How to Select a Spine Surgeon

General Considerations

In addition to specific questions, there are three general considerations that can help guide your selection from different spine surgeons:

Decision Making

1. When considering surgery, every patient should keep in mind that spine surgery is almost always an elective procedure, and there are very few times that spine surgery is absolutely essential. You are the only one who knows how bad your pain is, and the decision to proceed with surgery is absolutely your decision. The surgeon’s role is to educate you and assist with the decision-making process – providing you with information about your full range of options, and describing what is technically possible, the difficulty and risk of the procedure and potential benefits. Therefore, it’s important that you select a surgeon who is helpful in providing you the information you need to decide whether or not to proceed with surgery.

Neurosurgeon or Orthopedic Surgeon

2. Patients often ask what kind of surgeon should do their spine surgery: a neurosurgeon or orthopedic surgeon?
While each specialty has a different focus in training, both are equally qualified to do the majority of spine surgery (there are some exceptions to this rule: for example, a neurosurgeon is generally better suited for tumor surgery and an orthopedic surgeon for deformity).
Neurosurgeons and orthopedic surgeons frequently work together on a case and even in the operating room.

In addition to the usual surgical residency requirements, both neurosurgery and orthopedic surgery specialties offer fellowship programs in spine that include an additional year of training specific to spine surgery. At the very least, your surgeon should be board certified or board eligible in orthopedic or neurological surgery.

Important Factor

3. Another very important factor is the amount of the surgeon’s practice devoted to spine surgery. A physician who focuses on spinal surgery is going to be far more adept and current in newer surgical techniques then one who performs spine surgery only occasionally. For example, the North American Spine Society requires that at least 50% of a physician’s practice be devoted to spine treatment as inclusion criteria for the society, which is probably a pretty good benchmark.

You can generally gather the above information about the referred surgeon from reliable sources, such as your family doctor, family, or friends who have been treated for back pain, and local hospital physician-referral services or universities, and from the physician’s practice web site.

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