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Frequently Asked Questions (FAQ)

Do I need a Neurosurgeon?

Fortunately, very few people will actually need to see a neurosurgeon.  If your primary care physician or other medical specialist has referred you to a neurosurgeon, don't be too alarmed.  The vast majority of those patients will not need surgery, but you will need a neurosurgeon to discuss treatment options (non-surgical vs surgical).  Neurosurgeons treat a wide variety of diseases of the brain (brain tumors), spinal diseases (disc herniation, spinal stenosis, spondylosis) and peripheral nerves (carpal tunnel).  If you have had a spine MRI but have not been referred, yet, you can submit your MRI results for a courtesy review of your MRI report to see if a neurosurgery appointment is warranted.  Click the button to submit an MRI review request. 

 

Should I see a Neurosurgeon or an Orthopedic Spine Surgeon?

A neurosurgeon trains for 7 years after medical school to focus on surgery that impacts the brain, spinal cord, and spinal nerves.  When these are compromised, you can have neurological symptoms like referred pain shooting down your arms/legs or numbness in those affected areas.  You can have signs of weakness.  A neurosurgeon focuses restoring function to the brain, spinal cord, and spinal nerves, while protecting the bone structures of the spine.  This may involve surgery in the brain and spine, and neurosurgeons often utilize microscopic neurosurgery techniques developed for brain surgery when doing surgery in the spine.

An orthopedic surgeon trains for 5 years after medical school to focus on surgery that impacts the bones and joints of the entire body.  After 5 years of orthopedic surgery residency, some orthopedic surgeons will train for one year in a spine fellowship in order to treat orthopedic disorders in the spine.  When the bones/joints/discs of the spine are compromised, you can have pain at the local site of the bone fracture or dislocation (back pain).  Orthopedic spine surgeons address structural problems associated with the bones and joints, such as scoliosis, spinal deformity and fractures.  

 

In some cases, neurosurgeons and orthopedic surgeons combine their expertise together if both the nerves and the structures are severely affected, requiring a specialist in each area.  The specialist you see will depend on your signs and symptoms and what organ system it primary affects.  

Should I have Laser Surgery?

Laser spine surgery is often confused with minimally invasive surgery.  Minimally invasive surgery (MIS) is a specialized spine surgery technique developed through medical school research and pioneered by Dr. Kevin Foley at Semmes-Murphey Clinic in Tennessee in the 1990s.  This uses a small incision (about 14-16 mm) to introduce surgical tubes that enable spine surgery with less damage to the surrounding tissues.  Some centers use this exact technique developed by Dr. Foley and may occasionally charge extra for the use of a laser instead of the accepted standard MIS surgical instruments and techniques, and this is what is called "laser spine surgery."  There is no peer-reviewed outcomes research that indicate a superior value of the use of laser in this setting.  Laser is very rarely indicated, as noted by the American Association of Neurological Surgeons (click for reference)

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