Spine surgery is a specialized field that entails managing, diagnosing, and treating conditions affecting your spine and its surrounding structures to improve your health and overall quality of life. It also requires specialized expertise and knowledge. While both a neurosurgeon and orthopedic surgeon can perform a spine surgery, there are variations in their experience, approach to treatment depending on the health condition, recovery follow-up, and training. The expertise and experience of your medical practitioner are some of the factors to consider when choosing between a neurosurgeon and an orthopedic surgeon.
Who is an Orthopedic Back Surgeon?
An orthopedic surgeon is trained and qualified to diagnose, prevent, and treat health conditions affecting muscles and bones. They also know about injuries and diseases that affect your musculoskeletal system, including nerves, ligaments, cartilage, tendons, and bones. They also treat congenital conditions, injuries, or degenerative diseases.
Orthopedic surgeons focus on improving patients' lives through treatments and therapies. They address the root causes of pain or determine why a patient lacks mobility before formulating a treatment plan to restore the patient's quality of life. Your orthopedic surgeon can correct issues through surgical procedures or prescribe nonsurgical treatments with rehabilitative physical therapy or medication.
They also do the following:
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Interview patients and perform exams to review their physical conditions and identify osteopathic issues
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Educate patients on their diseases
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Order and interpret diagnostic tests
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Perform treatment and procedures
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Collaborate with other medical experts
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Complete patient charts and maintain records
Who is a Neurosurgeon?
A neurosurgeon is specialized in the treatment and diagnosis of the central and peripheral nervous system, including trauma, vascular disorders, spinal degenerative diseases, congenital anomalies, and infections of the spine or brain.
Although a neurosurgeon can perform a surgical procedure on your spine, they typically recommend conservative or nonsurgical treatment first. For instance, if you have severe chronic back pain, the neurosurgeon can first recommend physical therapy or anti-inflammatory medications. If your symptoms fail to improve, the neurosurgeon can recommend surgery.
Variation in Recovery
Orthopedic surgeons and neurosurgeons address identical but varying aspects of spine health.
The professionals also use varying strategies to help with patients' recovery. Most neurosurgeons work in private and public hospitals. Therefore, they work with other experts, like an in-house critical care team. Following a patient’s surgical procedure, this team handles the patient's daily case management. Maintaining constant communication with your neurosurgeon can sometimes be challenging.
On the other hand, an orthopedic surgeon often operates in private practices, conducting their operations at surgical facilities or via hospitals with which they have established a working affiliation. Like a neurosurgeon, an orthopedist works with a team of rehabilitation experts, including occupational therapists and physical therapists. You, the patient, are more likely to maintain contact with your surgeon during healing, which is advantageous.
Education and Training
There are various training requirements to become a neurosurgeon, including the following:
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Completing prerequisites and applying to medical school — In university, you should complete prerequisite courses like physics, biology, and chemistry. You should also complete research and study for the Medical College Admissions Test.
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Completing medical school is the initial step to becoming a doctor and lasts four years. The first two years are spent in the classroom, learning the basics, while the remaining two are spent in the hospital, receiving hands-on training.
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Completing residency — Neurosurgery residency is the longest residency of medical specialties and lasts seven years. You will learn how to perform neurosurgical procedures and surgeries during this period. You should take the neurosurgery board examinations at the end of your residency education.
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Completing fellowship (optional)—You can pursue a fellowship (more medical training in a neurosurgery subspecialty) for two years.
The training for neurosurgeons incorporates learning to conduct surgeries that treat neurosurgical issues, like tumors, nerve compression, and spinal injuries. Their training focuses on the spine's nervous structures and ways to reduce pressure or address neurosurgical disorders.
Becoming an orthopedic surgeon is a journey that demands passion, resilience, and commitment to improving patients' lives. Here is a brief overview of their training pathway:
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Undergoing a four-year undergraduate degree
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Completing medical school —A medical school degree typically takes four years, during which the professional learns about clinical skills, pharmacology, physiology, and anatomy.
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Residency training for five to six years — Becoming an orthopedic surgeon involves completing a residency program where the resident receives hands-on training, engages in surgeries, and gains experience treating and diagnosing musculoskeletal issues.
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Fellowship for two years (Optional) —The orthopedic surgeon can further their expertise by training in a given orthopedic subspecialty.
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Board certification—Finally, the orthopedic surgeon should acquire accreditation from the American Board of Orthopedic Surgery to practice.
Differences in the Health Issues Treated
Orthopedic back surgeons treat wide-ranging spinal conditions, especially those involving the musculoskeletal components. The conditions include spinal deformities, scoliosis, degenerative disc issues, and fractures. Orthopedics can also address chronic pain, sports-related injuries, and musculoskeletal conditions impacting the spine.
On the other hand, neurosurgeons treat disorders impacting the normal function of the nerves and spinal cord. These conditions include herniated discs, spinal stenosis, nerve compression, and spinal cord tumors.
Although an orthopedic back surgeon and a neurosurgeon can treat issues like herniated discs, a neurosurgeon focuses on the neurosurgical implications of those conditions.
Variation in Surgical Methods
While neurosurgeons and orthopedic surgeons conduct surgical procedures on the spine, their approaches and specialization areas differ. Typically, orthopedics focuses on medical procedures that restore function and rectify spinal alignment, like a laminectomy or spinal fusion. They could also conduct surgeries that stabilize broken vertebrae or address spinal deformities.
In contrast, neurosurgeons specialize in alleviating pain in a patient’s nerve roots or spinal cord. Their surgical methods can include discectomy or decompressive laminectomy, which removes part of the spine, applying pressure on your nerves. Neurosurgeons also address more complicated spinal issues that impact your spinal cord directly, like spinal injuries or tumors.
Variation in Follow-up Care
Your orthopedic surgeon works with patients from initial consultation through rehabilitation after treatment. That means you can continue seeing them for your follow-up appointments and track your recovery process through physical therapy until you are fully healed.
Neurosurgeons follow up with their patients following a surgical procedure, but they focus on the surgery more. After your initial recovery, you will transition to other medical experts for ongoing rehabilitation.
Do Neurosurgeons and Orthopedic Spine Surgeons Treat Nerves
It is a common misconception that neurosurgeons are more concerned about nerves than orthopedic surgeons. Both medical professionals are careful about protecting a patient’s nerves when conducting a surgery. They handle surgeries involving anatomy in close contact with the nerves within the spinal column with utmost care because the potential risks are significant. Surgeries of this magnitude cannot be successful without safeguarding the nerves.
Additionally, orthopedic surgeons and neurosurgeons undergo training together, learning similar surgical methods and procedures. Therefore, the gap between them is growing less noticeable. Choosing a fellowship-trained and board-certified surgeon ensures the physician has been adequately prepared and equipped for the potential risks and magnitude of neck and back surgeries.
What to Expect When You Visit Your Neurosurgeon or Orthopedic Back Surgeon
During the initial consultation, your medical practitioner will thoroughly evaluate your medical symptoms and history. They will inquire about the location, intensity, and duration of pain and any previous treatment you have undergone. They can also perform a physical exam to evaluate your nerve function, reflexes, or range of motion to identify the root cause of the discomfort.
The physician can also order diagnostic imaging, like a CT scan and MRI, to obtain a clear picture of your nerves and spine. After making a diagnosis, the physician will discuss treatment options, including minimally invasive treatments, surgery, and conservative therapies.
The consultation is your chance to ask questions, understand the benefits and risks of your treatment option, and determine the best treatment option.
Surgeries Performed by a Neurosurgeon
Surgeries a neurosurgeon performs are as follows:
Lumbar Puncture
Also called the spinal tap, lumbar puncture is a neurological procedure performed to diagnose disorders affecting the central nervous system, like spinal cancer.
The procedure entails a needle insertion into the patient’s spinal canal to suck off cerebrospinal fluid (the fluid surrounds your brain and spine as a protection against injuries). A neurosurgeon can conduct the procedure to:
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Inject medication or spinal anesthetics
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Check for infections, diseases, and inflammations
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Measure a patient’s cerebrospinal fluid pressure
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Inject dye or radioactive substances into the cerebrospinal fluid to identify its flow
Anterior Cervical Discectomy
Anterior cervical discectomy treats herniated discs, a prominent cause of neck and arm pain. The neurosurgeon examines the posterior neck before removing the herniated part and fusing nearby discs. The procedure can sometimes be an outpatient treatment.
Laminectomy Surgery
Neurosurgeons conduct laminectomies to treat severe back pain. The surgical procedure entails making small incisions around the spine that allow the removal of all or part of a vertebra, rectifying issues associated with nerve and spinal cord pain or discomfort. Laminectomies should be the last resort for individuals with crippling back pain after the failure of other treatment options.
Cervical Corpectomy
A cervical corpectomy involves removing damaged discs and vertebrae from your spine to relieve pressure on your nerves and spinal cord. Physicians perform it when a discectomy is inadequate to treat the health condition.
A discectomy removes protruding parts of a disc and related bone spurs. In contrast, a corpectomy removes the vertebral bone alongside the discs below and above to decompress your affected nerve roots and spinal cord. d
Surgeries Performed by an Orthopedic Back Surgeon
An orthopedic back surgeon performs surgeries that include the following:
Lumbar Spinal Fusion
An orthopedic surgeon performs lumbar spinal fusion on patients experiencing scoliosis or a misshapen spine. They can also use the procedure to address nonspecific or severe back pain because of degenerative variations to a patient’s spine that have not improved with nonoperative care.
The orthopedic back surgeon fuses some spinal bones to prevent additional movement within the spinal vertebrae to treat back pain without affecting a patient's physical well-being.
Laminectomy Surgical Procedure
An orthopedic surgeon performs a laminectomy on patients suffering from lumbar spinal stenosis or a narrowed spine. The surgeon extracts the abnormal components within the musculoskeletal system, like ligaments or bone spurs, to address weakness and pain. Laminectomy patients might require spinal fusion when receiving back pain treatments.
Disc Replacement
Disc replacement entails the removal of a herniated disc for replacement. After removal, the orthopedic surgeon can recommend installing artificial discs within the spine to help enhance movement and stability and prevent pain.
Unlike spinal fusion, disc replacement has minimal risks for a patient’s movement limitations.
Some forms of orthopedic back surgery are robotic-assisted. The sophisticated robotics technology enables the surgeon to navigate better with greater accuracy and precision, resulting in quicker healing, fewer side effects and complications, an increased success rate, and better outcomes.
Orthopedic treatments to address back pain do not always begin and end with a surgical procedure. The treatment plan for many patients also includes medication, rehab or physical therapy, and other state-of-the-art methods.
Overlapping and Collaboration Areas
Neurosurgeons and orthopedic spine surgeons receive thorough education on handling the nervous system while undergoing training and taking precautions to preserve nerve health during surgeries. Surgeries near your spinal nerves are complex and need cautious consideration of your nerves to improve the success rate.
Due to the evolution of modern medicine, innovative technology now merges facets of both medical fields. The collaboration encourages a more thorough approach to patient treatment. Most spine facilities provide multidisciplinary approaches to care where neurosurgeons and orthopedic surgeons collaborate. For instance, a patient with chronic back pain due to lumbar facet joint arthritis can first undergo a diagnosis from an orthopedic back surgeon. However, if spinal cord compression is discovered, a neurosurgeon can perform surgery.
Other benefits of collaboration include the following:
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Fellowship programs— Neurosurgeons and orthopedic spine surgeons can receive additional training with a focus on spinal surgery, enabling them to learn from each other
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Clinic and hospital teams — Most clinics employ orthopedic surgeons and neurosurgeons for a multidisciplinary approach to spinal treatment that combines expertise when addressing complex conditions. The multidisciplinary approach offers the most suitable care to patients with various spinal issues, from nerve functions to bone structure treatments.
How to Know Whether You Need a Neurosurgeon or an Orthopedic Back Surgeon
Deciding who to consult between an orthopedic surgeon and a neurosurgeon regarding your health condition depends on factors that include the following:
Condition and Diagnosis
You should start with understanding your condition and diagnosis. Certain spinal conditions could primarily involve neurosurgical components, although others can be orthopedic. Issues like aneurysms and tumors among other nerve-related issues, are usually within the scope of neurosurgeons. On the other hand, orthopedic surgeons focus most on issues like arthritic changes, spinal deformities, spinal injuries, and herniated discs.
Communication Skills
Choosing a spine specialist involves reviewing their approach to patient care and communication. A good relationship with your physician significantly affects your overall experience. An orthopedic surgeon is popular for their hands-on approach and focus on the physical approach, whereas a neurosurgeon offers a comprehensive approach to the neurological implications of spine conditions. It is essential to consider how every medical practitioner's communication system resonates with you and how comfortable you feel discussing your health concerns.
Fellowship Expertise and Training
Review the qualifications and professional experience of your specialist. Focus on the specialization in the relevant medical field. A skilled and highly trained specialist is better prepared to address complicated cases.
Treatment Options
Go over treatment options with your specialist. They will give you a comprehensive treatment plan that contains surgical and non-surgical approaches. Consider potential risks, pros, and the success rates of all options.
Health Insurance Coverage
Before deciding whom to treat you, consider your health insurance coverage. You can contact your health insurance provider to determine what your policy covers. That way, you will avoid financial surprises after treatment.
Does the Treatment Plan Meet Your Lifestyle and Needs?
Treating your back or neck pain extends beyond the medical facility. Your physician should be able to advise and guide you on different lifestyle modifications that assist in alleviating pain, including dietary choices, exercising, and sleeping on a supportive mattress. The doctor might not handle the lifestyle modifications directly but should have adequate knowledge of the subjects to advise you.
Find a Skilled Back and Neck Pain Specialist Near Me
When choosing your spine specialist, it is wise to focus on the physician's specialization and experience instead of the title. Both neurosurgeons and orthopedic back surgeons are trained and can treat spine diseases and perform spine surgery. Nevertheless, you should consider consulting a neurosurgeon if you suffer from neurological conditions affecting your spinal cord, spinal trauma, or spinal tumors. An orthopedic surgeon is more suitable for spinal conditions like spinal deformities, facet joint issues, or degenerative disc issues.
At LAMIS, we are dedicated to alleviating pain, preventing further spinal damage, and restoring function. Whether you need an orthopedic back surgeon or a neurosurgeon, we offer stellar care to you and help you recover from your health condition, improving the quality of your life. Please contact our Los Angeles facility at 310-734-6088 to book your appointment.
