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Should you See an Orthopedic Surgeon or Neurosurgeon for a Spine Problem?

dirksBy Peter Dirksmeier, MD

I often hear people ask the question “What is the difference between an orthopedic spine surgeon and a neurosurgeon?” Both neurosurgeons and orthopedic surgeons see patients with spine problems and perform spinal surgery. All orthopedic surgeons and neurosurgeons gain experience in the diagnosis and non-surgical and surgical treatment of spinal disorders during their residency training programs (after medical school). In academic neurosurgery and orthopedic surgery departments, there are specialized surgeons who practice only spinal surgery and provide this important training to residents as part of their core curriculum. Though things were different years ago, today, if neurosurgery or orthopedic surgery residents wish to specialize in spinal surgery, they typically elect to do a post graduate fellowship in spine surgery.

This intensive focused training is typically one or two years after residency training. As a result, there are a large number of orthopedic surgeons and neurosurgeons who specialize in spine surgery. Both neurosurgeons and orthopedic surgeons specializing in spine surgery are skilled in taking care of disc degeneration, disc herniations, spinal stenosis, spondylolistheses and fractures of the spine.

There are a few areas where there still is a difference. For example, only neurosurgeons are trained to perform procedures inside the lining of the spinal canal called the dura. Therefore, diagnoses like spinal cord tumors, tethered spinal cord, Chiari malformation and syringomyelia, still fall under the domain of the neurosurgeon. On the other hand, pediatric and adult scoliosis, kyphosis and other spinal deformities are predominantly treated by orthopedic surgeons. Present day neurosurgical and orthopedic spine specialists have developed a collegial relationship and have come together in many international organizations to include the North American Spine Society and Cervical Spine Research Society.

Patients today can seek consultation with either a neurosurgeon or orthopedic surgeon who is appropriately trained and who has devoted his or her practice to spinal disorders. In other words, you want to seek surgeon who takes care of spine problems day to day, week to week month to month and year to year. Don’t be afraid to ask your surgeon about his training, practice focus and experience with whatever procedure is being discussed/recommended.