Spinal pain, nerve issues treated by Cayuga Health Neurosurgery


James Metcalf, MD
James Metcalf, MD

Patient care at Neurosurgery Services of CMA goes well beyond precision surgery at Cayuga Medical Center operating rooms and can include treating neck and back pain with physical therapy, pain management, exercise, and medications.

Most of the practice’s patients are seen for disorders of the spine and include lumbar and cervical issues. The conditions can be painful, but they are often effectively treated without surgery to end months of discomfort.

“A majority of patients with back or neck pain will respond to non-surgical treatment that may include over-the-counter anti-inflammatory medications, physical therapy, and activity modification,” says James Metcalf, MD, who leads Neurosurgery Services of CMA team of healthcare providers.

Many patients come to Neurosurgery Services of CMA after being referred to the practice by their primary care physician. Other patients seeking relief from neck or back pain make a direct contact for a consultation appointment. The patient’s initial visit usually involves a comprehensive evaluation with Dr. Metcalf or one of the practice’s physician assistants, Erica Lawlor, Marlee Drumheller or Desiree Long from the Cayuga Spine Center. Many neurologic conditions have similar symptoms, and a thorough physical examination as well as an extensive review of the patient’s medical history is essential for Dr. Metcalf and his team to develop an effective care plan.

It’s important for the care team to know the type of discomfort a patient has, how long they have had the pain or related symptoms, and what range of motion or activity limitations a patient has. Patients may also be asked about past health conditions such as herniated disks, arthritis, or previous injuries to the spine or back.

During the initial consultation, some patients may learn they need diagnostic testing. Imaging tests such as X-rays, CT scans or MRIs can help determine the condition causing the patient’s pain, and laboratory tests can disclose potential nerve disorders. If those tests are needed, a physician assistant coordinates the patient’s appointments and tracks the results which can also be posted for the patient on their confidential digital portal.

When a patient’s care plan is developed, several therapies are considered. Physical therapy is often recommended as the first technique to resolve back or neck pain. Desiree Long, PA, from the Cayuga Spine Center evaluates the patient’s information to recommend a treatment plan such as physical therapy, massage, interventional pain management, exercise, or medication. Many patients find these therapies reduce their pain without surgery.

If non-surgical care does not relieve a patient’s pain, Dr. Metcalf may recommend surgery. When patients need surgery, the experienced team at Neurosurgery Services of CMA guides them through the surgical process from preoperative evaluation, hospital care, and postoperative care, with the goal of returning to normal activity.

“When surgery is needed, our goal is to perform the best procedure to relieve patients’ symptoms and facilitate their neurological recovery. For patients with complex neurosurgical conditions, we can arrange for prompt evaluations with our network of subspecialists at large medical centers,” says Dr. Metcalf, who has practiced neurosurgery at Cayuga Health since 2013.

Cayuga Health and Neurosurgery Services of CMA use advanced computer and imaging technology to diagnose spinal conditions and in the operating room during surgery. Dr. Metcalf uses specially designed equipment to move tissue and muscles to access the affected area. The technology allows the surgeon to remove tissue to relieve the pressure on the spinal nerves or make repairs to improve the patient's condition.

Dr. Metcalf has been practicing at Neurosurgery Services of CMA and Cayuga Health for 11 years and teaching neurosurgery for more than 25 years, most recently at the University of Rochester. After receiving his medical degree from the Medical College of Georgia in Augusta, he did a general surgery internship at the National Naval Medical Center in Bethesda, MD and a neurosurgery residency at the University of Tennessee in Memphis where he was also a clinical professor of neurosurgery for 19 years.

The care team at Neurosurgery Services of CMA is:

Marlee Drumheller, PA. She joined the practice in 2023 after obtaining a Master of Physician Assistant Sciences degree at Saint Francis University in Loretto, PA.

Erica Lawlor, PA. She has a certification from the National Commission on Certification of Physician Assistants and received her Master of Science in Physician Assistance Studies from Lemoyne College in Syracuse.

Desiree Long, PA. She joined the Spine Center at Cayuga Health in January 2022. She graduated from the master’s program for Physician Assistance Studies at Lemoyne College in Syracuse.


For more information on neurosurgical care at Cayuga Health and Cayuga Medical Associates Neurosurgery, or the Cayuga Spine Center, call (607) 269-0033. Neurosurgery Services of CMA is located at 905 Hanshaw Road Suite A, Cayuga Heights.