Medically reviewed by Dr. David L. Greenwald, MD, FAANS, FACS — dual board-certified spine surgeon & neurosurgeon. Last reviewed October 2026.

Spine surgery is never our first step — but when conservative care and injections haven't worked, the right procedure can relieve pain and restore function for good. At Desert Spine and Pain, surgery is performed by a dual board-certified spine surgeon and neurosurgeon who uses minimally invasive techniques wherever possible, so most patients recover faster and get back to life sooner.

How Minimally Invasive Spine Surgery Works

What Is Spine Surgery?

Spine surgery is any procedure that corrects a problem in the bones, discs, joints, or nerves of the spine. In almost every case the goal is simple: take pressure off a compressed nerve or spinal cord, stabilize a segment that has become unstable, or both — so the pain stops and you can move, work, and sleep normally again. It is not a single operation but a family of procedures, ranging from a small outpatient decompression to a complex multi-level reconstruction.

At Desert Spine and Pain, spine surgery is the last step, not the first. The large majority of back and neck problems improve with conservative care and interventional pain procedures. When those have been exhausted — or when a nerve is in danger — the right operation, done well, can end pain that nothing else has touched. Because Dr. Greenwald is both a spine surgeon and a neurosurgeon, the bone, the disc, and the delicate nerves are all handled by one expert.

Spine Surgery Procedures We Perform

Most people searching for "spine surgery" don't yet know which operation they need — that's our job to determine. These are the main approaches we offer, each matched to a specific problem:

When Is Spine Surgery Needed?

Surgery becomes the right choice in a minority of cases — but in those cases, waiting too long can cost you function. You should be evaluated for surgery when:

• Conservative care hasn't worked. Pain that persists despite several weeks to months of physical therapy, medication, and image-guided injections.
• You have nerve-related symptoms. Leg or arm pain, numbness, tingling, or weakness from a pinched nerve — especially if it's getting worse.
• There is instability or deformity. A slipped vertebra (spondylolisthesis), a fracture, or progressive curvature that's driving the pain.
• Your spinal cord is being compressed. Signs of myelopathy — clumsiness, balance or hand-coordination problems — warrant prompt evaluation, because decompression protects function.

Surgery Only When It's Truly Needed

Most spine conditions never require an operation, and we exhaust conservative and interventional pain options first. When surgery is the right answer, Dr. Greenwald's dual training as a spine surgeon and a neurosurgeon means both the structure and the nerves are handled by one expert — and that minimally invasive techniques are used whenever possible. All surgical procedures are performed at an accredited affiliated surgical facility.

The Minimally Invasive Advantage

Whenever it's safe and appropriate, Dr. Greenwald operates through a small incision using a tubular retractor that gently spreads the muscle instead of cutting through it. Compared with traditional open surgery, a minimally invasive approach generally means less blood loss, less post-operative pain, a shorter hospital stay, and a faster return to activity. Many of our procedures are performed on an outpatient basis, so you go home the same day. Not every problem can be solved this way — but when it can, it's our first choice.

What to Expect — From Consultation to Recovery

Deciding on surgery should never feel rushed or one-sided. Here's how the process works at Desert Spine and Pain:

• Consultation & imaging. Dr. Greenwald reviews your history, examines you, and studies your MRI or CT to pinpoint the exact source of the problem.
• An honest recommendation. You'll hear whether surgery is truly warranted — and if a less-invasive option could work first, we'll tell you.
• The procedure. Your operation is performed by Dr. Greenwald at an accredited affiliated surgical facility, using the least-invasive technique that will fully address the problem.
• Recovery & follow-up. You're given a clear, personalized recovery plan and seen in follow-up to make sure you're healing and getting back to the activities you love.

Recovery & Getting Back to Life

Recovery depends on the procedure. After a minimally invasive decompression or microdiscectomy, many patients are up and walking the same day and returning to light activity within a couple of weeks. More complex procedures such as a multi-level fusion take longer — often several months for the bone to fully heal — with activity gradually increased along the way. Whatever the operation, you'll leave with specific instructions and a recovery timeline built around your life and your goals.

Insurance, Out-of-Network & Cost

We welcome out-of-network patients of every kind and you don't need a referral to be seen. Our team verifies your coverage and explains any out-of-pocket costs before anything is scheduled, so there are no surprises. Because many of our patients come to us after a car accident or injury, we also coordinate closely with personal-injury attorneys and offer 24/7 concierge support for accident-related spine surgery.

Proudly Serving the Greater Phoenix, Arizona Area

Why Choose Our Spine Surgeon in Phoenix

Your surgery is performed by a spine surgeon who is also a board-certified neurosurgeon — a dual qualification few surgeons in Phoenix hold, and one that matters most when nerves are involved. We welcome out-of-network patients, require no referral, and partner closely with personal-injury attorneys for accident-related spine surgery.

Spine Surgery: Frequently Asked Questions