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What is the difference between a Neurosurgeon and an Orthopeadic Spine Surgeon for spine surgery?

There a two paths by which a physician may become a spine surgeon.  All physicians attend medical school with a similar baseline of training.  The training for a given specialty follows medical school during a residency.  There are residencies for orthopaedic surgery and neurosurgery but not specifically spine surgery.  For an orthopaedic surgeon their residency is typically 5 years and will cover spine surgery as well as the other specialties in orthopaedics, such as joint replacement and sports medicine.  Likewise, a neurosurgery residency will train their residents is all of the fields of neurosurgery including brain surgery.  Many neurosurgeons feel comfortable in caring for spinal disorders after their residency.  Most orthopaedic surgeons will seek out an additional year of fellowship training devoted specifically to spine surgery before practicing as a spine surgeon.

The differences between the two lines of training has lessened.  Thirty years ago there was a significant difference in how surgeons practiced.  Many orthopaedics surgeons performed fusions and scoliosis surgery while neurosurgeons would treat spinal tumors and perform decompressions.  These differences were based on the fact that there were not “spine surgeons” who devoted their practice to spinal surgery but rather there were a number of orthopaedic and neurosurgeons who dabbled in spine surgery.   As the technology for spine surgery improved, there are now surgeons who devote their practice to spine and work to be proficient at the many facets of spine surgery.  For surgeons trained in the last 20 years, there has been a convergence of the philosophies and techniques used to treat spinal disorders between the two specialties such that both groups should be comfortable caring for a majority of spine problems.  There are still some historical differences between the two groups.  It is more common for an orthopaedic surgeon to be trained in scoliosis surgery and for a neurosurgeon to be trained to care for tumors of the spinal cord and nerves.

If you are considering having a spine surgery and are looking for the best trained surgeon, I believe that for spine surgeons trained in the last 20 years, there is little difference between the two groups for treating a vast majority of the common spine conditions.