Common Questions

It can be overwhelming if you or a family member is facing a neurosurgical disease or disorder. It is normal to have many questions about conditions, treatment options, recovery, outcomes, and more. Below are some questions our surgeons are asked on a frequent basis. We hope you find these questions and answers helpful, but it is always a good idea to bring any questions with you to your next appointment. One of our experienced and compassionate neurosurgery team members will be happy to spend time with you, answering all of your questions.


Should I have spine surgery?

The decision of whether or not to have spine surgery is a daunting one. It is all too common in this era for patients, lawyers, and sometimes surgeons to jump to the conclusion that spine surgery is the only option when it comes to experiencing back pain.

Usually back pain and pinched nerve pain (radiculopathy) will settle down and go away within a few weeks or months with little or no treatment. To that end, many neurosurgeons feel that spinal surgery is over-performed, with numerous patients given little opportunity to overcome their spinal disorders through non-operative or "conservative" management.

The ideal management of spinal disorders should be in a multidisciplinary fashion, meaning they should be managed not only by our neurosurgeons, but also with assistance and input from physical medicine and rehab physicians, orthopaedic surgeons, physical and occupational therapists, physician assistants, resident physicians, pain management specialists, interventional radiologists, neuroradiologists, and neurologists.

When it comes to the final decision of whether or not to have spine surgery, our team feels that there is no better medical or non-medical personnel to make this call than a neurosurgeon. Neurosurgeons are not only trained to treat the spine; they are the only medical specialists that are trained  in the surgical treatment of the actual contents of the spine: the spinal cord and its nerves.

Neurosurgeons are involved in the total management of the spinal and pinched nerve disorders from the very first days of their training. After graduating from medical school, neurosurgeons spend an additional six to eight years of hands-on education exposed to and learning how to treat the full spectrum of spinal diseases, including degenerative (due to wear and tear), oncologic (involving tumors), congenital (from before birth), infectious, and traumatic.

What types of spinal surgeries do you perform?

Carilion neurosurgeons perform all types of spinal surgeries, including disectomies, laminectomies (uncovering the spinal cord and nerves), minimally invasive techniques (such as the use of tv endoscopes), instrumentation (placement of screws, rods, plates, cages, artificial discs, etc. to internally support the spine), tumor removal, blood clot removal, repair of fractures, placement of spinal cord stimulators and pain pumps, the surgical eradication of infections, and more.

My physician told me that I need back surgery. Should I get a second opinion?

It is wise for a patient facing back surgery to access more than one surgeon's opinion about their disease and treatment options. The principle goal of Carilion's neurosurgery team is to guide patients through their diseases without surgery whenever possible, and to offer the best surgery when it is not. Each case is evaluated thoroughly and objectively on its own merits. Optimal treatment strategies are developed and extensively discussed, and alternative treatment options are explored whenever possible. Most patients' cases are reviewed by several team members, in effect providing patients with multiple second opinions. Particularly complicated or critical cases are reviewed by the whole team in multidisciplinary conferences.

Do you have second opinion service?

Yes, Carilion's neurosurgery team is proud to offer a second opinion service. Through this service, a patient or the physician facing the recommendation of spinal surgery may request a second opinion from our team. Most cases are streamlined so that the patient can be seen within five business days by one of our neurosurgeons. If the Carilion neurosurgeon comes to the same opinion as the original recommendation, the patient will be notified and any further questions they may have about the treatment or procedure will be addressed. Conversely, if the Carilion neurosurgeon disagrees with the recommended treatment, the patient's case will then be reviewed with other members of the Carilion neurosurgery team, in effect providing the patient multiple second opinions. Overall, this service is meant to reassure a patient in their decision making about their surgery and in some cases explore alternative treatments if the second opinion does not agree with the first recommendation.

To access Carilion Clinic Neurosurgery's second opinion service, please call (540) 343-4092 and notify our scheduling personnel that you are seeking a second opinion and reference a potential surgical problem.

Please bring the following with you to your appointment:

  • All related imaging studies (MRIs, CT scans, Myelograms, PET scans, etc.)
  • All related medical information (including documentation from other surgeons, records of previous similar surgeries, medical records, etc.)

Our neurosurgeons will try to render a final opinion during this appointment, but there are instances when further diagnostic studies may need to be ordered.