Carolina Neurosurgery & Spine Associates

What Carolina Neurosurgery & Spine Associates does

Carolina Neurosurgery & Spine Associates (CNSA) is an independent, physician-owned medical practice founded in 1940 and headquartered in Charlotte, North Carolina. It operates nine clinic locations across North and South Carolina and employs roughly 50 physicians, 42 advanced practice providers, and over 550 staff, making it one of the oldest and largest private neurosurgical practices in the country. CNSA serves adult and pediatric patients requiring neurosurgical, spine, physiatry, pain management, neurology, imaging, and physical therapy services, with patients drawn from 53 states/US territories and 12 countries.

The practice's clinical offering spans surgical and non-surgical treatment of brain tumors, cranial and vascular conditions, pediatric neurosurgery (including spasticity and adolescent idiopathic scoliosis), physiatry, and the full spine service line — from conservative care through minimally invasive lumbar and cervical procedures, endoscopic spine surgery, robotic-assisted spine surgery, intraoperative navigation, orthobiologics (PRP, bone marrow aspirate), and the TOPS procedure. On the technology side, CNSA uses AI-driven pre-operative surgical planning for spine alignment and is the only Charlotte-region provider of stereoelectroencephalography (SEEG) for adult and pediatric epilepsy. Adjacent service lines include on-site MRI/CT/X-ray, physical therapy across six Charlotte-area locations (including Titleist-certified golf rehabilitation), LSVT BIG therapy for Parkinson's, and the Carolina Sports Concussion Program providing free baseline ImPACT testing for high school athletes. The Carolina Center for Specialty Surgery, an ambulatory surgery center co-owned with Atrium Health since 2006, was recognized among U.S. News' Best Ambulatory Surgery Centers for Orthopedics & Spine.

CNSA's revenue is generated through fee-for-service clinical care (consultations, imaging, surgery, physical therapy, pain management), with pricing varying by procedure and insurance coverage. GTM is predominantly referral-driven, sourced from primary care physicians, self-referrals, hospital emergency departments, and hospital partners — most notably Atrium Health. On October 1, 2025, CNSA restructured its operating relationship with Atrium Health: nearly 300 teammates from seven Charlotte-area clinics and the Greensboro clinic joined Atrium Health under an enhanced partnership, integrating operational, data, and clinical resources into the health system while the CNSA clinical brand and physician ownership were preserved. The practice is led by CEO Troy Bouzakis.

Name

Carolina Neurosurgery & Spine Associates

Legal name

Carolina Neurosurgery & Spine Associates

Website

https://cnsa.com

Company type

Private

Founded year

1940

Operating status

Operating

Headcount range

501–1,000 employees

Short description

Carolina Neurosurgery & Spine Associates (CNSA) is a physician-owned private neurosurgical and spine practice founded in 1940, headquartered in Charlotte, NC, with 50 physicians across nine Carolinas locations serving adult and pediatric patients requiring brain, spine, physiatry, and pain management care.

Ownership category

akta.pro rank

Headquarters

HQ city

Charlotte

HQ country

United States

HQ region

North America

Offices9 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Infrastructure, Marketing or Sales

Revenue model

1. Clinical Healthcare Services: Revenue generated from providing neurosurgical and spine care services including consultations, diagnostic imaging, surgical procedures, physical therapy, and pain management treatments

Pricing tiers

Go-to-market motion1 record

Distribution channels4 records

Marketing channels7 records

Core offering

Carolina Neurosurgery & Spine Associates is a private medical practice delivering surgical and non-surgical treatment for the full spectrum of adult and pediatric brain, spine, and peripheral nerve disorders. Its offerings span neurosurgery (brain tumors, cranial, pediatric, vascular, spine), physiatry, pain management, orthobiologics, physical therapy, and diagnostic imaging, delivered through nine Carolinas locations and a jointly-operated ambulatory surgery center. Care is supported by advanced technologies including robotic spine surgery, intraoperative navigation, AI-driven pre-operative planning, and SEEG epilepsy treatment.

Product overview

Carolina Neurosurgery & Spine Associates is a healthcare practice offering a comprehensive range of neurosurgical and spine care services. The practice operates as a single unified practice with multiple service lines including adult and pediatric neurosurgery, spine surgery, physiatry, physical therapy, and imaging services. Key products include surgical treatments (brain tumors, cranial surgery, spine surgery, vascular surgery), minimally invasive procedures (endoscopic spine surgery, minimally invasive lumbar/cervical surgery), orthobiologics (platelet rich plasma, bone marrow aspirate), rehabilitation services (physical therapy, golf rehabilitation, LSVT BIG therapy), and diagnostic imaging (MRI, CT, X-Ray). The practice also provides the Carolina Sports Concussion Program and wellness education through the Back Talk Doc podcast. Patients access care through online scheduling via Luma Health, a patient portal, and online bill pay. The practice operates the Carolina Center for Specialty Surgery as a joint venture facility. The group includes 50 physicians, 42 advanced practice providers, and over 550 employees across nine office locations.

Differentiator

Problem solved

Functional benefit

Brands

• CNSA Foundation: A foundation supporting brain tumor research, awareness, and education through events like the Headed for Hope 5K.

Products and services

• Neurosurgery (Brain Tumors, Cranial, Vascular, Pediatric, Spine Surgery) Surgical treatment of brain tumors, cranial disorders, vascular conditions of the brain and spine, pediatric neurosurgical conditions (spasticity, adolescent idiopathic scoliosis), and comprehensive spine surgery for adults.
• Physiatry and Pain Management Physical medicine and rehabilitation services for assessing and treating spine disorders, post-operative management, and individualized non-surgical patient care.
• Physical Therapy and Golf Rehabilitation Individualized physical therapy including specialized programs for golf-specific rehab, dry needling, Graston Technique, Pilates, McKenzie Method, custom foot orthotics, and LSVT BIG therapy for Parkinson's and similar conditions.
• Orthobiologics (Platelet Rich Plasma and Bone Marrow Aspirate) Regenerative-medicine treatments including platelet rich plasma (PRP) and bone marrow aspirate procedures to promote healing.
• Minimally Invasive Spine Surgery (Endoscopic, Lumbar, Cervical, Laminectomy) Minimally invasive surgical approaches including endoscopic spine surgery, minimally invasive lumbar and cervical surgery, and spinal laminectomy to treat spine conditions with reduced tissue disruption.
• Diagnostic Imaging (MRI, CT, X-Ray) Diagnostic imaging services including MRI, CT, and X-Ray to support neurosurgical and spine diagnosis and pre-operative planning.
• Carolina Sports Concussion Program Concussion diagnosis and management program for athletes age 10 and older, including free baseline ImPACT testing for high school athletes.
• Carolina Center for Specialty Surgery Ambulatory surgery center specializing in orthopedic and spine surgery, operated as a joint venture with Atrium Health and serving as the key location for the SpineFirst program.
• AI-Driven Pre-Operative Surgical Planning Artificial intelligence-driven pre-operative planning service that processes medical imaging to produce precise surgical alignment plans for spine procedures.
• Robot-Assisted Spine Surgery Robot-assisted spine surgery capability offering improved precision in spine surgery procedures.
• Stereoelectroencephalography (SEEG) Epilepsy Treatment SEEG-based epilepsy diagnostic and treatment service; CNSA is the only practice offering SEEG in the Charlotte region for adult and pediatric patients.
• Total Posterior Spine Surgery (TOPS) Comprehensive posterior-approach spine surgery using the TOPS procedure for applicable spine conditions.

Named customers7 records

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability2 records

Feature4 records

Partnerships

Eight partnerships are on record, tiered core and minor.

• Atrium HealthcoreStrategic or Co-development Partner · 1 October 2025Enhanced partnership bringing CNSA's Greensboro team and nearly 300 Charlotte-area clinic teammates into Atrium Health. Unites knowledge, resources, and teams to power expanded neurosurgery and spine care across multiple locations. The Carolina Center for Specialty Surgery was formed through a joint venture with Atrium Health in 2006.
• NuVasive Spine Foundation (NSF)coreStrategic or Co-development Partner · 1 November 2021CNSA physicians volunteer for medical mission trips to Honduras providing spine surgery and care to medically under-resourced communities. NSF is a nonprofit dedicated to operating medical mission trips bringing life-changing spine surgery, technology and training to underserved areas.
• One World SurgerycoreStrategic or Co-development Partner · 1 January 2018Partner in Honduras medical mission trips. CNSA physicians including Dr. Joseph Stern serve on the Physician Leadership Council for spine at OWS. Holy Family Surgery Center serves as the mission site.
• Bless Back WorldwideminorStrategic or Co-development Partner · 1 January 2014CNSA physiatrist Dr. John Welshofer participated in medical mission trips to Nicaragua through Bless Back Worldwide to provide primary and specialty care.
• World Pediatric ProjectminorStrategic or Co-development Partner · 1 January 2008CNSA pediatric neurosurgeons have participated in medical mission trips to the Dominican Republic since 2008, caring for approximately 130 children and performing 56 surgeries at the largest indigent pediatric hospital.
• Nuestros Pequeños HermanosminorStrategic or Co-development PartnerCNSA partnered with One World Surgery and Nuestros Pequeños Hermanos in Honduras to bring a 14-year-old girl to the US for spinal cord surgery.
• Sowing Seeds of FaithminorStrategic or Co-development PartnerLocal nonprofit 501(c)(3) organization dedicated to education and healthcare welfare of people of Nicaragua. Supporting Dr. Welshofer's initiative to establish sustained medical education programs.
• Levine's Children's HospitalcoreStrategic or Co-development PartnerCNSA pediatric neurosurgeons work closely with Levine Children's Hospital to deliver advanced neurosurgical treatment options for children.

Scale indicators8 records

Recent moves8 records

Expansion highlights6 records

Direct peers

• Goodman Campbell Brain and Spine: Goodman Campbell Brain and Spine is one of the largest private neurosurgery practices in the U.S., based in Indianapolis. It offers the same core neurosurgical and spine service model as CNSA - adult and pediatric neurosurgery, spine surgery, and pain management delivered through a large multi-physician private group.
• Texas Back Institute: Texas Back Institute is a large private spine specialty practice in Plano, TX, focused on surgical and non-surgical spine care, including minimally invasive and motion-preservation techniques. It is closely comparable to CNSA's spine service line and similar in being a physician-owned, multi-site specialty group.
• Semmes Murphey Clinic: Semmes Murphey Clinic is a private neurosurgical and spine practice based in Memphis, TN, founded in 1912. It is one of the most direct comparables to CNSA: a long-standing, large private-practice neurosurgery group offering surgical and non-surgical brain, spine, and pain care with academic affiliations and an emphasis on complex cases.
• Virginia Spine Institute: Virginia Spine Institute is a private, multi-physician spine specialty practice in Reston, VA, offering comprehensive surgical and non-surgical spine care, physiatry, and physical therapy. It mirrors CNSA's integrated spine service line and physician-owned specialty model.
• Midwest Spine & Brain Institute: Midwest Spine & Brain Institute is a private neurosurgery and spine practice serving the Minneapolis-St. Paul metro. It is a close comparable to CNSA in scope (neurosurgery, spine surgery, pain management) and operating model (private, multi-physician group).

Regional players

• Novant Health: Novant Health is a major regional health system headquartered in Winston-Salem, NC, with significant presence in the Charlotte metro. It is comparable to Atrium/CNSA's footprint and competes for the same neurosurgical and spine patient population in the Carolinas, making it the most direct regional incumbent.
• Prisma Health: Prisma Health is the largest not-for-profit health system in South Carolina, providing neurosurgery and spine care across the Upstate and Midlands. It is a regional peer in that it delivers the same categories of services in a shared Carolinas geography, though it does not directly compete clinic-for-clinic with CNSA.

Broad incumbents

• Hospital for Special Surgery (HSS): HSS is the nation's leading specialty hospital for orthopedics and rheumatology, including a large spine surgery program. While much larger and academic-affiliated, it overlaps with CNSA's high-acuity spine and surgical focus and represents the upper bound of what a specialty musculoskeletal provider can scale to.
• Atrium Health (Advocate Health): Atrium Health (now part of Advocate Health) is the major regional health system that is CNSA's primary hospital partner and which absorbed ~300 CNSA teammates in October 2025. It is broadly comparable as a large provider of inpatient and outpatient neurosurgical and spine care across the Carolinas, and is the most consequential counterparty in CNSA's GTM motion.
• Rothman Orthopaedic Institute: Rothman Orthopaedic Institute is a large, multi-site private orthopedic and spine practice based in the Mid-Atlantic. It is comparable to CNSA in operating as a private specialty group with a significant spine surgery component, though it spans the broader orthopedic continuum.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks7 records

Key highlights7 records

Customer concentration

• Xtwitter.com/cnsa_insights?lang=en
• YouTubeyoutube.com/user/CarolinaNeurosurgery
• Facebookfacebook.com/carolinaneurosurgery
• LinkedInlinkedin.com/company/carolina-neurosurgery-&-spine-associates/mycompany
• Instagraminstagram.com/carolinaneuroandspine

Revenue estimate

Valuation estimate

Number of profiles

Profiles5 records

Subsidiaries2 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Carolina Neurosurgery & Spine Associates