Today spine surgery can be performed by either a neurosurgeon or an orthopedic surgeon. There is an emerging field of "spine surgery" that incorporates both specialties. Although not currently the case, in the future, there may be a well-defined medical specialty of "spine specialists" defined by its own board certification. Neurosurgeons and orthopedic surgeons get their board certification from two different places. A neurosurgeon will seek certification from The American Board of Neurological Surgery and an orthopedic surgeon will seek their certification from The American Board of Orthopedic Surgery. Currently there is no certification process that recognizes The American Board of Medical Specialties. One of the most important things that a patient can do is make sure that their doctor is certified by the proper board to make sure that their doctor has met the highest standards set by his or her peers.
Neurosurgeon Training
All neurosurgeons trained in the United States (and many places abroad) gain experience in the diagnosis and nonsurgical and surgical treatment of spinal disorders during a six or seven year residency training program (after medical school). When physicians graduate from an accredited neurosurgery training program, they usually have assisted in many hundreds of spinal procedures. If they wish to gain even more advanced training, they may elect to do a post-graduate fellowship in spine surgery. This intensive, focused training is typically one or two years after residency training. Though most patients think of neurosurgeons as "brain surgeons", it may be interesting to know that the majority of operations performed by neurosurgeons across the country are spine surgeries. In large group practices and certainly in academic (university-based) neurosurgery departments, there are some neurosurgeons that specialize in brain surgery and do very little spine surgery. In these settings, they will have a colleague who specializes in spine surgery.
Orthopaedic Surgeon Training
All orthopedic surgeons are also exposed to spine surgery during their four or five year training program. Some orthopedic residencies are at institutions where there are one or more orthopedic surgeons who specialize in spine surgery. At these institutions, orthopedic residents in-training may be exposed to a volume of spine surgeries comparable to many neurosurgery programs. In some orthopedic training programs, the emphasis is on trauma or joint surgery or on sports medicine. As in neurosurgery, some orthopedic surgeons who wish to specialize in spine surgery and gain further training may pursue a post-graduate (after residency) fellowship in spine surgery.
Both Can Specialize in Spine Surgery
Many years ago your choices were limited but today there is a large number of orthopedic surgeons and neurosurgeons who specialize in spine surgery. More and more, we are referring to each other as "spine surgeons" as the distinction between us is becoming nonexistent. Both neurosurgeons and orthopedic surgeons specializing in spine surgery are skilled in taking care of disc herniations, disc degenerations, spinal stenosis, fractures of the spine, slippage of the spine (spondylolisthesis), scoliosis, bone tumors of the spine, etc. For younger patients, there is a subset of spine specialists that is devoted to the pediatric patient (usually defined by patients below age 15 or so).
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