Orthopaedic Surgeon vs Neurosurgeon

What type of doctor is best for spine surgery?

Sorting out the best surgeon for your spine surgery is just one of the many hurdles you need to get through, and you might find yourself weighing up the difference between an orthopaedic surgeon vs neurosurgeon.

Let me cut straight to the point — there’s no ‘best’ type of surgeon for spine surgery. Sorry to anyone hoping for a straightforward answer! Both orthopaedic surgeons and neurosurgeons have extensive training and experience. But there are some differences to consider. 

Today, we speak with spine surgeon Keat Ooi, who shares his thoughts on the topic.

Orthopaedic Surgeon vs Neurosurgeon for Spine Surgery

Neurosurgeons and orthopaedic surgeons both deal with the spine, but they specialise in different areas. Neurosurgeons are experts in fixing the brain, spinal cord and peripheral nerves. Orthopaedic Surgeons, on the other hand, are fixers of bones, joints, muscles and ligaments – the bits that hold your whole body together.

Both sorts of surgeons can do spinal operations like fusions, discectomies and artificial disc replacements. And they treat chronic back problems including sciatica, herniated discs and scoliosis – the kind of thing that drives you mad with pain.

So neither specialty is “better” by default.

HOT TIP. A common misconception is that Orthopaedic Surgeons are only good at operating on the lumbar spine. The truth is they are perfectly qualified to do cervical operations (operate on the neck).

How to Pick the Right Spine Surgeon for Your Surgery

Rather than getting hung up on whether your surgeon is an orthopaedic or a neurosurgeon, focus on what they actually do on a day to day basis.

Many spine surgeons go the extra mile and do extra fellowship training in spine surgery after they’ve finished their specialist training. Some even keep going after that, to get extra expertise. So look for any spine specific training, like a spine fellowship or other advanced training that focuses just on the spine.

When chatting with a potential surgeon, ask them whether they regularly do your specific procedure – not just “spine surgery” in general – and try to get a sense of how much of their work is actually focused on spine surgery, rather than being a mix of all sorts of unrelated operations.

And pay attention to how they explain things to you. You want clear, straight answers, sensible options (including non-surgical options that might be worth considering) and an honest chat about what the risks and results might be. A good surgeon should make you feel at ease, not leave you feeling any more nervous than you need to be.

4 Questions to Ask Your Spine Surgeon

Here are some helpful questions to ask that can help you decide who to go with:

1. How many of these specific procedures do they do per year? (A higher frequency has been associated with better outcomes in some studies, though results vary by setting and case mix. (Meta-analysis review).
2. What are the potential complications and risks of this surgery? You need to be aware of the risks.
3. What kind of results have they actually gotten with this surgery? You want to know what they’ve seen in their practice.
4. What happens if you decide to hold off on surgery? They should be able to give you some idea of what your options would be then.

Other things to consider:

• 
  Check that the doctor is is registered with the national regulator (via AHPRA). Make sure they’re qualified to do what they claim to be able to do.
• Have they got fellowship training in spine surgery? That suggests they’re pretty serious about this area of medicine.
• Do they do minimally invasive  or other up to date techniques? You want to know if they’re up to date with the latest thinking.
• What percentage of their practice is actually related to spine surgery? If they’re not doing a lot of it, how can you be sure they’re any good?

After you’ve seen the surgeon, take some time to reflect on the following:

What to Think About After You See the Spine Surgeon

• Did they take the time to explain what’s going on with your spine and what’s causing your pain in a way that made sense?
• Did they give you a range of treatment options and make sure that surgery was really the last resort?
• Were non-surgical treatments mentioned? You want to know if they’re open to other ideas.
• Do you feel like they really listened to you and understood what you’re going through?
• Were all your questions answered to your satisfaction?

Thinking these things through will help you make the right choice for your spine – and your spine health.

Key Takeaways for Picking a Spine Surgeon

Spine surgery is a big decision, so don’t get hung up on job titles. Focus on a surgeon who’s spine-focused, explains things clearly, and does your exact procedure often.

• Judge the surgeon’s spine focus, not their label (ortho vs neuro).
• Look for post-fellowship subspecialty training in spine surgery.
• Ask how many of your procedure they do each year, and their typical outcomes and risks.