Paths to spine surgery: ortho vs neurosurgery?

[KinasePro]

Is there a tangible difference between practice patterns of spine surgeons trained via ortho vs nsurg routes?

At my institution, it seems that ortho does slightly more degenerative spine and deformity, while neuro does more oncology. But even this distinction might be a stretch.

Is there a bias in the spine community for one training route over the other? Seems like the big names come from both fields, but ortho trained surgeons might have more influence overall in the literature (rush, jeff, washU, etc...). Clearly, neurosurgery residency provides more experience than ortho, but I always got the impression that neurosurgeons generally don't love spine but will "settle" for a spine practice for a better lifestyle. What say you, neurosurgeons?

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[BurghStudent]

Not a neurosurgeon, but I asked a ortho spine guy this same question. He basically said this: if you love spine, great. What do you want to have to deal with on the side while you are a spine surgeon? The question comes down to if you like joints more, or brain more.

 

[KinasePro]

Not a neurosurgeon, but I asked a ortho spine guy this same question. He basically said this: if you love spine, great. What do you want to have to deal with on the side while you are a spine surgeon? The question comes down to if you like joints more, or brain more.

Yeah, I've heard this as well. Basically, go with whichever residency you find more bearable.

I've heard other odd things though. Like at some institutions, neurosurgery does the decompression and ortho puts in the fusion instrumentation (not this case at my shop). Also heard that ortho dominates certain spine markets, neurosurgery dominates others.

 

[Serous Demilune]

Also ortho usually doesn't go into the dura. Anything intradural is handled by nsg.

 

[KinasePro]

Also ortho usually doesn't go into the dura. Anything intradural is handled by nsg.

Well, ortho does fix durotomies, but thats about it. That puts certain tumors and cord trauma strictly in neurosurgery territory. Does neurosurgery do deformity?

 

[Serous Demilune]

Well, ortho does fix durotomies, but thats about it. That puts certain tumors and cord trauma strictly in neurosurgery territory. Does neurosurgery do deformity?

I'm sure a spine fellow with neurosurgery training would like to think he could.

 

[mmmcdowe]

Some neurosurgeons correct deformity yes, though most do not do major back whacks routinely in that sense. There's usually one guy in a given program who thrives on that sort of stuff.

 

[MohnishKodali]

When patients are considering having spine surgery, one of the most common questions they have is, "Which is better, a neurosurgeon or an orthopedic spine surgeon?"
Actually most types of spine surgery, both specially trained orthopedic surgeons and neurosurgeons may be considered.
Many years ago, neurosurgeons were primarily responsible for spine surgery, but in the past 20-25 years or so spine surgery has evolved so that both neurosurgeons and orthopedic surgeons specialize in spine surgery, and for most of the typical spine operations both types of surgeons are equally well qualified.
In both specialties, the surgeons may subspecialize, such as in the case of surgeons who specialize in pediatrics, cervical spine, lumbar spine, hand and wrist surgery, plastic surgery, or in other areas or procedures.