What a neurosurgeon actually does in a consultation

A neurosurgery consultation is not a scan review. It is a structured medical assessment that happens to include your imaging.

I listen first. Your history is the single most important piece of information — more than any scan. Where the pain is, what makes it worse, when it started, what has been tried, what you can and cannot do because of it.

I examine next. A focused neurological examination often takes only five minutes but frequently changes the diagnosis compared to what the scan alone would suggest.

Only then do I look at your imaging with you, and correlate the findings to your history and examination. A disc bulge on MRI is only surgically relevant if it matches your symptoms and examination — otherwise it is just a picture.

Finally, I explain my thinking, present the options, and we make a plan together. You should leave understanding not just what I recommend but why.