March 1, 2023

Diagnosing & Treating Conditions of the Spine and Neck

What is a Spine Surgeon?

Spine surgeons are medical doctors who specialize in diagnosing and treating conditions of the spine (e.g., back and neck). All spine surgeons have obtained an M.D. or D.O. degree and must complete additional certifications and post-medical school training. These specialists must complete an approved residency program immediately after medical school, followed by at least one or more additional years of spinal surgery fellowship training.

There are two main paths to becoming a spine surgeon: becoming an orthopedic surgeon or a neurosurgeon specializing in spinal surgery. These physicians subspecialize by completing additional fellowship training to further refine and gain expertise to address the spine. Both orthopedic spine surgeons and neurosurgeons must also pass certification exams by their respective accrediting boards.

What Does a Spine Surgeon Do?

The primary role of a spine surgeon is to diagnose and treat conditions of the spine, including the neck and back. As their name implies, they will recommend and perform surgical intervention if surgery is an appropriate or necessary treatment option. They will perform examinations and recommend additional testing as needed to discern the type of procedure best suited to support safe and optimal patient outcomes. Spine surgeons also recommend and provide conservative, nonsurgical treatment approaches when available and appropriate.

In general, spinal surgeons use their time and expertise to diagnose spinal conditions, develop treatment plans, prescribe rehabilitative therapies, and provide follow-up care as needed. As spine specialists, spinal surgeons are particularly suited to determine the best treatment options and collaborate with other healthcare specialties (e.g., pain management specialists, rehabilitative therapists, etc.) to support spine health.

Specific examples of conditions treated and interventions provided are described further below.

When Should I See a Spine Surgeon?

You should seek the expertise of a spine surgeon when experiencing any changes to your spinal health, such as pain, injury, or suspected injury in your neck or back. If your symptoms are severe, worsening, lasting a week or more without improvement, recurrent, or affecting your daily life, it is time to contact your doctor.

Other common signs and symptoms of potential spinal health concerns you should be aware of include:

• Back or neck pain or discomfort
• Back or neck stiffness or mobility concerns
• Changes in posture or curvature of the spine
• Changes in sensation (e.g., numbness or tingling)
• Changes in strength or stability
• Changes in bowel or bladder function
• Suspected congenital or degenerative conditions
• Suspected central nervous system conditions
• Suspected inflammatory or autoimmune conditions
• Impairment to your daily activities and functioning

Though we often think of pain as the primary indicator of spine health, changes in strength, sensation, and bowel or bladder function could indicate that a spinal condition is impacting related nerve or muscular functions. If you are experiencing any of these or other possible spinal symptoms, consider contacting a spine surgeon or asking your primary care physician for a referral.

If you're searching for a spine surgeon you can trust, chat with us to find a spine surgeon near you.

What Can I Expect at My First Spine Surgery Appointment?

Like most initial visits with a new medical provider, your first appointment with a spine surgeon involves your doctor getting to know you and your specific case. They will ask you questions to understand your current symptoms and concerns. They will also review your records and ask additional questions about your prior medical conditions, prior procedures and surgeries, current medications, recent imaging or lab results, family history, and other pertinent aspects of your current or previous medical history.

Your spine surgeon may choose to perform some basic visual or physical screenings depending on the nature of your concerns. This could include visually inspecting your neck, back, or trunk to examine skin integrity, spinal alignment, or any other observable characteristics. They may also perform basic manual manipulation or other hands-on screenings to evaluate your joint mobility, pain, alignment, sensation, and other functions.

Depending on your concerns and your initial examination, the spine surgeon may order additional lab tests or imaging to help determine a diagnosis or to inform their treatment recommendations.

Common imaging or testing that may be ordered by a spine surgeon include:

• Lab value testing - used to identify or rule out metabolic concerns
• X-Rays - used to diagnose bone or tumor concerns
• Computed Tomography (CT) - used to inform bone and soft tissue diagnoses
• Magnetic Resonance Imaging (MRI) - used for in-depth examination of soft tissue without bone obstructing the image
• Myelogram (contrast with CT or X-Ray) - used to identify or rule out irregularities in the spinal cord, spinal canal, nerve roots, and other tissues
• Nerve Conduction Velocity (NCV) and/or Electromyography - both tests are used to determine muscular vs. nerve functioning disorders

These tests and imaging may be done in the office or outsourced to a testing or imaging center. Where testing occurs largely depends on the type and availability of those resources within your doctor’s specific practice setting.

After collecting all the necessary information, your spinal surgeon will provide you with a diagnosis, treatment plan recommendations, and any plans for collaborating with additional specialists or follow-up visits to monitor progress as needed.

What Conditions Can a Spine Surgeon Diagnose?

As spine specialists, spinal surgeons can diagnose and treat a wide array of conditions related to neck and back health. These conditions may involve any aspect of the spinal anatomy such as vertebrae, discs, musculature, nerves or spinal cord, and tendons or ligaments.

Examples of common diagnoses identified and addressed by spine surgeons include:

• Herniated, slipped, or ruptured discs
• Scoliosis, lordosis, or kyphosis
• Tumors or other growths on the spine
• Degenerative disc disease
• Compression fractures or other spinal fractures
• Neck or back sprains
• Spondylolisthesis
• Spinal stenosis
• Ankylosing spondylitis
• Sciatica
• Radiculopathy
• Cauda Equina Syndrome
• Avascular Necrosis
• Other infections or inflammation of the spine
• Congenital condition affecting spine health (e.g., muscular torticollis)
• Autoimmune conditions affecting spine health
• Osteoarthritis or rheumatoid arthritis of the spine

These conditions may result from illness, injury, chronic disease, general effects of aging, or congenital health conditions. Patients’ genetic predispositions, obesity, poor posture, lifestyle choices (e.g., smoking), or other environmental factors (i.e., work involving heavy lifting or repetitive movements) may also increase the risk of developing spinal health issues.

What Treatment Can a Spine Surgeon Provide?

Spine surgeons are trained to perform a variety of advanced or minimally invasive surgical interventions.

Common surgical procedures for the spine include:

• Spinal fusion
• Discectomy
• Foraminotomy
• Laminectomy
• Kyphoplasty
• Laminoplasty
• Artificial disc replacement
• Minimally invasive or microsurgery approaches

These interventions may also require the placement of additional artificial structures to reinforce the surgical area as indicated. Spine surgeons can also recommend and provide nonsurgical interventions when surgery is not an option or when opting for more conservative approaches.

Common nonsurgical treatment options provided or recommended by spinal surgeons include:

• Corticosteroid or other injections
• Electrical nerve stimulation
• Spinal braces and orthotics
• Rehabilitative therapy (e.g., physical or occupational therapy)
• Medications for pain or neurological management
• Nerve blocks
• Therapeutic massage
• Acupuncture

Because your spine is vital to supporting your entire musculoskeletal system and is in close proximity to your nervous system, any spine surgery carries inherent risks. Typically, spine surgeons will explore nonsurgical, conservative treatment options before recommending surgical intervention. However, surgery may be required depending on the success of conservative treatment, the severity of your symptoms, and your spinal anatomy and structural integrity.

These examples are just a few of the many treatment approaches your spine surgeon is trained and qualified to provide. Be sure to discuss your specific surgical and nonsurgical treatment options with your provider.

Orthopedic Spine Surgeon vs Neurosurgeon: What's the Difference?

While both are specially trained to diagnose and treat conditions of the spine, there are some differences in the breadth of training each subspecialty undergoes. Orthopedic surgeons are trained to treat musculoskeletal conditions. Orthopedic spine surgeons have further specialized to focus on treating the neck and back. In contrast, neurosurgeons are trained to address the central and peripheral nervous systems. Those neurosurgeons who specialize in spinal surgery focus particularly on the spine, spinal cord, and related neural pathways. Regardless of training backgrounds, both orthopedic and neuro spinal surgeons offer valuable expertise in the diagnosing and treating of spinal conditions.

It is common and appropriate to seek multiple opinions, particularly when considering spinal treatment or surgery. When looking for a spine surgeon who can best address your specific case, feel empowered to ask questions about their medical training, approach, and recommendations to determine if that physician is a good match for your wants and needs.