Orthopaedic spine surgeons and neurosurgeons are equally qualified to perform most types of spine surgery. Both perform cervical, thoracic, and lumbar surgery, including spinal cord and nerve decompression, spinal fusion, microsurgery and minimally-invasive spine surgery.
WHAT IS THE DIFFERENCE IN TRAINING?
Both types of surgeons complete four years of medical school before entering a residency in their specific field. Traditionally, orthopaedic surgeons complete five years of residency training in the diagnosis and treatment of all musculoskeletal (bone, joint, muscle and nerve) disorders including those of the spine, whereas neurosurgeons complete residency training in disorders of the brain and spine. Many spine surgeons will complete additional training in spine surgery after their residency called a fellowship. A fellowship involves more specialized training in advanced spinal surgery techniques including spinal fusion, minimally invasive spine surgery, and complex spinal reconstruction.
ARE SOME TYPES OF SURGERY MORE COMMONLY PERFORMED BY ONE OR THE OTHER?
In some specific instances, either a neurosurgeon or an orthopaedic spine surgeon may be the more appropriate choice. For example, an orthopaedic spine surgeon may be more capable of doing spine deformity surgery (such as surgery for scoliosis and other large spinal deformities), whereas a neurosurgeon can better treat intradural tumors, i.e. tumors that are inside the central nervous system.
HOW SHOULD I CHOOSE A SPINE SURGEON?
For the most part, the qualifications of the surgeon to do spine surgery are more driven by the amount of training in spine surgery and the amount of the surgeon's practice devoted to spine surgery rather than by whether or not the surgeon is a neurosurgeon or orthopaedic surgeon.
QUESTIONS TO ASK ABOUT YOUR SPINE SURGEON
- Is the spine surgeon fellowship trained in spine surgery?
- Is the spine surgeon part of a multidisciplinary spine center?
- Is the spine surgeon trained in microsurgery and other minimally invasive techniques?
- Is spine surgery a big part of the surgeon's practice, or is he or she more of a general orthopaedic surgeon or neurosurgeon?
A physician who focuses on spinal surgery is likely to be far more adept and current in newer surgical techniques than one who only occasionally performs spine surgery.
QUESTIONS TO ASK YOURSELF AFTER SEEING THE SPINE SURGEON
- Did the surgeon fully explain the diagnosis and cause of your pain?
- Do you feel comfortable with the surgeon and feel that all of your questions have been satisfactorily addressed?
- Did the surgeon offer a full range of treatment choices or immediately discuss surgical treatment?
Often you may still have several non-surgical care alternatives available, which may help you avoid unnecessary surgery.