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Pain management Doc recommending me for surgery, not sure which is better neuro or spine doctor

Hello all, so I am a 31 yo Female suffering from chronic neck pain stemming from an accident while service on active duty. It has been about 2.5 years since my accident and have been in constant care from a civilian pain management doctor for about the past year. In between I have tried just about every type of therapy, medication etc. About 8 months ago my pain managment doc recommended I see a spine surgeon he highly recommends. Upon first visit with that doctor I just didn't feel overly comfortable and honestly the thought of surgery is completely nerve racking. Since I was fresh out of the service, still in school and only a few months at my current job surgery was really not an option. However, I have now reached the year mark with my employer and qualify for FMLA, and am getting ready to graduate this May I have found myself back on the chopping block (no pun intended) for cervical surgery. When it comes to my spine my C3-C4 & C4-C5 have a slight 2mm disc protrustion, C5-C6 a large protrusion at 4mm, flatttening the left ventral cord and mild left forminal stenosis, finally my C6-C7 has a 2mm disc protusio with mild effacement of the ventral thecal sac. Broken down, C3-C4, C4-C5, C6-7 have spondylitic changes with disc protusions and moderate left central stenosis at C5-C6. Basically surgery is the only way I may ever have some relief. I have read various threads where people have procedures done by nuero and some by spine surgeons. I have two follow ups scheduled but looking to see which path may be best as I move along in this process....any feed back is truly appreciated.



  • Roxx, let me answer your question -- generally it's a coin toss. They both do the same thing, although if I were to have brain surgery, I'd want a neurosurgeon. The orthapaedic surgeon is equally qualified for the kind of surgery you're looking at. If it were my choice, I'd choose the person with most experience. The last time I checked, the odds of a successful spinal fusion surgery increased dramatically when the practitioner had performed over 600 similar surgical procedures.

    Now, please learn as much as you can about your condition and non-surgical interventional techniques that may help your chronic pain syndrome. Often enough, spine surgery leads to increased pain. In my opinion, surgery should be a last resort, only after one has exhausted all other alternatives.

    In this new century, an entire suite of non-surgical interventional pain management procedures have been standardized for spine-based pain syndromes. For many of us who have been told by both orthopaedic and neurosurgeons that surgery was their only answer to relieve pain, outpatient procedures like nerve blocks and radio-frequency nerve ablations have offered a new lease on life. Until you have consulted with an interventional pain doctor (these people are generally advanced-trained anesthesiologists), you have not explored all treatment options.

    There's lots of information available here and in other places on the internet, and for those of us who suffer chronic back pain, knowledge is necessary to negotiate the various pitfalls of pain treatment.

    Best wishes.
  • rmojicarrmojica Posts: 2
    edited 04/04/2014 - 3:18 AM
    Thank you for all the information. Since my surgery I have tried a mutlitude of things to help with the pain. Every type of injection and therapy out there. According to my pain management doctor he said he could do thing to help with the pain but he is more concerned with the amount of strength I'm losing on my left side (i.e, shoulder, arm and hand). I have made appointments with both doctors for later in the month so hoping to get more answers and hopefully get me on the road to recovery.
  • dilaurodilauro ConnecticutPosts: 9,839
    there are generally two doctors involved. I always opt for a Neurosurgeon, since they have more experience directly with the central nervous system related to spinal conditions and surgery. But since a bone graft would be required (assuming this will be a ACDF vs a posterior approach), an orthopedic type of surgeon will be required if you are taking the bone graft from your own body.

    When a nerve root is compromised, most surgeons would opt to have the surgery performed sooner vs later. THe longer a nerve is impinged by a disc, the long the potential recovery time for the nerve.

    I would ask your pain management doctor for their opinion and suggestion.

    There are no professional medical folks on this forum board. We can only talk about our own experiences and from research that we may have done.

    Best advice is to get that advice for a medical professional.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • my pain guy recommended a neurosurgeon because in his opinion, he felt that they were more detailed oriented and more thorough. i have had both surgeons and to tell the truth, there was not much difference in pain levels. i had more side effects with the orthopedic surgeon, blood clot, collapsed lung, staph infection but that was probably because i was in the hospital for 10 days and my fusion was 12 hours long. this was 13 years ago so i think things have changed since then. the neurosurgeon did my last fusion 2 1/2 years ago and went in though the side. i was out of hospital in 3-4 days and i had major pain on my left leg which was nerve oriented. he said he never had this happen to him before but he talked to a buddy of his and this guy had the same side effect that my neuro had. i guess my druthers would be with the neuro due to him being more in tune with the nervous system. orhtos deal more with bones and muscles. but there was not that much difference and i would go with who makes you feel better and more at ease with and who seems more confident to you. i have had 4 fusions, one neuro and 3 orthos. i am still here and still above ground so i am satisfied except for 13 years of chronic pain.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
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