FAQs Answered by Dr. Bonaroti: 

I am suffering from low back (or neck) pain. Why is my doctor not ordering an MRI scan?

First, most back pain is short lived, and treated conservatively (non-operatively). This means that with a short course of physical therapy or other treatment, the back pain resolves, and the MRI scan would NOT change the treatment plan.

Second, MRI scans are indicated under specific situations – like when there is the presence of nerve symptoms (radiculopathy), such as radiating pain, numbness or weakness. In this case the MRI scan is more likely to demonstrate a treatable cause. However, even in these cases, resolution without surgery is common, and a short course of treatment before obtaining the MRI scan is recommended for the same reasons as above.

There are specific “red flags” associated with more severe conditions like infection, cancer, so spinal cord compression.  A well-trained neurosurgeon will screen for these potential problems with a specific set of questions, and also looking for clues in your history and physical examination. If appropriate, an MRI scan may be obtained at the initial evaluation.

In the absence of these “red flags,” a wait and see approach with a period of conservative treatment (usually 6 weeks) before obtaining an MRI scan is recommended.

This is NOT simply an insurance company policy. This approach is good medicine.  Both the Congress of Neurological Surgeons, and the American Association of Neurological Surgeons, have endorsed this practice as a means for neurosurgeons and patients to avoid wasting scarce healthcare resources and dollars – dollars which are increasingly the responsibility of patients!  

For more information about MRI scans, click here

What is a Nurse Practitioner?

In Pennsylvania, Nurse Practitioners (NPs) may diagnose medical conditions, develop and implement treatment plans, order and perform diagnostic tests, and deliver other health care services in a collaborative approach with a licensed physician. While there are no current requirements that specify direct supervision, Surgical Spine Associates realizes the importance of a team approach and each healthcare provider works closely together to provide the highest quality care.

In Pennsylvania, all Nurse Practitioners must complete, at minimum, a master's or doctoral degree and have advanced clinical training beyond their initial professional registered nurse (RN) preparation. Didactic and clinical courses prepare nurses with specialized knowledge and clinical competency in multiple areas of healthcare.

During your encounter with us you may experience several different healthcare professionals. Specifically, you may see a doctorate prepared healthcare professional. The “Doctor” title is utilized to define their professional title and can be utilized by other professionals that are not Medical Doctors (MD) or Doctors of Osteopathic Medicine (DO). Feel free to ask for additional clarification from your healthcare provider if needed. We will be happy to answer any questions you may have.

What is a Physician Assistant?

Physician Assistants (PA) are medical professionals who take medical histories, examine and treat patients, make diagnoses, prescribe medications, order and interpret lab work and imaging, refer to specialists, assist in surgery, counsel patients and perform minor procedures.

PAs are educated at the master’s degree level in programs that are approximately three academic years in length, and include more than 2,000 hours of clinical rotations. Their training as medical generalists provides PAs with diagnostic and treatment skills in all areas of medicine and for all patients, regardless of age or gender. Their education also positions PAs to treat the “whole patient,” meaning a PA working in cardiology – in addition to discussing a patient’s heart issues – is likely to notice a skin condition and either treat it or provide a referral to a dermatology practice.

PAs practice in every state and in every medical setting and specialty, improving healthcare access and quality. You may encounter a PA during one of your visits in our office. Surgical Spine Associates realizes the importance of a team approach and each healthcare provider works closely together to provide the highest quality care.

Should you have any questions or concerns related to your treating provider, feel free to contact us at anytime. We will be happy to answer any questions you may have.

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