Do You Need a Neurosurgeon for Your Neck or Back?

A neurosurgeon is a physician who does surgical procedures to repair disease or injury of the brain, spinal cord, or nerves. Sometimes back pain or neck pain requires neurosurgical intervention, although surgery is not a common approach for treating these issues.

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Some of the conditions that neurosurgeons treat include disc degeneration, cauda equina syndrome, scoliosis, spina bifida, spinal cord injury, spinal infections, cysts, tumors, and more. While there are circumstances when these conditions can be treated surgically, there are also situations in which these conditions can be treated without surgery.

Neurosurgeons often use bone grafts or spinal instrumentation such as plates, screws, rods, and cages.

Orthopedic surgeons can operate on some of these conditions as well. Generally, neurosurgeons operate on conditions that affect the spinal cord, which is composed of nerves, while orthopedic surgeons operate on the spine, which surrounds the spinal cord and is composed of bone. But these structures affect each other, so sometimes structural causes of back pain can be treated by a neurosurgeon, sometimes by an orthopedic surgeon, and sometimes either type of surgeon could treat it.

Getting Started With a Neurosurgeon—Are You In the Right Place?

You wouldn't normally make an appointment to see a neurosurgeon for treatment of your back or neck pain. You should first see your primary care doctor, who will take a medical history, examine you, and possibly order diagnostic tests.

Most of the time, back or neck pain is caused by muscle spasms or mild inflammation, and neurosurgical referral is not common. You might be prescribed treatment with medication and/or physical therapy—and this often helps. Often, strategies like lifestyle modification can help too. For example, adopting a better position while working on the computer can alleviate some types of back or neck pain.

If you have signs of spinal cord disease or injury that could be surgically corrected, you may be referred to see a neurosurgeon.

Signs of spinal cord disease or injury include:

  • Leg or arm pain or weakness
  • A spinal cord deficit detected by your neurological examination
  • Diagnostic tests, such as computerized tomography (CT) or magnetic resonance imaging (MRI) showing disease or injury of the spinal cord
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Article Sources
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  1. American Board of Medical Specialties. ABMS guide to medical specialties. 2019.

  2. Hyun SJ, Jung JM. Spinal deformity surgery : it becomes an essential part of neurosurgery. J Korean Neurosurg Soc. 2018;61(6):661-668. doi:10.3340/jkns.2018.0150

Additional Reading
  • Conditions and Treatments. AANS website, Patient Information Page.

  • Willems, P. Decision Making in Surgical Treatment of Chronic Low Back Pain: The Performance of Prognostic Tests to Select Patients for Lumbar Spinal Fusion. Acta Orthop Suppl. Feb 2013.