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August 5, 2008 - 11:51pm
Which type of Surgeon? Orthopedic Surgeon or Neurosurgeon?
Which type of Surgeon? Orthopedic Surgeon or Neurosurgeon?
We are frequently asked on this message board “Which surgeon is better? An Orthopedic Surgeon or Neurosurgeon? The truth is, depending upon your specific condition, probably either in many situations.
As you can read here, both can perform a wide range of spine surgery so, much more of an issue for most of us should be, not which type of surgeon, but the specific area of expertise, qualifications, practical experience and success rate in your type of surgery, of the surgeon that you choose. Also very important is choosing a surgeon who you feel you can communicate easily with.
So, anyway, still what is the difference?
Simplistically, neurosurgeons work on the nervous system, while orthopedic surgeons work on “bones”. But this is too simplistic, as many of our spinal problems involve both the nerves (spinal cord) and bones (e.g. vertebrae). The following is a better “Surgeon 101” definition:
Neurosurgeons
“Neurosurgeons focus on diagnosis and treatment of the brain and nervous system, such as the brain, spine and spinal cord, nerves, and blood vessels within the skull. Neurosurgeons must complete a five to six year training program in a neurological surgery residency program.”
Orthopedic Surgeons
“Orthopedic surgeons diagnose and treat bone and joint disorders such as spinal disorders, arthritis, sports injuries, bone tumors, skeletal deformities, and joint replacements.Orthopedic surgeons complete a five to six year training program in an orthopedic surgery residency.”
Source: Spine-Health Surgeon vs Neurosurgeon Info
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The following perhaps gives an even clearer definition and comparison:
Both Can Specialize in Spine Surgery
Unlike in the past, both types of surgeons - neurosurgeons and orthopedic surgeons - are considered "spine surgeons". Since the spine is a central point of both the skeletal structure and the nervous system, it is an important area for both types of surgeons. Many surgeons of both types sub-specialize to treat exclusively or primarily a single type of condition, such as herniated discs or spinal fractures, or they may specialize in juvenile patients.
Differences
Orthopedic surgeons are generally more qualified at treating spinal deformities while neurosurgeons are generally more qualified to treat problems within the dura of the spinal cord.
The most important difference between any surgeons will be their level of experience with the specific procedure you are having done.
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Of course expertise, training, experience and track record should be the top priority when determining which surgeon is best, but there are other ‘non technical’ or at least ‘more human’ factors that you also should consider, such as:
- How well does your surgeon communicate with you?
- Will he/she spend the time to answer your questions?
- Does he/she come across as empathizing with you?
Or more simply, how comfortable do you feel with your surgeon?
Spine-health.com also has lots of good information regarding selecting the right surgeon:
http://www.spine-health.com/treatment/back-surgery/orthopedic-surgeon-vs...
http://www.spine-health.com/treatment/back-surgery/choosing-best-spine-s...
http://www.spine-health.com/treatment/back-surgery/getting-a-referral-a-...
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Important: My comments here and comments from other members reflect personal opinions only. You should not act on any advice or opinion posted in these forums without seeking proper medical advice from a qualified doctor. Please, ALWAYS check with your personal physician before taking any action regarding your health!
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thanks Bruce that is alot of useful info.
Good job
www.google.com Does this show
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Ron DiLauro, Spine-Health System Administrator 06/29/11
I say Neurosurgeon! My dad used an Orthapedica and it did not go well, where I had a Neurosurgeon and had a totally different recovery!
TaraW
I have to agree with Bruce,
It depends entirely on the surgeon, on his training and skills. Prior to my three-level fusion in May, I consulted both ortho-and neurosurgeons. I really liked the ortho plus my PCP told me that she would definitely select that particular ortho as he is outstanding. I am really happy I went with him, I had an absolutely pain-free surgery (from the moment I woke up I felt no pain whatsoever) and a very easy recovery. All my symptoms are gone, so needless to say that I am very satisfied.
So I say, scrutinize the surgeon very very carefully, look at his qualifications, ask other doctors, nurses, and learn all you can about him. Also, prepare yourself for the surgery as well as you can, eat right, try to be in good physical shape, and have a positive attitude.
Kin
SF Peninsula CA resident
Decompression and L3-S1 fusion with instrumentation, 5/1/08
First you need to do your own research on the potential surgeons. Years ago neurosurgeons were the only ones to work on the cervical portion of the spine but now-a-days ortho surgeons do the disc surgeries too. Either surgeon will be fine as long as you do your research on them and you feel comfortable with him/her. For any reason you fell iffy or you get a gut feeling about the doctor, keep looking. My first surgeon was a neuro but the one doing my future surgery is an ortho. Good Luck.
Sept 12, 1997 - ACDF @ c4-5 & c5-6 levels
Sept 16, 2008 - ACD w/ADR @ c6-7 level (The cause for this surgery was due to stress put on the disc below the fusion that was done in '97)
Either--BUT--After doing a ton of reasearch, reading, asking, listening, and checking the creds. of those whose patients speak of the most successful outcomes here's what I found: There are a few things in the spine that only a neuro surgeon can do, as mentioned above. Beyond that, the most important variables that I have isolated are that whether neuro or ortho, their work is limited to the spine, that they have done a spine post-residency FELLOWSHIP at a well-rated spine center (e.g. Rush in Chicago, Hospital for Special Surgery in NY, etc.)and that they are Board Certfied. There are exceptions to everything of course, and I am sure that there are surgeons without those particular qualifications, but this is, IMHO, a great starting place.
I too found myself dealing with a doc who was not one for volunteering information I needed. Would give him a "0" for bedside manner. Already knowing, however, that he was certainly well qualified and well regarded by his peers, I just used that as a starting place. It led me to realize that I had no idea what I was getting into. When I had done more research, I called him back prepared with a list of very specific questions, to which I received a very complete and comprehensible list of answers. Whether intentionally or not, he compelled me to prepare for what I was facing--a very good thing! Had he just explained it all at the original face to face, I'm not sure I would have absorbed much info; I'd have been taking notes on everything, and understanding very little. I guess I finally realized I don't need him to be nice, or even mildly sympathetic. I DO need him to be knowledgeable, skillful, well read on all things current in the field, and respected by his staff. The thought of a doc whose staff doesn't carry that with them completely creeps me out. Also, regarding all things spinal, structurally, the ortho guys tend to have a much more "mechanical engineering" mindset (for lack of a better phrase), and have an engineer's way of thinking in terms of the tension, stress, torque, strengh of materials, etc. The docs treat you, and the rest of the staff gives you your care. The distinction is important, it seems to me, anyway. Oh well, I blather. And I'm as terrified as the next guy, as so far I've only had "procedures". The surgery is yet to come. Yikes!
HI,
Mines an Ortho has a good repuation but is a man of few words which is really annoying. He often skims over my questionsand when I left relaise he hasn't answered them!
The nurses say that he works by, if you don't ask you don't want to know but sometimes the lack of straight talking is quite frustrating. And yes, I told him this too.
So, I know what a mushroom feels like, In the dark!
Hi Itsalongwalk,
Even though my own OS is very approachable, I could relate to your description of feeling like a mushroom, as I had a boss once who was like that. As bad as that was, perhaps it is preferable to have a surgeon who keeps you in the dark. My doc is good at paying attention to me, but for my own piece of mind, I still write them up on a small index cards, let him know that I need to ask him some questions, and then go through item=by-item. Maybe your surgeon is just not a believer in idle chat, but when you present pre-formulated and and very specific questions, he will respond better. Does not hurt trying it.
Good luck,
Kin
SF Peninsula CA resident
Decompression and L3-S1 fusion with instrumentation, 5/1/08
My ADr will be done at st marys in sf ca. Have you been there before My dr is Zucherman
My ADr will be done at st marys in sf ca. Have you been there before My dr is Zucherman
I have a spinal sergeon that is both He is the head of a great hospital here in Colorado. So If anyone is looking for a great Dr. or even a 2nd opinion I think my Dr. is one of the best. I have had the great joy of being rejected by Dr.s cause how complex my case is. And had a few that just didn't know how to treat what was going on. I have fusions in neck and back
32yrs 3kids 15 spine surgeries in 4 years cervical and lumbar
Smiling every day I'm still walking
A childs love is the BEST medicine of all!!!!
Hi,
I am new to the site.I had spinal fusion from T9 to L1 with rods,cage,etc.I had an anterior and posterior approach.I think I am doing well,but would like to hear from others.It's hard to know if you are on track when you don't have a first post op visit with doc until 9 weeks after surgery.Any feedback will be appreciated.
Thanks Kay
I had a L5 to S1 with hardware, front and back. This was 9 weeks ago. I don't even remember what was going on at 4 weeks. The drugs help you forget... everything. Recovery is very slow. Very slow, although I do notice a difference in the last 2 weeks. The pain I experienced before the surgery is gone. It was replaced with a different more intense pain...but strangely better. I am less mobile, and I can't lay on my back thru the night. But, again, it's worse but it's better.
I wouldn't worry, eat a lot of fruit, move very slow, and don't fall. I think you will know exactly what I mean in another month or so.
I can finally tell I'm getting better.
I wasn't sure if I needed an Orthopedic Surgeon or Neurosurgeon for my C7 fracture. After talking to both, the neurosurgeon convinced me. My C7 was loose and was affecting my spinal cord. So since the surgery would involve the surgeon working so close to my spinal cord, it was easy to decide on the Neurosurgeon.
ToYoung, I was really excited to see someone in Colorado in a post talking about surgeons. I've put a link below to the doc that I'm consulting with about surgery on Monday - he was referred to me by a friend's co-worker who said he's fantastic. Who did you use?
~ October 21, 2008 - ACDF, 3-level (C4/5, 5/6 6/7), with hardware and eight screws. All fused and hardware is stable.
~ January 6, 2010 - TLIF at L4/5, two rods and four pedicle screws.
~ July 2010 - New CT and MRI on cervical shows further problems above fusion at C2/3 and worst at C3/4.
I am in no way affiliated with the medical profession. Any recommendations I make are based on my personal experiences only, so do not take my comments as medical rules.
Three years ago I was in bad shape because, I had two ruptrued disc plus three bulging. Also My sciactic nerve was pinched down my left leg with a dropped foot. The neurosurgeon i was refered to said he could fix my but, did not know how much nerve damage was done. So he offered two options L4S/L5S1 microdiscectomy or an fusion we went with the microdiscectomy. The unexpected hapened during surgery the discs that ruptured calicfied around my nerve and, he scraped all of around the nerve.
Right after sugery I did not have a dropped foot and, everyone was amazed how well things worked out for me. The only never damage have is a little numbess in my big toe so, I'm very happy how I turned out. For the neurosurgons get my vote. Still for my situation I have to stay active tru to walk 1-2 miles per plus daily stretching. If I ever need anything spine related I'm back to my neurosugeon because, he made me a believer. On a light note I'm a avid bowler and, I was able to get back to bowling and did not miss a beat. I'm sure there plenty ortho surgeons that could have this same surgery with no problem. It is amazing what surgeons can these days. Best of luck to everyone
Greetings neighbour, maybe. Saipan has been my home for 16 years. Within a month or so I will have two lumbar fusions and then 2 cervical fusions. I would appreciate having your neurosurgeons name. What device was used and did you have an autograft from your hip?
Cheers, Cap Carl
First Welcome to Spine Health (I see that was your first post)
You have found a great source of information and there are lots of friendly members who will share their experiences, which makes you feel less alone and can even really help in dealing with some of the problems we face.
I think you may find that you don't get a reply to your question.
The post was made a very long time ago (2008) and the fact that the name is not verified means, (I think), that the person has left Spine Health and is no longer a member.
If you start a new post asking your questions, I think you'll find people will answer fairly quickly.
Nice to have you join our gang.
Grade 2 spondylolisthesis causing severe stenosis + DDD
L4/L5 decompression (laminectomy) and PLIF 19th March 2010
Herniations at T12/L1, T9/T10 and T8/T9 (mildly indenting cord)
Significant cervical spondylosis from C3-C7
C3/C4 and C4/C5 are compressing the cord (mild to moderate)
Waiting 6 months to see how much worse things get
Yes, I realize I may not get a reply. My reason for
contacting is due to the fact we live on a small island. I will have two lumbar fusions and 2 cervical fusions. To save time and travel expenses I would like to have both at same time. I suspect there will be objections to that. I have been referred to a neurosurgeon located Honolulu. Regarding procedure cost, I do have options, Manila, Bangkok, Singapore and Bangalore. Cheers, Cap Carl
I certainly wouldn't want to be recovering from both a lumbar and cervical fusion at the same time!!
Have you had any spinal surgery yet?
What is your diagnosis? Did you have an accident?
I am 8 months into my lumbar fusion recovery and doing quite well. However, I am now having pain and problems with my neck.
I hope that you manage to find a good surgeon that you can get to.
Grade 2 spondylolisthesis causing severe stenosis + DDD
L4/L5 decompression (laminectomy) and PLIF 19th March 2010
Herniations at T12/L1, T9/T10 and T8/T9 (mildly indenting cord)
Significant cervical spondylosis from C3-C7
C3/C4 and C4/C5 are compressing the cord (mild to moderate)
Waiting 6 months to see how much worse things get
When I had my first back surgery I was seeing two very good docs; one an ortho, the other a neuro. The neuro did not have anytype of bedside manner, however, when push came to shove, I am so thankful I ended up with this neurosurgeon. I had so many complications involving the nerves in the spinal colum and, this doc spent an extra two hours reattaching , etc. The ortho. would have simply done a fusion. Since this was over 20 years ago, I just used an Ortho doc to fuse my neck! OUCH!. I am absoultly sure it was not a good decision. I am having numerous issues and, also need another back surgery. I will NOT use an ortho! I am waiting now for the neurosurgeon to get me into his practice. I know I shouldn't paint all orthos as "not as good", however, I personally will never use one again. Get a really good neurosurgeon, they seem to have more training and, IF you have nerve issues, (which happens a lot) they at least are well trained or, at the very least have MORE training. I wish you luck, and am a bit shocked you will have two procdures at the same time. How are you doing???
and I feel I coudn't have made a better choice. Now I also has developed a severe scoliosis from the disc being lost on one side for several levels so an N/S was out of the question.
The O/s both fused my lumbar and corrected the scoliosis and I have to say he is wonderful. He patiently answers all my questions and even draws diagrams where necessary (I am a visual person) and I have never been out of his office in under 30 mins.
He is polite and diplomatic and I feel I really picked a winner on all counts.
I do know a lot of both O/S and N/S who wouldn't give you the time of day if you begged for it so I do think it is up to the individual Dr and the condition you are having treated.
Blessings Sara
Personal experience, and research.... Neuro's wait until your fusing before throwing you into PT (makes sense), Orthopedics throw you right into PT, some people ending up needing to get surgery over again. ewwwwww......
"If you're lucky enough to live in the mountains, you're lucky enough"
I have not heard before that neurosurgeons wait before introducing patients to PT while orthopedic surgeons start patients straight away on PT. My orthopedic surgeon had me wait 4 months before commencing a PT program.
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Important: My comments here and comments from other members reflect personal opinions only. You should not act on any advice or opinion posted in these forums without seeking proper medical advice from a qualified doctor. Please, ALWAYS check with your personal physician before taking any action regarding your health!
I went to an orthopedic surgeon 2 days ago in Conroe Tx. He wants to do a lumbar fusion on me. He said I would be in intense PT 2 weeks after the surgery. That really concerns me. I had a laminectomy/discectomy in 2005 and they started PT soon after that. I really beleive that is a big reason why I still have so much trouble with my back. I am really trying to decide what to do.
That sounds wrong to me. I would talk to another Doctor. How long does it take for bones to grow together? I would guess more than 2 weeks.
My Ortho is waiting 6 weeks before letting me start PT after my fusion.
33 yr old mama to a 1 yr old baby boy and 4 yr old princess!
Spondylolisthesis grade 2-3 has caused aged disc. Surgery 02/09/10 spondylolisthesis allignment and L5/S1 Fusion.
my ortho does not even send u to pt unless you cannot move right after 8 weeks, they give u exercises to do at home and then they take it from there. i went to a ns 18 months ago and his reply was "I wouldn't touch that, just keep going to traditional therapy your not in any danger and it really doesn't look like a surgery is necessary" this after 10 years of pain, and getting worse. this year went to a very good os and he said this should of been done a long time ago!! so i guess they are all different. I'm sure a ns would of thrown me in some hard collar and i would of hated that and not been able to wear it anyway. most younger docs are getting away from that, and I am more comfortable with that!! i been in pt all my life. I hope i don't need it ever again. never really helped, and most those exercises you can do at home!!
PAULA, 3 C-SECTIONS 84-86-90, TORN CARTILIDGE KNEE, ARTHROSCOPIC SURGERY 2002, LEFT SHOULDER PAIN FOR 3 YEARS, SURGERY FOR BURSITIS, AND BONE SPURS,FOR THAT IN DEC 2004, NECK AND UPPER BACK PAIN FOR OVER 12 YEARS, CAR ACCIDENT 1999, FALL 2004, WORK, CONSTANT REPETITION, LIFTING, ECT. ACDF 10/22/08 C4-6 USED BONE BANK, TRIED ALL THERAPY BEFORE THIS SURGERY, NOTHING WORKED (ONLY TEMPORARILY) (chiro, accupuncture, pt, massage, cervical neck blocks, trigger point injections, botox injections, for neck and shoulder blades, ( muscle relaxers, pain meds, all made me sick,) always got headaches from those things,) god i wish i could take something, antidepressants, mood stabilizers, tens unit, ice, heat, neck traction unit at home, currently have tendenitis left elbow 4 yrs, bursitis, both shoulders now, and ddd, stenosis, and just had the acdf c4-6!! let's see what happens!!
Do you have any sites for Canadian trials? Thanks Charry
Any answers I have is not medical advice only a Doctor can help you with that. Just sharing my personal experience as a fellow Spine Health member only. Mild DDD of complete lumbar area with recent healing of L5-S1 HD and annular tear.Leg &foot weakness nerve compression L4-L5.Mod. disc changes C5-C7 nerve impingement sore elbow and numb hand. Sept. 2011 MRI L4-L5 disc bulge and L5 facet joint and narrowing. Meds-Oxycontin 80mg,Cymbalta,Lyrica, Flexeril,Naproxen,Serax. Platinum Infrared heating pad. ER and Oncology trained and Cardiology RN on Disability. Keep the faith.
Afraid none that I know of.
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Important: My comments here and comments from other members reflect personal opinions only. You should not act on any advice or opinion posted in these forums without seeking proper medical advice from a qualified doctor. Please, ALWAYS check with your personal physician before taking any action regarding your health!
When I had my back fused 2 years ago, I first went to a OS,a NS assisted him, which I was told they always do with any back surgery. Had I known better, I would have gone to the NS first, his care and knowledge helped more than the OS. I am dealing with scar tissue as a result of the surgery and the NS has been more helpful. Hope this helps.
I went with the neurosurgeon as I had the fear of
a surgeon damaging my nerves and arachnoid spaces.
I was assigned a post operative physical therapy program and went to a week in a step down rehab unit after a week in the hospital for three level fusion with cages and instrumentation.
I am now going to have a revision surgery because an auto accident caused a disc fragment and non union which we have
following for three years.
I did so great after my spinal fusion and three months had
an auto wreck that damaged my SI joint and back again.
I am so scared, although the radiologist said it won't be as bad as the first surgery as this is a type of touch up.
I will get second and third opionions again. Anyone have to have a revision of their fusion for non union? How did you do ?
BJ
I had a fusion on two levels on 2/28/2006 L4-L5 & L5-S1 by an Ortho. After my surgery I was still in major pain for many months and the pain kept getting worse and worse, yet my surgeon took x-rays every few months and kept telling me I was getting better and the fusion was getting solid. However, I told him over and over about my increasing pain and finally after 8 months he did a CT scan.
The scan showed that the L4-L5 level was not solid at all. and my spine was not stable. He had to do a "revised" fusion on 10/31/2006. It turns out that the screws were loose and he had to re-do the fusion on that level, put in larger screws, new hardware and it ended up taking well over two years for that fusion to get solid.
To this day, more than 4 years later, I am still in pain, though I recently had the hardware removed from that fusion.
I am sorry about all your troubles and that you need a revision. Several people posted on this site who needed or had revision surgeries. Hopefully some people will respond who would be able to share a similar experiences with you.
Best wishes,
Kin
SF Peninsula CA resident
Decompression and L3-S1 fusion with instrumentation, 5/1/08
Has anybody had nucleoplasty done? If so, did it work or help? Also, if you have any knowledge about nucleoplasty's success that would help. I have an L5-S1 contained herniation that causes mild sciata down my right leg. I have done some research and talked to an ortho about it. He seems to say its kind of new and they dont know how well it works quite yet, but he didnt seeme opposed to me finding a dr in town who does this procedure. The ortho said that it wouldnt inhibit his ability to do a microdiscectomy if i so chose to go that route eventually. Any input would be greatly appreciated.
I actually know the exact product you re refering to. And yes, its relatively new.
All I can tell you is what I know I really don t have an answer because of its novelty. It will take some years before ID studies can be completed...
This procedure & product is based on the philosophy of minimal invasive-anatomic preservation. Which it does promote. However, degenerative disc disease will likely continue its course, and potentially require another adjacent level surgery later...
I can tell this, an ideal candidate for this procedure is someone who is younger rather than older, someone with only one level of unhealthy disc & preferably 5-1...like you.
Also, someone who is going to diligently follow up with they re post surgical care. Which is essential!
Good luck!
p.s. im going to tell you a little secret.... newer procedures like these or annular repair and dynamic stabilization... are approved by the FDA but take years to get coded. So your surgeon & hospital will have issues getting reimbursed for it... between that and the lack of data, most surgeons will not be willing to do a procedure.
which by no means either validates or opposes the theory of this particular surgical medicine...just mentioning
I have worked with both Ortho and Neuro guys in my career. I am a highly trained health professional who decided to go into research & development instead of medicinal practice.
Furthermore I have been in hundreds of spine surgeries with both Ortho and Nuero surgeons.
I ll make this short and sweet...
Nuero docs are more maticulous and skilled generally when dealing with spinal procedures. And when your in situ(in the wound) and working around the dura with instrumentation...thats a good thing.
Whereas Orthopedic guys (or ladies) tend to run into in situ itrogenic (surgeon caused) complications that require longer procedure time and potentially less efficacious post surgical results.
Go Nuero - going ortho is like taking a import car to a garage that specializes in domestic... even though they know what they re doing, take it to the import guy, its they re specialty
To put an international perspective on this, as we have many international members, what you say may be more applicable to the US scene (I am assuming that you are in the US). Whereas in many other countries where our members come from (e.g. Australia, New Zealand, UK, Singapore (me)) a far greater proportion of spinal surgeries, especially lower spine surgeries, are carried out by orthopaedic surgeons. It may not hold true in these countries that orthopaedic surgeons are potentially any less competent than neuro surgeons when it comes to spine surgery.
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Important: My comments here and comments from other members reflect personal opinions only. You should not act on any advice or opinion posted in these forums without seeking proper medical advice from a qualified doctor. Please, ALWAYS check with your personal physician before taking any action regarding your health!
Well, I am in the US, in California to be precise, and I believe that when it comes to the lumbar area below the point where the spinal cord ends, a skilled OS can be every bit as good as some NS, of course, he or she has to have special training in spinal surgery. My OS had his spinal fellowship at Harvard, and has a very good reputation (in addition to being just a real nice guy). I had a textbook perfect three-level spinal fusion and both at the hospital and at the rehab the OT and nurses kept telling me that they can spot his patients because they are doing so much better than others, with significantly less complication. I know that not all OSs are created equal, as neither are all the NSs, but before somebody makes this judgment just based on the speciality, this person should do extensive research about the surgeon in question, in order not to dismiss perhaps the best choice.
Kin
SF Peninsula CA resident
Decompression and L3-S1 fusion with instrumentation, 5/1/08
I have decided to have a neurosurgeon perform my L4-L5 level PLIF next month. I had seen a couple of orthos last year...all saying that a fusion would be my only choice. Then, I started having nerve problems in my right leg, so I went to see a couple of neurosurgeons. Both of them said that a fusion was the only alternative. So, since I am currently having nerve problems along with disk issues, I chose to go with a neurosurgeon for my operation. I'll let you know if I should have chosen otherwise after the fact (like it'll make a difference then).
Well I am feeling pretty lucky, I get to have both, my surgery was originally scheduled for Dec. 10th but was canceled due to a big misunderstanding, I just had it rescheduled and my ortho surgeon got a better look at the area he would enter in and he noticed I have a short neck with a high collar bone which is going to be difficult with a C5 to 7 fusion, so he is calling on a neuro to assist in the surgery and I am glad now it was cancelled, cause having two surgeons on the job makes me feel a little safer.
Great information everyone. Thanks
I have had both lumbar and cervical fusions. I had the same surgeon do both, an Orthopedic Spine Surgeon. I actually did not find a neuro I felt I could trust my spine to. When I had L3-S1 fused 360, my surgeon had a Vascular surgeon open anteriorly for him. Good thing he did, I had a softball-sized lipoma lying on my anterior spinal column, wrapped around some arteries...
11/08 L2-3 fusion .
10/02 ACDF C5-6 (Awesomely successful!!), A&P Fusion L3-S1 2/01 with Harrington Rods and Pedicle Screws. Hardware removed 18mos later due to titanium allergy. PLIF L2-3 11/2008. I also have "several thoracic herniations" per MRI 6/2011, SI Joint dysfunction, DJD and scoliosis. I have had at least 15 injections from my neck down, latest was in my right SI joint, was helpful. Current meds: Fentanyl, Nucynyta, Soma, Tomamax,& Lyrica.
Hi,
I think this decision is really also about personal "matches" of doctor and patient.
I went to one of the top spinal orthopedic surgeons in the area - highly recommended though no one seems to give high marks for "bedside manner." After 3 visits, I can safely say I spent longer IN the MRI machine than with the doctor. I didn't feel I knew anything about what was going on and what options were. I felt I had to "sneak a peek" at my own MRIs when no one was in the room.
I went to a neurosurgeon and it was just great. First met with his PA, they pulled out the MRI, drew on them, explained everything. Asked questions beyond "how much pain are you in?" I felt really good, even though the only option was surgery. But I could see on the MRI why that made sense. They run really late on appts
but you know that you will get their attention when they get to you.
I would say that it is good practice to maybe get two opinions - one from an orthopedist and another from the neurosurgeon. I felt the orthopedist was more worried with actual pain...the neurosurgeon with other symptoms (weakness, numbness, leg issues).
But it all comes down to who you trust in the end. Even if the orthopedist came to the same decision (surgery) I wouldn't have felt comfortable under that knife...
I have used an Orthopedic Surgeon for all three of my surgeries however, he ALWAYS has a Neurosurgeon present during all of his surgeries. My first Neurologist I ever went to for my neck pain looked at my MRI and told me that there was absolutely nothing wrong with my neck.
Laurie
I went to both an orthopedic surgeon and a neurosurgeon for opinions. Both had the same conclusion and both would have been great choices for my microscopic discectomy. Both had stellar reputations. Went with the orthopedic surgeon (and an AP of Neurosurgery) because he was in my PPO's plan and I'm very happy with the outcome. He has a background in both plus bio-mechanics.
My surgeon's short list resume:
Professor of Orthopaedics and Neurosurgery and Biomechanical Engineering with expertise in the surgical treatment of all neck and back disordersand Executive Co-Director of UCLA Comprehensive Spine Center
Overall - Seek an opinion with both types of surgeons. Get lots of referrals and you will definitely feel that "connection" with the right one. Make sure they've done your surgery many times and again - get lots of referrals.
My friend who is a Physical Therapist gave me references and who better to get an opinion from besides friends and family. PT's see all these patients post op and can recognize good work from bad work.
Second opinions are important and if you're not happy go for the 3rd and 4th! It's your health!
Surgery: Microendoscopic Discectomy - Jan 26, 2009
Off all pain (toxic) meds - wahoo!
Remaing nerve Damage in the foot/ankle hoping it heals
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Pre-surgery MRI Report:
Large right paracentral disc protrusion L4/L5 (6mm)
Servere right foraminal narrowing
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2 Cor 4:16 - Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. So we fix our eyes not on what is seen, but on what is unseen. For what is seen is temporary, but what is unseen is eternal.
He CECE,
I'm in the process of possibly getting a TLIF performed on my L5-S1. Was wanting your suggestions on how to go about getting referrals.
Can we not name Dr.'s on this site?(New to the site)
I'm in LA. and have researched a few Dr.s. I'm leaning toward one at Cedars, because of his background, but also because of my Insurance coverage there.
How did you go about getting referrals?
-Roger
aka Lumbarmonkey
Lumbar Monkey
Being as how I had a degenerative disc and spinal cysts my primary doc thought it best to go that route.