Do I need to See a Neurosurgeon?


As an orthopedic spine surgeon, I am trained to take care of the entire spine from the base of the skull down through the sacrum. A significant part of my practice is caring for the cervical spine, which is the part of the spinal column in your neck. People can develop arthritic changes or injuries to the intervertebral discs that can pinch on the nerves or spinal cord. As a patient, this will cause pain in your arms, and sometimes even affect your balance. Often times, people have the misconception that only neurosurgeons care for this part of the body. This may originate from how spine care used to be delivered, however, much has changed through the years.

Back in the early days of spine surgery (in the early 21st century), there certainly was a significant difference in issues that neurosurgical spine surgeons would address as opposed to orthopedic spine surgeons. Orthopedics actually has its name rooted in spine care. “Ortho” meaning straight and “ped” meaning child, quite literally comes from the treatment of scoliosis in children. Orthopedic spine surgeons, focused much of their care on scoliosis, and eventually operative care was focused on spinal instrumentation. Instrumentation started with Harrington rods and wires, and now includes the placing of any type of metal implants to straighten or stabilize the spine.

Neurosurgical treatment began with the treatment of the spinal cord and the surrounding layers of tissue. Neurosurgical training involves learning to care for conditions of the brain and spine, with particular focus on the soft tissues. Orthopedic training includes learning to care for conditions of the entire musculoskeletal system, including the spine, and not the brain. There is particular focus on the science of bones and muscle (musculoskeletal health). Through the years, overlap has gradually developed to the point where we are today. Many neurosurgical spine surgeons treat spinal deformity such as scoliosis, and most orthopedic spine surgeons treat spinal column injuries, tumors and spinal stenosis. In fact, when I did my spine fellowship in 2009 at the University of Utah, I spent time with both orthopedic and neurosurgical spine surgeons. The cases that we performed on the orthopedic and neurosurgical services were virtually identical. Most graduates of both types of residency programs spend an additional year or two training specifically in spine surgery, leading to the convergence of the two types of surgeons.

Today, we each perform 95% of the same types of procedures, as most of our care is focused on relieving spinal stenosis in the cervical, thoracic, and lumbar spine that causes pain in the arms and legs and may lead to neurologic dysfunction. So, if you have pain that runs from your neck down into your arms and hands, or are experiencing numbness and clumsiness in your hands and feet, this could be coming from your neck. You do not need a neurosurgeon. Ortho Rhode Island is certainly well equipped to take care of your needs and get you back to the quality of life you deserve.

NOTICE: MRI imaging at our Providence office is currently unavailable due to construction. We appreciate your patience as we work to improve your experience!