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Orthopedic Surgeon vs. Neurosurgeon for Spine Surgery

When patients are considering having spine surgery, one of the most common questions they have is “which is better, a neurosurgeon or an orthopedic spine surgeon?” The quick answer is that for most types of spine surgery, both specially trained orthopedic surgeons and neurosurgeons may be considered. This article profiles the similarities and differences between the two specialties, and provides additional advice on how to select a spine surgeon.

Both Can Specialize in Spine Surgery

Many years ago, neurosurgeons were primarily responsible for spine surgery, but in the past 20-25 years or so spine surgery has evolved so that both neurosurgeons and orthopedic surgeons specialize in spine surgery, and for most of the typical spine operations both types of surgeons are equally well qualified.

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In both specialties, the surgeons may subspecialize, such as in the case of surgeons who specialize in pediatrics, cervical spine, lumbar spine, hand surgery, plastic surgery, foot and ankle surgery or in other areas or procedures.
Neurosurgeons

Neurosurgeons may be Medical Doctors or Doctors of Osteopathy, and complete a five to six year residency focused on the surgical treatment of neurological conditions. Neurosurgeons are trained in the diagnosis and treatment of disorders involving:

* Brain
* Spine and spinal cord
* Nerves
* Intracranial and intraspinal vasculature

Some neurosureons specialize exclusively on brain surgery, some on spine surgery, and some split their practice between the two.
Orthopedic Surgeons

Orthopedic surgeons may be Medical Doctors (MD) or Doctors of Osteopathy (DO) who have completed a five-year surgical residency focused on the treatment of musculoskeletal conditions. Orthopedists specialize in the diagnosis and treatment of almost all bone and joint disorders.

* Spinal disorders
* Arthritis
* Sports injuries
* Trauma
* Bone Tumors
* Hand injuries and deformities
* Foot and Ankle problems
* Total Joint Replacement

Some orthopedic surgeons focus their practice exclusively on spine surgery, some on other types of joints (e.g. hips, knees, shoulders), and some split their practice among two or more areas.

Both neurosurgeons and orthopedic surgeons may complete fellowship training to do most types of spine surgery, but there are a few types of spine surgery in which one specialty tends to be more qualified than the other, such as:

* Orthopedic surgeons tend to be better qualified to do spinal deformity surgery, e.g. scoliosis, other types of spinal deformity.
* Neurosurgeons tend to be more qualified to perform intradural surgery (surgery inside of the dura in the spinal cord), e.g. thecal sac tumors.

Spine Fellowships

Both orthopedic surgeons and neurosurgeons may extend their training after residency by participating in a spine fellowship program. These fellowships provide additional, specialized training for orthopedic surgeons and neurosurgeons that have successfully completed their residency training and earned their board certification or eligibility in their specialty. The fellowship is a marker of a surgeon who has chosen to specialize in spine surgery and is willing to make the extra investment in training to become more skilled.

This was not always the case. Before spine surgery was a recognized subspecialty – 15 to 20 years ago – it was not common, and often not an option, for orthopedic surgeons or neurosurgeons to do a spine fellowship program. For surgeons with this type of tenure, if they have specialized their practice in spine surgery, then they have likely earned their additional training in their practice. spine-health.com

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NOTE: This information is solely advisory, and should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.

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Disclaimer: The entire contents of this website are based upon the opinions of Dr. Nebel, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Nebel and his community. Dr. Nebel encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. Neither Dr. Nebel nor any practice associated with Dr. Nebel endorses, recommends or is otherwise suggesting treatment or any other services by any person, company, firm identified in this publication. References to third-parties are for convenience only. You, the reader, are solely responsible to qualify any third-party service provider or the necessity and/or quality of services. This document is for general use only and is not intended as medical or professional advice; you, the reader, are solely responsible to obtain medical and/or other professional advice regarding your individual personal circumstances. This content may be copied in full, with copyright, contact, creation and information intact, without specific permission, when used only in a not-for-profit format. If any other use is desired, permission in writing from Dr. Nebel is required. © Copyright 2012 Dr. Donald P. Nebel Jr. All Rights Reserved.
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