The Different Types of Spine Surgeons

Should a Neurosurgeon or Orthopaedic Surgeon Perform Your Spine Surgery?

Question: What doctor is the better choice to perform spine surgery—an orthopaedic surgeon or neurosurgeon?
— Glen Ellyn, IL

Answer: The short answer is that it depends on the skills and experience of the spine surgeon and your particular condition.

Two medical colleagues looking at x-ray imageAs their names imply, neurosurgeons focus on diseases of the nervous system, including everything from the brain and spinal cord to peripheral nerves in the extremities. Orthopaedic surgeons focus on diseases of the skeletal system, including bones and joints, as well as their motion and function.

Since the spine involves both the nervous system and the skeletal system, specialists from both fields are equipped to perform most types of spine surgery. Generally speaking, all neurosurgeons are trained to do spine surgery, but only some orthopaedic surgeons are. Some orthopaedic surgeons have enough exposure in their training to perform spine surgery, while others pursue additional training in spine surgery, which is called a fellowship. A fellowship is optional education to sub-specialize in an area of medicine.

Both neurosurgeons and orthopaedic spine surgeons treat neck and back pain, pinched nerves, spinal stenosis, and other general spine conditions. However, there are areas of specialization. Neurosurgeons typically handle all spinal cord injury, spine and spinal cord tumors, and vascular malformations (such as dural arteriovenous fistulas).

Orthopaedic spine surgeons, on the other hand, typically handle pediatric deformity, high grade scoliosis, and pelvic fixation. As expected, the lines are blurring, and we are seeing more shared territory between the two specialists.

My advice is to talk with your primary care or referring physician about the skills of the surgeon they are referring to you. They want the best outcome for you and will only send you where they feel comfortable.

If you'd like to learn more about this topic, read the SpineUniverse article about the differences between neurosurgeons and orthopaedic surgeons.