Neurosurgeon vs. orthopedic surgeon: making the right choice
A “spine surgeon” can either be a neurosurgeon or orthopedic surgeon. Both receive training in spinal pathologies, but their specialty training differs.
All neurosurgeons are required to perform a six- or seven-year residency training program to gain experience in the diagnosis and treatment of spinal disorders. Only neurosurgeons are trained to perform procedures inside the spinal canal, such as spinal cord tumor removal.
Deciding whether or not to have spine surgery?
This is can be a very difficult decision. Patients with spinal problems often receive varying recommendations and different surgical options by various surgeons. Also, many patients are recommended for surgery when a non-surgical treatment may be successful.
Anatomy of the Spine
The spine is a complex network of nerves, muscles, joints, ligaments and tendons vital to performing everyday activities we normally take for granted, such as walking and sitting. The spine is made up of 24 vertebrae and the sacrum and coccyx.
The spine’s segmented structure is designed to be amazingly flexible. The spine is also curved to make balance possible when standing upright and to increase carrying strength. This flexibility and curvature also make the spine extremely vulnerable to injury, such as compression fractures or abnormal spinal curvatures.
The brain is the body’s command center, issuing and receiving signals to the body through the spinal cord. Because conditions of the spine often affect the spinal canal and spinal cord, the neurosurgeon’s role is integral to proper treatment of spinal conditions.
Spinal Disorders: Causes, Risk Factors and Signs and Symptoms
Besides injuries many disorders affect the spine, spinal canal and spinal cord, which include infections, tumors, scoliosis and age-related disorders such as osteoporosis, spinal stenosis and herniated discs. Spinal disorders often cause pain when bone changes put pressure on the spinal cord or nerves. They can also limit movement.
Causes, risk factors and signs and symptoms of spinal disorders vary depending on the condition. The natural aging process, trauma, congenital defects, cancer and infection are all risk factors for various disorders and injuries.
Common spinal conditions include:
- Neck pain
- Back pain (anywhere along the spine; low back pain is very common)
- Herniated disc
- Spinal stenosis
- Radiculopathy
- Myelopathy
- Chiari malformation
- Facet syndrome
- Spondylolisthesis
How is a spinal disorder diagnosed?
A thorough health history and a physical examination are required to diagnose a spinal disorder. Imaging tests are usually ordered to confirm the diagnosis. These tests are also helpful to determine a prognosis and the best course of treatment. Diagnostic techniques include:
- X-rays
- Computed tomography (CT)
- Magnetic resonance imaging (MRI)
- Dual-energy x-ray absorptiometry (DXA or DEXA) or bone densitometry
- Discography
Office consultations are focused on thoroughly assessing an individual patient, to be able to provide the information needed to make the best diagnostic choice.
How are spinal disorders treated?
Treatment of spinal disorders varies greatly depending on what condition is being treated. Non-invasive conservative treatments are often tried first and surgical options tried when conservative measures don’t bring needed relief.
Conservative treatments include:
- Limiting or stopping activities contributing to the condition
- Over-the-counter pain medications, such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) for pain
- Narcotic pain medications, such as opioids, and muscle relaxants
- Bone-strengthening drugs (bisphosphonates) may be prescribed to help stop and/or restore bone loss.
- Back bracing provides external support by greatly limiting the normal spinal motion of fractured vertebrae
Surgical treatments may or may not be minimally invasive depending on the condition and procedure. Some treatments include:
- Cervical disc replacement – surgical implantation of an artificial disc between two vertebrae in the neck after a cervical disc has been removed
- Discectomy – minimally invasive surgery for herniated discs; used to take out the portion of bone compressing the spinal nerves or suction bad disc material
- Kyphoplasty – minimally invasive surgical filling of an injured or collapsed vertebra; relieves pain and improves posture
- Laminectomy – removal of a piece of vertebra called the lamina to open up space and relieve pressure on the nerves; relieves back pain
- Minimally invasive spine surgery – any number of spinal surgeries performed by making small incisions and guiding specially designed small instruments and a light to the applicable area of the spine
- Spinal cord stimulator (SCS) – implantation of electrodes to generate electrical charges on the spinal cord; relieves pain transferred through the spinal cord
- Spinal fusion – surgery and bone graft to join two or more vertebrae; treats multiple spinal conditions
Neurosurgeon vs. orthopedic surgeon: making the right choice
A “spine surgeon” can either be a neurosurgeon or orthopedic surgeon. Both receive training in spinal pathologies, but their specialty training differs.
All neurosurgeons are required to perform a six- or seven-year residency training program to gain experience in the diagnosis and treatment of spinal disorders. Only neurosurgeons are trained to perform procedures inside the spinal canal, such as spinal cord tumor removal.
Dr. Robert Goodman is here for those seeking a second opinion or to work with physicians to create customized treatment plans for each individual. If you are experiencing back pain or problems or have already been diagnosed, but would like more information, contact us today to schedule an appointment.
What is trigeminal neuralgia?
The trigeminal nerve carries sensation from the face to the brain. Trigeminal neuralgia (TN), also known as tic douloureux, typically occurs when the nerve becomes compressed by a blood vessel. The pressure results in a jolt of severe pain when any part of the face is stimulated (e.g., brushing teeth, putting on makeup, smiling).
