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Do I Need a Neurologist?

Most spine surgeons are asked to evaluate people and to make determinations for surgery. Once a person goes to a surgeon, they are going with the thought that they do need surgery. These people are generally upset when surgery is not scheduled immediately as they are symptomatic and “just need to get something done”.

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Most of the time, even though you were sent to a surgeon, you do not need surgery. This should be a great relief for most people.  Spine surgery is usually necessary when there is a significant risk for your life, or an important bodily function.   These situations are rare.  Most people who have back pain do not need surgery and get better in the next 3 months with conservative measures.

One reason that surgery may not be beneficial for a certain person is when the patterns of pain, numbness, or intermittent weakness may not be totally consistent with spine problems. When spine problems are ruled out you may be referred to a neurologist, who is a type of physician who is an expert in diagnosing conditions that may mimic a surgical problem.

To give an example, people with diabetes may have numbness, tingling, and pain to the arms and legs.  For diabetics, the reason may be their high blood sugar levels have now caused changes to the nerves throughout the body.  These nerve changes can cause similar (but not the same) symptoms as those who have significant pinched nerves to their spine.  A neurologist, with different tools like nerve conduction studies, further diagnostic testing of the brain, the spinal cord, and physical exam testing can determine if the complaints are related to something such as diabetes.

The neurologist will also use their expertise of physical examination to explore the possibilities of other entities that can cause some of the spine like conditions.  These can include Multiple Sclerosis, side effects of chemotherapy or even circulatory problems.  These conditions are not helped by spine surgery and are often made worse.

You will always be able to find a surgeon who will take the risk of doing surgery for you.  Without a life-threatening situation, it may be more prudent to pursue further evaluations before making a surgical decision. One of these decisions could be to see a neurologist if it is recommended.

Last modified: July 19, 2019

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