Appointments

Specialist Surgical Assessment for Spinal and Neurological Conditions

The neurosurgical service at Sydney Spine Institute is led by Professor James van Gelder, an experienced neurosurgeon with expertise in complex spinal and neurosurgical conditions.

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Meet Professor James van Gelder

Conditions We Assess and Treat

While surgery can play an important role in the treatment of certain conditions, most spinal problems do not require an operation. Careful assessment is essential to determine whether surgery is likely to provide meaningful benefit and what alternative treatment options may be available.

Professor van Gelder provides clear, evidence-based advice regarding diagnosis, treatment options, expected outcomes, potential risks, and recovery considerations, helping patients make informed decisions about their care.

Our Approach to Surgical Decision-Making

Deciding whether surgery is appropriate requires careful consideration of the diagnosis, symptom severity, impact on daily life, previous treatments, and the likely balance of benefits and risks.

At Sydney Spine Institute, surgical recommendations are guided by evidence, clinical expertise, and shared decision-making.

Evidence-Based Decision Making

Treatment recommendations are guided by current evidence, clinical assessment findings, imaging results, and the individual needs of each patient.

Surgery Only When Appropriate

Surgery is recommended only when there is a clear clinical indication and a reasonable expectation that it will improve symptoms, function, or quality of life.

Clear Communication & Shared Decision-Making

Patients receive clear information about the likely benefits, risks, alternatives, recovery expectations, and areas of uncertainty before making treatment decisions.

Focus on Minimally Invasive Techniques

When surgery is recommended, we focus on minimally invasive techniques. Where possible, we aim to avoid fusion surgery using simpler, less invasive procedures.

Integrated Rehabilitation Support

Surgery is only one part of the recovery journey. Patients may also benefit from physiotherapy, exercise physiology, pain coaching, or medical management before and after surgery.

When Surgery May Not Be Required

Many Spinal Conditions Can Be Managed Without Surgery

Many patients referred for spinal assessment improve through a combination of education, rehabilitation, exercise therapy, medication management, lifestyle modification, and other non-surgical treatments.

Where surgery is unlikely to provide meaningful benefit, patients may be directed towards our Spine Physician, Spine Physiotherapy, Exercise Physiology, Pain Coaching, or Metabolic Health services to ensure they receive the most appropriate care.

Our Care Pathway

Assessment

We take the time to understand your symptoms, medical history,
goals and lifestyle.

A thorough assessment helps us identify the causes of your condition and the most appropriate next steps.

Non-Surgical Treatment

We prioritise non-surgical options to reduce pain, improve function and support your overall health.

This may include medication management, hands-on therapy, exercise, education and lifestyle support.

Rehabilitation & Recovery

We focus on long-term recovery through personalised rehabilitation programs.

The goal is to restore movement, build strength and help you return to the activities you value.

Surgical Assessment only If Required

Surgery is considered only when non-surgical treatments have been exhausted and symptoms persist.

If needed, we'll ensure you receive a thorough surgical assessment and guidance on the best options for you.

We take a patient-centred, multidisciplinary approach, working together to deliver the right care at the right time, helping you achieve the best possible outcome.

Certain neurosurgical and spinal conditions require urgent assessment.

For emergencies, call 000 or attend your nearest Emergency Department.

These include:

  • Progressive weakness
  • Significant loss of function
  • Spinal cord compression
  • Cauda equina syndrome
  • Severe neurological deficits
  • Unstable spinal fractures
  • Other urgent neurosurgical conditions

Our referral triage process helps identify urgent cases and prioritise appointments accordingly.

Neurosurgeon & Spine Surgeon

Professor James van Gelder

Professor James van Gelder is an experienced neurosurgeon with expertise in complex spinal, brain and peripheral nerve conditions. He has more than 30 years of experience across major public and private hospitals where he has held senior leadership positions contributing to the improvement of the standard of neurosurgical care in Australia.

His approach combines evidence-based decision-making, prioritising of the least invasive approaches, and clear communication to help patients understand their options and make informed treatment decisions.

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Preparing for Your Appointment

Providing relevant information before your consultation helps ensure appointments are appropriately prioritised and allows our team to review your case in advance.

Please provide:

  • Current referral letter
  • Relevant MRI or CT reports
  • Relevant specialist letters 
  • Completed appointment request form

Our team reviews this information to determine appointment priority and ensure urgent cases are identified promptly.

We aim to collect the information we need before your appointment, so in most cases you won’t need to bring anything. If you haven’t already provided them, please bring:

  • Your Medicare or DVA card
  • Your concession card, if applicable
  • Your private health insurance details, if applicable
  • Your workers compensation or CTP claim details, if applicable
  • Your referral letter
  • Relevant imaging and radiology reports
  • Letters from other specialists involved in your care

Related Services

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