Orthopedic Back Surgeon vs. Neurosurgeon: Find the Best Fit

When you have a problem that you just can’t solve, your first inclination is to call someone who can fix it. Obviously, you want to make sure that the person you’re calling is the right person for the job. You wouldn’t want to call a plumber, for example, if your car won’t start. This is pretty basic logic. But, what if the problem is slightly less straightforward. What if you must decide between the right surgeon for your back pain: an orthopedic back surgeon vs. a neurosurgeon?

So far we’ve established that when you have a special problem, you call a certain specialist. Easy, right? Well, what if I told you that doctors don’t necessarily work that way. I know, it flies in the face of everything we’ve established so far, but bear with me.

You see, a neurosurgeon isn’t necessarily just a “brain guy,” much in the same way that a back surgeon isn’t just a “back guy.” Both can specialize in surgical procedures involving the spine. One isn’t necessarily better than the other. What you really want to pay attention to is the individual holding their respective title. What experience do they have? Obviously, when it comes to bodily ailments, you’re going to want someone who has experience dealing with the specific problem that you have. And it is certainly possible that either a back surgeon or a neurosurgeon has experience in the particular niche that suits you.

To dive a little deeper, you’re going to be more concerned with “who” someone is instead of “what” they are. A doctor’s function is defined by the experience they have. For instance, there are plenty of very knowledgeable college professors who have textbook-level expertise when it comes to the spine. But you wouldn’t necessarily trust them with your surgery, would you?

When do I want a Neurosurgeon?

When we think of neurosurgeons, we think of the brain. After all, that’s what those guys work on, right? Well, true, but there’s a little more to these doctors than just that. In fact, a neurosurgeon does a lot more than just brain surgery. Believe it or not, 70% of a neurosurgeon’s time is devoted to the spine. They work to alleviate back pain, neck pain, herniated discs, degeneration, leg pain, and much more. Instead of thinking of neurosurgeons as brain specialists, think of them as nervous system specialists (which includes the brain, the spine, and nerve endings).

Another common misconception that people have when it comes to neurosurgeons is that they are all about surgery. This is a myth. The truth is, the vast majority of neurosurgeons end up prescribing non-invasive or conservative care as opposed to complex surgery. For instance, the vast majority of cases involving back pain are easily remedied through the use of anti-inflammatory drugs. Of course, there more severe cases that require much more attention, but those instances are somewhat less common.

Today, surgery performed by neurosurgeons is more of a science than it ever used to be. The advent of new, specialized tools and imaging techniques have paved the way for a bevy of less intrusive methods. Doctors commonly refer to this new field of procedures as minimally invasive surgery. With smaller incisions, you can expect faster recovery times, less scarring, and less assumed risk when it comes to your back surgery.

When do I want an Orthopedic Back Surgeon?

An orthopedic surgeon specializes in the musculoskeletal system, which includes your spine, bones, and soft tissues that enable movement (i.e. muscles, ligaments, and tendons). Like neurosurgeons, orthopedic back surgeons address nervous system disorders that involve the spinal cord and peripheral nerves; however, unlike neurosurgeons, these specialists do not treat nervous system disorders that affect the brain. For all intents and purposes, consider brain tumors and neurological movement disorders (such as Parkinson’s) to fall exclusively under the umbrella of neurosurgery.

Although there is a considerable amount of overlap between orthopedic surgery and neurosurgery, an orthopedic back surgeon is a true spine specialist. Neurosurgeons treat a wider range of disorders, whereas an orthopedic surgeon performs back surgery day-in and day-out. As we will discuss later, training and outcomes are everything. When selecting your surgeon, look carefully at their credentials for fellowship training. An orthopedic surgeon is more likely to have completed an additional five years of training in the field of spine surgery than a neurosurgeon. But, this isn’t always the case.

How do I know if I need Back Surgery?

Surgeons wear many different hats. Chances are if you need back surgery, then your current physician will refer you to the right person. That person may be a back surgeon. Or, they may be a neurosurgeon. Your options will depend on your location and what is immediately available to you.

So how exactly does your doctor determine that you need to see a specialist for a surgical procedure? Well, the criteria vary depending on numerous factors that change from case to case. But in the most general terms, if you have been experiencing uncomfortable symptoms for a period of two weeks or more, then it is time to see a doctor. Once you get in touch with your general care provider, they will likely prescribe you a conservative treatment, such as anti-inflammatory medication or a special physical therapy exercise regimen. If two more weeks pass without any improvements on your end, then you may end up being a candidate for surgical correction.

There are many different types of surgeries that doctors perform for a myriad of different cases. Generally speaking, you can divide surgery into two major categories: traditional open back surgery and minimally invasive surgical procedures. Usually, you’re going to want to fall into that latter category if you truly do need surgical correction. Most of the time, patients can get by with minimally invasive surgical techniques. That being said, sometimes a problem is so major that it has to be done the old fashioned way. Luckily, such occurrences are quite rare, and minimally invasive surgery tends to be the best avenue.

The Importance of Spine Fellowships

When it comes to neurosurgeons and back surgeons, they share similarities in their backgrounds. More specifically, orthopedic surgeons generally complete a five-year surgical residency that focuses on the treatment of musculoskeletal conditions. Meanwhile, a neurosurgeon typically completes a five to six-year residency that focuses on the surgical treatment of neurological conditions. No matter which background you are referring to, both are related to the spine in one way or another.

So how am I supposed to know which is better: a neurosurgeon or an orthopedic surgeon? Well, again it depends on the individual in question. Instead, look at the qualities that you desire in your ideal surgeon. Typically speaking, you want a doctor who has extended upon their usual residency by completing a spine fellowship program. Furthermore, you want to make sure that this ideal doctor has also earned their board certification or eligibility in the area that they claim to specialize in. A surgeon who has completed a spine fellowship has the special distinction of being someone who is willing to make the extra effort in training to become more skilled in a niche area. That is who you want to be your surgeon.

Spine fellowships have only really gained popularity within the last 15-20 years. Back in the 90’s, it was not very common for back surgeons or neurosurgeons to have completed such a program. In fact, in many cases, it was not even feasible. Today, however, you can and should look for a doctor who has completed a spine fellowship program—whether they are an orthopedic surgeon or a neurosurgeon.

Contact Us

Have you experienced painful symptoms in your back for a period of two weeks or more? Have conservative avenues failed to give you the relief that you desperately need? If so, then you may want to consider giving our offices a call at (855) 210-0899.

Dr. Daveed Frazier is a Harvard-educated, board-certified, and fellowship-trained orthopedic spine surgeon as well as a respected lecturer and accomplished researcher. When it comes to treating back pain, there are few who can match his impressive credentials. At New York City Spine, we pride ourselves on our ability to serve the specific needs of each and every client who walks through our door. For more information, contact us today!