Frequently Asked Questions

What do I need to bring with me to my first appointment?

Please make sure you complete the new patient paperwork prior to your first visit and bring it with you to your appointment. You can either complete the paperwork online through the Patient Portal, print the paperwork from our website, arrive one hour early, or ask that the paperwork be mailed to you.  With that complete, please plan to bring the following with you to your first appointment:  insurance card(s) and a co-payment (if applicable); a photo ID; a list of all current medication; and a MRI disc.

Please plan to arrive 30 minutes prior to your scheduled appointment time.

What is a neurosurgeon?

A neurosurgeon is a physician who specializes in the diagnosis and surgical treatment of the central and peripheral nervous system, including congenital abnormalities, trauma, tumors, vascular disorders, infections of the brain or spine, stroke, or degenerative diseases of the spine.

What training does a neurosurgeon have?

Each of our neurosurgeons are board-certified and have completed rigorous and extensive education and training.  In fact, because of the complexities of neurosurgery, the training period is one of the longest of all areas of medical specialty.  Following college, advanced training includes four years of medical school, a one-year internship, and a five to seven year neurosurgical residency.  Finally, after completion of residency and two years of practice, a surgeon is then eligible to take the American Board of Neurological Surgery exam.

Why do I need to see a neurosurgeon?

The most common condition that neurosurgeons treat is that of pain in the neck or lower back, spreading to the arm or leg due to a ruptured disc or spinal stenosis.  Patients with conditions or disorders impacting the nervous system, which includes the brain, spinal cord, and peripheral nervous, also fall under this specialty.

What conditions does a neurosurgeon treat?

Some of the specific conditions and disorder include the following:

  • spinal stenosis
  • herniated discs
  • ruptured discs
  • spine fractures
  • carotid artery blockage
  • brain tumors, benign and malignant
  • pituitary tumors
  • craniosynostosis
  • aneurysm
  • arteriovenous malformation
  • hydrocephalus
  • head injury
  • carpal tunnel syndrome
  • Ulnar Neuropathy
  • trigeminal and glossopharyngeal neuralgia
  • hemifacial spasm
  • spinal injury
  • spinal cord tumors
  • peripheral nerve injuries
  • entrapment neuropathies
  • intracerebral hemorhhage
Which insurance plans do you accept?

We are pleased to accept most major insurances.  We do recommend that you call your insurance provider to confirm our participation with your insurance before scheduling an appointment.

Do I need a referral to be seen at your office?

While we do not require a referral, a referral could be a requirement of your insurance plan.  We strongly recommend that you check with your insurance regarding your coverage options and their list of participating providers.  Patients with an HMO insurance must comply with the insurance company’s referral process.  Some may require written authorization, which must be presented at the time of service. If you want to be seen by one of our specialist and your insurance does not require a referral we will be happy to see you.

What are some other treatment options other than surgery?

There are several options that could be considered instead of surgery, including activity modification, exercise, physical therapy, injection therapy and injections and massage therapy.

We recommend that you talk with your primary care doctor or one of our providers to better understand your options.

What causes back pain?

There are numerous causes to back pain.  The two main reasons are either injury, or simply weakness in that region of the body.  Often back pain occurs for no apparent reason.

A lack of muscle tone and excess weight, especially around your middle, also aggravates back pain.  Additionally, poor posture adds stress to the muscles and joints, causing fatigue and injury.

Even the slightest damage to your back’s structure can upset the delicate balance and make movement painful.  Your body will then try to protect this area by contracting muscles surrounding the area.  In fact, it’s the contracted muscles that cause the pain you experience.  Not only that, the contracted muscles also slow down blood circulation to the area which ultimately diminishes the necessary oxygen flow and prevents the body to heal itself.

While damage and associated pain can occur at any point of your spine, the most common site for paint is your lower back because it bears the majority of your weight, and is therefore under the most pressure.

How can I prevent back pain?

Your greatest weapon against back problems is that of exercise. Activity increases your aerobic capacity, improves your overall fitness, increases the muscle tone and helps shed excess pounds that stress your back.

 Stretching and toning your back and other supporting muscles helps reduce stress on your back. It reduces your risk of injury by warming up muscles, and it also increases your long-term flexibility.

Strength training can make your arms, legs and lower body stronger. In turn, your risk for falls and other injuries decreases. Strong arms, legs, and especially abdominal muscles also help relieve back strain.

Always ask your doctor or physical therapist for advice before beginning an exercise program, especially if you’ve hurt your back before or you have other health problems, such as osteoporosis.

What are common disorders treated by neurosurgeons?
  • Spinal ruptured and herniated discs
  • Spinal stenosis (narrowing of the spinal canal)
  • Spinal instability
  • Spinal deformity
  • Spinal fractures
  • Spinal vascular abnormalities
  • Spinal cord tumors
  • Spine tumors
  • Peripheral nerve injuries
  • Peripheral nerve compression i.e. carpal tunnel syndrome
  • Peripheral nerve tumors
  • Brain tumors
  • Brain vascular diseases
  • Aneurysms
  • Carotid stenosis
  • Cerebrovascular disease
  • Arterio-venous malformations
  • Brain hemorrhages
  • Brain infections
  • Head trauma
  • Concussions
  • Skull fractures
  • Subdural hematomas
  • Epidural hematomas
  • Intracerebral hematomas
  • Skull tumors
  • Skull abnormalities
  • Hydrocephalus
  • Spina bifida
  • Movement disorders, i.e. Parkinson’s disease and tremor
  • Epilepsy surgery
  • Pituitary tumors
  • Optic nerve tumors
  • Pain
  • Trigeminal neuralgia
  • Chronic pain
What is a myelogram, how is it done and does it hurt?

A myelogram is an x-ray examination of the spine and spinal nerves.

The test is done by an x-ray doctor (radiologist) in the hospital. The doctor uses some medicine to numb an area in the lower back. After this is done, the doctor places the spinal needle into the area around the nerves and injects the dye. After the dye is in place, the needle is removed and x-rays are taken of the area of concern. Then the patient is taken to CAT scan, where a scan is done of the area. The patient is then brought back to the room and discharged later that day.

The injection of the numbing medicine and dye may burn and sting, but there is not usually too much pain with the test. At times, lying on the x-ray table is uncomfortable during the test.

Do the injections performed by our physicians hurt?

Most of our injections are not painful, although you may feel a tiny sting and some pressure. With more invasive procedures you may experience some discomfort, but with sedation, you should not have a problem. You should notify the physician if you have any questions.

Is sedation provided when having an injection?

The procedure is done with an anesthetic to locally numb the area for the injection. This process can take a significant amount of pain away from the procedure and allow for a faster recovery.We can arrange for oral medication to help you relax during the procedure.

How soon can I drive after my injection?

Patients are asked to have a driver when coming to the office for an injection. If you choose to have sedation you should wait at least six hours minimum before you drive. If you do not have sedation, you may drive as soon as the numbness from the injection has worn off.

What medications should I stop prior to the injection?

You should stop taking all blood thinners at least 5 days prior to the procedure.  If you are on an antiobiotic, you must reschedule your appointment until after you have finished the antiobiotic and the infection has completely cleared up.

You should continue taking your blood pressure medications.

How long does it take for an injection to work?

For those injections using steroids allow up to 72 hours for the steroid to reduce the inflammation. Once it is reduced the pain will typically subside.

How often and how many injections can I have?

As a general rule, you may have no more than 3 injections within a six month period and they must be at least 2 weeks apart.

Should I use Ice or Heat after the injection?

You may use ice for the first 24 hours after the injection and heat after that. Leave the ice or heat on the affected area for no more than 20 minutes at a time and then remove it for at least 20 minutes.

How soon after the injection may I return to my normal activities?

Unless instructed otherwise, you may return to work the following day, but you should limit your physical activity for several days.

Do injections hurt?

Most of our injections are not painful, although, you may feel a tiny sting and some pressure. With more invasive procedures you may experience some discomfort, but with sedation, you should not have a problem. Id you do, let the doctor know.

What would make me have muscle cramps after an injection?

Steroids can lower your potassium levels, and that can result in muscle cramps. To treat this you need to increase your potassium intake by eating fresh fruits such as bananas, apricots, grapefruit, oranges and tomatoes. Dried fruits, fruit juice, and coconut water are also high in potassium.

I am on Opiod medication and am scheduled to be seen in the office every month even though my medications are working fine. Why is that?

By law we are required to write narcotic medications for only 1 month supply, and they must be written and cannot be called in to the pharmacy. If a patient has been on the same medication regimen for several months with no complications, we may consider seeing him or her every other month.