What We Treat — G. Katsevman, MD | Neurosurgeon & Spine Surgeon

Symptoms Treated

It all begins with a diagnosis. Then the appropriate treatment is catered for each person based on their individual goals.

Yes, many times a neck picture (X-ray, CT, or MRI) has issues reported by the radiologist, but the person has no symptoms!
Sometimes the neck pain also extends into the back of the head.
This feels like zingers or a deep, shooting, stabbing pain. This can happen into the shoulders, between the shoulder blades, or into the arms. Where exactly it goes depends on the nerve that is affected.
This is the most serious, because it affects your FUNCTIONALITY. Many patients come to the office complaining of pain, but also have subtle issues of balance or hand problems. Unfortunately, many patients blame their balance on old age, and their hand problems on hand arthritis, but it is often due to the neck! Patients may feel wobbly, off balance, having to hold onto walls/their partner. Some patients have bowel/bladder incontinence or retention. Patients may also have difficulty with hand dexterity (buttoning their shirt, clasping their jewelry, picking up coins from a table, knitting, etc) or hand strength (opening jars/cans/water bottles).
Location also depends on the specific nerve affected.
Muscle group depends on the specific nerve affected.

Neck problems can present themselves in many ways:

Back

Yes, many times a neck picture (X-ray, CT, or MRI) has issues reported by the radiologist, but the person has no symptoms! We have seen many 80-90 year olds with significant scoliosis live their whole lives without issues!
Sometimes the back pain also extends into the hips. Often times, we need to differentiate the low back pain from hip pain and from sacroiliac joint pain (this is the joint that connects the hips to the spine).
This feels like zingers or a deep, shooting, stabbing pain. This can happen into the buttocks, legs or feet, rarely into the groin. Where exactly it goes depends on the nerve that is affected. “Sciatica” is the “radicular” shooting pain that occurs when the L4/L5/S1 nerves (which make the sciatic nerve) are the ones affected, and this shoots down the back of the buttocks/legs, often times into the foot.
Stenosis (or pinching) in the lumbar spine can cause claudication symptoms: cramping, heaviness, and/or pain in the buttocks, thighs, or legs when standing or walking for a prolonged time. To feel better, patients tend to have to periodically stop, stand still, or sit down before they can keep walking. Often, at the grocery store, patients feel better if they lean over a shopping cart.
Location also depends on the specific nerve affected.
Muscle group depends on the specific nerve affected.

Back problems can present themselves in many ways:

Peripheral Nerve issues can present themselves in many ways in many locations: pain, numbness, tingling, or weakness, in the hands and/or feet.

Median nerve compression at the wrist: the median nerve is pinched at the wrist. This can be asymptomatic (no issues, or can cause pain/numbness/tingling in the hand or first 3 fingers. Patients often say the pain/tingling wakes them up at night and they have to “shake it off.” If severe, it can cause weakness in the hand/fingers.
Ulnar nerve compression at the elbow: the ulnar nerve is pinched at the elbow (“the funny bone”). This can cause pain, numbness, or tingling into the arm or last 2 fingers. If severe, it can cause weakness in the hand/fingers.
The peroneal nerve is pinched at the knee. This can cause painless foot drop where patients have trouble picking up the foot but have no severe pain (e.g, no sciatia). Patients often have a “slapping foot” which “slaps” on the ground because it does not lift up.

Head/brain problems can present themselves in many ways:

Usually these symptoms are urgent and should prompt you to seek emergency room care for additional workup/testing. Various causes exist for these conditions (migraines, tumor, stroke, blood on the brain “hematoma”), etc).
A small population of patients have normal pressure hydrocephalus (NPH) - “fluid buildup” inside the brain. This can cause a triad of symptoms - “wacky, wobbly, wet” - confusion/memory issues, balance issues, and urinary incontinence.

When the spinal cord is pinched or compressed in the neck (cervical spine) or midback (thoracic spine). This can cause balance issues (ataxia), problems with walking (gait issues), hand dexterity issues, weakness, dropping of objects, or bowel/bladder issues.

The discs are worn out, and the bones are becoming more bone on bone. Another fancy word for arthritic changes is “spondylosis.”

When the bones in the neck or back are slipped or displaced in relation to one another.

Curvature of the spine. May happen in adolescence (adolescent scoliosis) or with aging as the spine degenerates (degenerative scoliosis); The alignment can become “deformed” from normal, which can cause many of the aforementioned symptoms and affect function. This can happen due to aging, trauma, infection, etc.