<p>Returning to driving is a significant milestone for patients recovering from spine surgery, representing restored independence, mobility, and mental well-being. However, this decision involves numerous challenges, including biomechanical restrictions, the effects of pain management, cognitive recovery, patient-reported outcomes, and diverse medico-legal considerations. This review consolidates current evidence on recovery timelines, biomechanical factors, and the influence of medications on driving ability. It also examines the role of regional legal frameworks and professional guidelines in shaping decisions by both patients and surgeons. Additionally, it highlights interdisciplinary approaches to enhance post-operative care and discusses the broader relevance of these findings for other medical fields, proposing future research to advance understanding in this area.</p>