Battle royale: neurosurgeon versus orthopedic surgeon for your back problems

You don't need to be a brain surgeon to figure out that it takes a brain surgeon to do surgery on your brain. However, brain surgeons, or neurosurgeons as they're known to hospitals, can also perform surgery on your back. This is because neurosurgeons are trained in the care of the nerves that come off your brain and the spinal cord.

On the other hand, the spinal cord runs through the spine, and the spine is made of bones. It doesn't take a brain surgeon to figure that one out! That's why you could go to orthopedic surgeon, or bone doctor as the non-brain surgeons call them, to take care of your back. When you have a problem with your back, it's hard to know which doctor is the most appropriate one to choose. Both have experience in spinal surgery, and both are viable options for your surgical needs. Making a choice can be the difference between a good surgery or a botched one.

Just what do they know: your surgeon's training

Both doctors will have gone to medical school, either a school of medicine or a school of osteopathy. Neurosurgeons will then take a 6 to 7 year residency program that exposes them to different spinal problems and allows them to perform hundreds of supervised surgeries. After their residency, they can choose to do a fellowship in spinal surgery to get even more experience. A neurosurgeon can choose to focus on just spinal problems even though they have the ability to perform brain surgery. Likewise, an orthopedic surgeon will undergo a 4 to 5 year residency program that will expose them to different types of orthopedic surgeries. Surgeons at this time can choose to specialize in spinal surgeries. After residency, orthopedic surgeons can also choose to take up a fellowship of 2 to 3 years to further specialize in spinal surgery.

The differences between them: what each surgeon can do

Although both surgeons take a similar course and can do most of the same things, there are some differences between each type of surgeon. Both neurosurgeons and orthopedic surgeons can repair problems with discs such as herniations and degenerations. They can also handle spinal fractures, spinal stenosis, slippage of the spine, scoliosis, and bony tumors of the spine. Neurosurgeons are the ones who can typically perform surgeries inside the dura mater, or the innermost lining, of the spinal column. This means they are the only type of surgeon who can perform surgeries on spinal cord tumors, arachnoid cysts, spinal cord arteriovenous malformation, tethered spinal cord, spina bifida, tumors at the base of the skull, nerve root tumors, and a handful of other more complicated nerve related surgeries. Orthopedic surgeons are normally tapped for procedures such as scoliosis and spinal deformities.

The most important thing to know: selecting your surgeon

When selecting a surgeon, the debate whether or not to have been a neurosurgeon or orthopedic surgeon is inconsequential. The single most important question you need to ask your surgeon is whether or not he treats the type of defect that you need treated. Ask your surgeon how many surgeries he has performed that are similar to the surgery have planned. Whether or not the surgeon is a neurosurgeon or an orthopedic surgeon does not matter so much, but what matters is his experience in the type of surgery you need him to perform. Make sure your surgeon is accredited by the board in his chosen specialty, either neurosurgery or orthopedic surgery, and that he is a member in good standing. Also, ask what sort of training he has undergone, and if he has had a fellowship or residency program to further his education in spinal surgery. It is experience more than specialty that is crucial in determining the best outcome for your surgery.

References:

• Spine Universe; Neurosurgeon or Orthopedic Surgeon? Does It Matter?; Gerald E. Rodts, Jr., MD and Lawrence G. Lenke, MD; May 2011
• About.com; Should I See a Neurosurgeon or Orthopedic Surgeon?; Jonathan Cluett; November 2006

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