Ortho Spine Surgeon & Neurosurgeon Comparison

It is important for patients to realize that both neurosurgeons and orthopedic surgeons perform spine surgery. Today, there is an emerging field of "spine surgery" that incorporates both specialties. In the future, there may be a well-defined medical specialty of "spine specialists" defined by its own board certification. This is not currently the case. Currently, neurosurgeons seek board certification from the American Board of Neurological Surgery and orthopedic surgeons seek certification from the American Board of Orthopedic Surgery. There is no certification process at the present time that is recognized by the "father" board, the American Board of Medical Specialties. It is very important that patients make sure that their doctor is certified by the appropriate board. This ensures that the doctor has met the highest standards set by his or her peers and passed both oral and written examinations.

Orthopaedic Surgeon Training: All Orthopaedic Surgeons trained in the United States (and many places abroad) gain experience in the diagnosis and nonsurgical and surgical treatment of spinal disorders during their residency training program (after medical school). Most orthopaedic residencies are at institutions where there are one or more orthopaedic surgeons who specialize exclusively in spine surgery. At these institutions, orthopaedic residents in-training are exposed to a large volume of spine surgeries. In some orthopaedic training programs, the emphasis is on trauma or joint surgery or on spores medicine. Orthopaedic surgeons who wish to specialize in spine surgery and gain further training may pursue a post graduate (after residency) fellowship in spine surgery. This intensive, focused training is typically one year after residency training.

Neurosurgeon Training: All neurosurgeons, just like orthopedic surgeons, are also exposed to spine surgery during their training program. As in orthopaedic surgery, if they wish to gain even more advanced training, they may elect to do a post-graduate fellowship in spine surgery. Though most patients think of neurosurgeons as "brain surgeons", it may be interesting to know that many of operations performed by neurosurgeons across the country are spine surgeries. In large group practices and certainly in academic (university-based) neurosurgery departments, there are some neurosurgeons that specialize in brain surgery and do very little spine surgery. In these settings, they will have a colleague who specializes in spine surgery.

Both Can Specialize in Spine Surgery: Though things were different many years ago, today there are a large number of both orthopedic surgeons and neurosurgeons who specialize in spine surgery. More and more, we are referring to each other as "spine surgeons" as the distinction between us is becoming nonexistent. Both neurosurgeons and orthopedic surgeons specializing in spine surgery are skilled in taking care of disc herniations, disc degenerations, spinal stenosis, fractures of the spine, slippage of the spine (spondylolisthesis), scoliosis, bone tumors of the spine, etc. For younger patients, there is a subset of spine specialists that is devoted to the pediatric patient (usually defined by patients below age 15 or so).

Fellowship Training: It may now be obvious that all orthopaedic surgeons and neurosurgeons are exposed to spine surgery in their residencies, and the question of orthopaedic surgeon vs. neurosurgeon may not be the appropriate question. The question should be fellowship trained spine surgeon vs. non fellowship trained surgeon. Perhaps the most important criterion differentiating spine surgeons from orthopaedic surgeons or neurosurgeons is the completion of a fellowship entirely devoted co the diagnosis and nonsurgical and surgical treatment of spinal disorders. Although both specialties are "allowed" to perform spine surgery, the extra training in spine surgery leads to greater expertise and sub-specialization specifically in spinal surgery. It is difficult to say that fellowship training leads to better surgical outcomes, but it certainly makes common sense that more intense subspecialization leads to more critical thinking and improved skills in the diagnosis and treatment of spinal disorders.