Conservative & Minimally Invasive Care
Spine Surgery on Long Island
At Long Island Brain & Spine, we take a deliberately conservative approach: we recommend spine surgery only when non-surgical treatments have been thoroughly explored and when surgery is genuinely likely to help.
What Is Spine Surgery?
Spine surgery refers to operations on the cervical (neck), thoracic (mid-back), or lumbar (lower back) spine to relieve pressure on the spinal cord and nerves, stabilize the column, or remove abnormal tissue.As a neurosurgeon, Dr. Missios’s training is focused specifically on the spinal cord and nerve roots — the critical structures that produce the pain, weakness, and numbness that bring most patients to our office.
Most spine surgeries today are performed through smaller incisions using microscopes and image-guided navigation for faster recovery.
Specialized Focus
Spine Conditions Treated
When Is Surgery Needed?
Most cases of neck and back pain do not require surgery. Physical therapy, injections, and time often resolve symptoms. We recommend surgery primarily when:
“We never recommend surgery based on imaging alone. Imaging findings like disc bulges are common even in people without pain. We treat the patient, not the MRI.”
Types of Spine Surgery
What to Expect
Planning Day
Detailed neurological exam and review of imaging. We ensure your MRI findings match your clinical symptoms before proceeding.
The Procedure
Performed at leading Long Island hospitals. Many MIS procedures are outpatient or involve only one overnight stay.
The Recovery
Return to desk work in 1-2 weeks for MIS cases. Fusions may require 3-6 months for full bone healing and physical therapy.
The Spine Surgery Process
Consultation
Dr. Missios reviews your imaging, medical history, and prior treatments, and discusses whether spine surgery is the best fit. For cancer-related cases, the recommendation is made in coordination with your oncology team.
Planning Day
A custom immobilization device (typically a facemask) is fabricated. High-resolution MRI and CT scans are obtained and fused. The neurosurgery, radiation oncology, and medical physics team designs a custom treatment plan with multiple beam angles to focus the dose precisely on your target.
Treatment Day
Treatment is painless — most patients describe it as similar to having an MRI. Depending on the target and the technology used, a single session typically lasts 30 to 90 minutes. Most patients drive themselves home the same day.
Follow-Up
Follow-up MRI scans, generally at three-month intervals initially, are used to confirm tumor control. SRS does not typically shrink tumors immediately — the goal is to stop growth and often produce gradual shrinkage over months to years.
Why Patients Choose Dr. Missios
Frequently Asked Questions
Not necessarily. MRI findings like disc bulges and degeneration are very common even in people who have no pain. What matters is whether the imaging matches your symptoms and if conservative treatment has been given a fair trial.
For a single-level microdiscectomy, many patients return to light activity within a week and desk work within two weeks. Fusion procedures take longer — typically six weeks for most activities and 3-6 months for full bone healing.
Spine surgery is most effective for relieving leg or arm pain caused by a pinched nerve. While it helps many causes of back pain, no operation guarantees 100% relief. We discuss realistic expectations specific to your case.
Absolutely. Second opinions are a routine and welcomed part of our practice. Dr. Missios often sees patients who are looking for a clear explanation of their surgical and non-surgical options.
Schedule a Spine Surgery Consultation on Long Island
If you or a loved one has been told you may need spine surgery, you deserve a clear, unhurried conversation with a board-certified neurosurgeon who will explain every option — including whether surgery is truly the right path. Dr. Missios sees patients at three convenient Long Island locations and offers second-opinion consultations.