When is a spinal surgeon referral needed?

Ends on the scenario, and as I mentioned before, we talked about red flag time symptoms. Clearly in the case of where there's been a trauma, quite severe accident, where you're not sure whether there could be a spinal problem. I mean, the person ends up in hospital in the trauma unit but where the symptoms have come on fairly suddenly and they're very unusual, these are the sort of things that would alert us that I think this patient needs referral and certainly anyone with quite severe back pain that's not responding well to painkillers and certainly if they have what we call neurological symptoms, if they're having sort of shooting pains, pins and needles as well as incontinence, so loss of sort of their bladder function or bowel function or numbness down below. These are the sort of things that alert us to thinking well look could there be some sort of severe nerve compression here and a neurosurgeon really needs to assess this patient.