Who Should I See if I Needed Spine Surgery, a Neurosurgeon or an Orthopedic Spine Surgeon?

Disorders and conditions of the spine are very common. Such conditions can result in pain, discomfort, weakness and changes in sensation that could interfere with someone’s quality of life and their ability to work. After seeking medical help, individuals suffering from such conditions might be advised and to have surgery. Patients and their referring physicians might be faced with the question of whether a neurosurgeon or an orthopedic spine surgeon should be consulted. In this article we will highlight the similarities and differences between the two types of surgeons. In addition, we will outline some of the important questions to consider when choosing a spine surgeon.

WHAT IS THE DIFFERENCE IN THEIR TRAINING?
After graduating from medical school, both types of surgeons complete an intense residency training program in their respective fields. For orthopedic surgeons, the surgical residency training is traditionally five years long, while for most neurosurgeons it is seven years long. Throughout their residency programs, both types of surgeons are trained in the diagnosis, management and treatment of conditions and disorders of the spine. Subsequently, many spine surgeons pursue additional specialized training in spine surgery by completing a spine surgery fellowship where they can master advanced spinal surgery techniques, such as minimally invasive and spinal deformity.

CAN BOTH TYPES OF SURGEONS PERFORM ALL TYPES OF SPINE SURGERIES?
Most conditions of the spine, especially degenerative ones, can be managed and treated by an orthopedic spine surgeon or a neurosurgeon. Traditionally, mainly orthopedic spine surgeons have performed spinal deformity surgeries. However, more neurosurgeons, through specialized fellowship training, are nowadays specialized in spinal deformity conditions. In addition, tumors and vascular lesions of the spinal cord are managed and treated by neurosurgeons, as well as, any other pathologies residing within the dura, the covering surrounding the spinal cord.

HOW TO CHOOSE A SPINE SURGEON?
Both types of surgeons, through their intensive medical and surgical training, are highly qualified to perform most types of spine surgery. Therefore, the question should not be about whether to see a neurosurgeon or an orthopedic spine surgeon, but rather about the specific spine surgeries a spine surgeon is specialized in performing. For example, some spine surgeons are more specialized in treating a specific region of the spine, such as, cervical or lumbar. Also, different spine surgeons might offer different approaches to address the same pathology. These approaches can vary from the traditional open approaches to the minimally invasive ones.

WHAT QUESTIONS TO ASK ABOUT YOUR SPINE SURGEON?

• Are they fellowship-trained in spine surgery?
• What was the focus of their fellowship training? Minimally invasive spine surgery, deformity, degenerative, tumor, etc.
• What percentage of their practice is devoted to spine surgery versus general orthopedic surgery or neurosurgery?
• For any given specific type of spine surgery, how many have they performed?

WHAT QUESTIONS TO ASK YOURSELF AFTER YOUR VISIT WITH A SPINE SURGEON?

• Were they able to help me fully understand my diagnosis and its cause(s)?
• Were they able to outline the goals of surgery and provide me with realistic expectations for my recovery?
• Did they discuss with me other alternative treatments, including non-surgical ones, and help me understand how my condition might change if I opted against surgery?
• Did they make me feel comfortable and at ease?

Mohamed Abdulhamid, MD
www.DrAbdulhamid.com
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