Inclusion Criteria:  adults consulting for a neck or back condition; aged 65 years old or older; referred for a consultation in neurosurgery to the CareAxis group, either directly by family physicians or from the Centre de répartition des demandes de service de Montréal and not considered as a potential surgical candidate based on the initial APPT assessment.  Exclusion Criteria:  1. Considered as a potential surgical candidate based on the initial advanced practice physiotherapist assessment.