance problems or gait instability

Progressive hand weakness, dropping objects, or balance difficulty may indicate spinal cord compression requiring prompt evaluation.

Learn more about treatment options for neck pain, arm pain, and cervical spine conditions..

Lower Back and Leg Symptoms

Lumbar spine conditions commonly cause:

Persistent lower back pain
Sciatica
Leg numbness or tingling
Weakness in the legs or feet
Difficulty standing or walking
Pain worsening while standing
Reduced walking tolerance
Symptoms interfering with sleep or work

Some patients experience neurogenic claudication caused by spinal stenosis, where walking becomes progressively limited until sitting or leaning forward relieves symptoms.

Learn more about Lumbar Spine Treatment.

Functional Decline

One of the most important aspects of surgical evaluation is understanding how symptoms affect function.

Patients may reach the point where they:

Cannot walk normal distances
Struggle to work comfortably
Cannot sleep due to pain
Avoid daily activities because of symptoms
Experience progressive mobility decline
Have difficulty performing normal household tasks

Functional limitations often play a major role in determining whether surgical treatment should be considered.

Spine Conditions Commonly Evaluated for Surgical Care

Dr. Garges evaluates a wide range of cervical, thoracic, and lumbar spine conditions that may contribute to pain, neurologic symptoms, spinal instability, or functional impairment.

Herniated Discs

herniated disc - compressed nerve diagram A herniated disc occurs when disc material extends beyond its normal boundary and compresses nearby nerves.

Cervical disc herniation may cause:

Neck pain
Radiating arm pain
Hand numbness
Arm weakness

Lumbar disc herniation commonly causes:

Sciatica
Leg pain
Foot numbness
Weakness in the leg or foot

Many herniated discs improve with conservative treatment. Surgical evaluation becomes more important when symptoms persist despite therapy, medications, injections, or activity modification.

Learn more about Herniated Disc Treatment.

Spinal Stenosis

Spinal stenosis involves narrowing of the spinal canal or nerve passageways.

This narrowing may result from:

Bone spurs
Degenerative arthritis
Disc bulging
Ligament thickening
Degenerative instability

Lumbar spinal stenosis commonly causes:

Leg pain while walking
Standing intolerance
Sciatica
Walking limitations

Cervical spinal stenosis may contribute to:

Arm weakness
Hand numbness
Loss of coordination
Balance problems
Spinal cord compression symptoms

Some patients improve with conservative care, while others develop progressive neurologic symptoms requiring surgical evaluation.

Degenerative Disc Disease

Degenerative disc disease describes progressive wear involving spinal discs over time.

Disc degeneration may contribute to:

Chronic neck pain
Lower back pain
Disc collapse
Nerve compression
Spinal instability

Not every patient with degenerative disc disease requires surgery. Imaging findings must correlate with symptoms and functional limitations.

Spondylolisthesis and Spinal Instability

Spondylolisthesis occurs when one vertebra shifts relative to another.

Spinal instability may contribute to:

Mechanical back pain
Nerve compression
Progressive deformity
Walking limitations

Some patients remain stable without significant symptoms. Others develop worsening instability requiring surgical consideration.

Spinal Deformity

Spinal deformity conditions such as scoliosis may progress over time and contribute to pain, imbalance, nerve compression, or mobility decline.

Adult spinal deformity evaluation considers:

Severity of curvature
Progression over time
Neurologic symptoms
Functional limitations
Overall spinal balance

How Dr. Garges Evaluates Surgical Candidacy

Surgical spine evaluation involves much more than reviewing an MRI report.

Dr. Garges performs comprehensive assessment to determine whether structural pathology identified on imaging is truly responsible for the patient’s symptoms and whether surgery is likely to improve function.

Evaluation Component	Purpose
Symptom Review	Identifies pain patterns, numbness, weakness, progression, and functional limitations
Neurologic Examination	Evaluates strength, sensation, reflexes, coordination, and spinal cord function
Imaging Correlation	Determines whether MRI or CT findings match symptoms and examination findings
Treatment History	Reviews physical therapy, injections, medications, and prior procedures
Functional Assessment	Evaluates mobility decline, work limitations, sleep disruption, and activity restrictions

Imaging findings alone do not determine treatment. Many MRI abnormalities represent age-related changes rather than clinically significant pathology.

Dr. Garges carefully determines:

Whether symptoms match imaging findings
Whether nerve compression is clinically significant
Whether neurologic deficits are progressing
Whether surgery is likely to improve function
Whether conservative treatment remains appropriate

Patients should bring prior imaging studies, radiology reports, operative reports, and records of prior treatment whenever possible.

Learn more about Spine Evaluation.

Types of Surgical Spine Procedures

When surgery becomes appropriate, procedure selection depends on the diagnosis, anatomy, spinal stability, location of pathology, and overall treatment goals.

Spinal Decompression Procedures

Decompression surgery removes pressure from spinal nerves or the spinal cord.

Common decompression procedures include:

Laminectomy
Laminotomy
Microdiscectomy
Foraminotomy

These procedures may be used to treat:

Spinal stenosis
Herniated discs
Nerve root compression
Foraminal narrowing

The goal is relieving clinically significant nerve compression contributing to pain, numbness, weakness, or walking limitations.

Learn more about Spinal Decompression Surgery.

Spinal Fusion Procedures

Spinal fusion stabilizes segments of the spine when instability contributes to symptoms or when decompression procedures may create instability.

Fusion may be considered for:

Spondylolisthesis
Degenerative instability
Spinal deformity
Recurrent instability after prior surgery
Multi-level degeneration

Not all spine surgery requires fusion. Surgical planning is individualized based on each patient’s anatomy and diagnosis.

Minimally Invasive Techniques

Some patients may be candidates for minimally invasive surgical techniques using smaller incisions and targeted surgical access.

However, minimally invasive surgery is not appropriate for every patient or condition.

Dr. Garges selects the surgical approach based on what best addresses the clinical problem rather than using a single technique for every patient.

When Spine Surgery May Be Considered

Most patients begin with conservative treatment before surgery is considered.

Non-surgical treatment may include:

Physical therapy
Medication management
Epidural steroid injections
Activity modification
Posture and ergonomic changes
Exercise and rehabilitation programs

Surgical evaluation may become appropriate when:

Symptoms persist despite conservative care
Neurologic symptoms progressively worsen
Walking becomes severely limited
Weakness develops
Spinal cord compression affects coordination or balance
Quality of life becomes significantly impaired

Progressive weakness, worsening neurologic deficits, or spinal cord compression symptoms require prompt evaluation.

Dr. Garges carefully evaluates whether surgery is likely to improve the patient’s symptoms, neurologic function, and daily activity level before making surgical recommendations.

Imaging and Surgical Planning

Advanced imaging plays an important role in spine surgery evaluation and planning.

MRI Evaluation

MRI is commonly used to evaluate:

Disc herniation
Spinal stenosis
Nerve compression
Spinal cord compression
Soft tissue abnormalities

MRI helps identify clinically significant pathology affecting neural structures.

CT and X-Ray Evaluation

CT imaging provides detailed evaluation of bone anatomy and degenerative changes.

X-rays help evaluate:

Spinal alignment
Instability
Scoliosis
Spondylolisthesis
Motion between vertebrae

Flexion-extension X-rays may be used when instability is suspected.

These studies help determine whether decompression alone or decompression combined with stabilization may be appropriate.

Why Patients Choose Dr. Garges for Surgical Spine Evaluation

Patients frequently seek evaluation after experiencing persistent symptoms, mobility decline, or uncertainty regarding whether surgery is truly necessary.

Dr. Garges focuses on careful surgical decision-making rather than recommending surgery based solely on imaging findings.

Patients often choose Dr. Garges because he:

Personally reviews imaging studies in detail
Explains findings clearly and directly
Evaluates both surgical and non-surgical options
Has extensive experience with complex spine conditions
Correlates symptoms carefully with imaging findings
Takes time to answer questions thoroughly

“Dr. Garges explained everything clearly so I understood exactly what was happening.”

“He reviewed my imaging carefully and explained why surgery was or was not appropriate.”

“I was struggling to walk normally and finally felt like I had answers.”

Patients are not automatically directed toward surgery. Recommendations are individualized based on diagnosis, neurologic findings, functional limitations, imaging correlation, and treatment goals.