Should I choose a neurosurgeon or an orthopedic spine surgeon?

There are multiple educational pathways to becoming a spine surgeon. Neurosurgical spine surgeons must complete a seven-year residency training program after medical school performing both brain surgeries and spinal surgeries on adults and pediatrics. During the seven years, two thirds of the time, or nearly five years, is focused on spinal surgery. Some neurosurgeons spend an additional year of fellowship focusing on both minimally invasive and complex spinal reconstructive surgeries. Orthopedic spine surgeons complete a five year residency program, of which usually only six months is focused on spinal surgery. They must then complete one additional year of fellowship training focused on spinal surgery. As a result, Neurosurgical spine surgeons graduate with 5-6 years of dedicated spine training and experience, while Orthopedic spine surgeons graduate with only 1.5 years. Orthopedic surgeons tend to be more focused on bone fusion and less comfortable working with nerve tissues. Neurosurgeons have extensive experience working with delicate nerve tissues, which is the most important part of any spinal operation.

Should I choose a spine surgeon who is in private practice or employed by the hospital?

Surgeons who are employed by a hospital system are more likely to face pressure from hospital administrators to perform procedures which are more profitable for the hospital or to choose spinal implants or technologies which are less expensive and are often chosen by the hospital. They also have fewer options about where to perform your surgery. Often, hospital surgeons are not able to perform surgery in outpatient surgery centers. These outpatient centers can provide higher quality care at lower cost to you. Private practice spine surgeons have greater freedom to choose the procedure or technology which is best for you and to deliver that care in a setting which is most appropriate and comfortable for you to achieve the best result.

Should I travel to an academic center or choose a local private practice surgeon?

All Neurosurgeons have trained at large academic centers. We all maintain close ties to those big named centers and have continued medical education throughout the year addressing any new or novel procedures and technologies. Academic surgeons frequently have a large portion of their time devoted to publishing research, much of which doesn’t translate to clinical practice. Private practice neurosurgeons spent 100% of their time taking care of patients and operating, often making them more efficient and experienced. When you stay local, you know your surgeon and can be assured no “surgeons in training” such as residents or fellows will be performing the surgery. Plus, your local surgeon lives in your community and has a vested interest in your success. We all see each other around town and want nothing more than to have positive local interactions.