Spine Surgery- Ortho vs Neuro

[RJGOP]

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I was wondering whether patients usually preferred Neuro over ortho for spinal procedures, or the reverse. Is it more of a dog eat dog convincing tactic surgeons use to persuade patients into choosing them, or do patients choose based off the type of spine injury they sustained, or spinal complication for that matter. For example, a spinal injury or complication dealing more with the nervous system. Would patients typically choose neuro for that. On the other hand, if the complication is more bone centered, would the patients naturally choose ortho. Thanks. Just wondering.

 

[deleted407021]

Orthopedics doesn't really enter the dura, as far is I've read on the neurosurgery sub forum. You should check there. Maybe not make a thread, but definitely search around.

 

[RJGOP]

Orthopedics doesn't really enter the dura, as far is I've read on the neurosurgery sub forum. You should check there. Maybe not make a thread, but definitely search around.[/QUOTE,



Thank you very much, but I have a question. How can orthos perform spinal surgeries without entering the dura?

 

[Pose]

There are two recent threads in this forum, one by a neurosurgery resident and one by a spine fellowship trained orthopedic surgeon. Might answer some questions for you.

Edit:

http://forums.studentdoctor.net/threads/orthopaedic-spine-surgeon-ask-me-anything.1059247/
http://forums.studentdoctor.net/threads/ask-a-neurosurgery-resident-anything.958231

 

[ChEMD]

The dura is located within the vertebral canal (within the vertebrae) as one of the layers surrounding the spinal cord. Thus, you can manipulate the bone without touching the dura.

 

[RJGOP]

There are two recent threads in this forum, one by a neurosurgery resident and one by a spine fellowship trained orthopedic surgeon. Might answer some questions for you.

Edit:

http://forums.studentdoctor.net/threads/orthopaedic-spine-surgeon-ask-me-anything.1059247/
http://forums.studentdoctor.net/threads/ask-a-neurosurgery-resident-anything.958231

Thank you very much for the help.

 

[RJGOP]

The dura is located within the vertebral canal (within the vertebrae) as one of the layers surrounding the spinal cord. Thus, you can manipulate the bone without touching the dura.

Thank you for the insight.

 

[Cyberdyne 101]

This is why I miss Uncle Harvey... Classic ortho vs neuro spine debates:
Neurosurgeon A (thinks he's talking to an ortho surgeon): "we do the same as you plus more. What happens when the patient has a tethered cord? Face it, you guys are useless."
Neurosurgeon B: "I'm not an orthopod you $&%#"

In all seriousness, there is a lot of overlap between the two. In many cases they work together. The spine fellowship at the Cleveland Clinic is available to both neurons and orthopods.
http://my.clevelandclinic.org/neurological_institute/spine/medical-professionals/fellowships.aspx

In the case of the patients, it depends on the experience of the specific surgeon.
The following is a direct quote from the spine health website:
"For most types of spine surgery, the real question to ask is not whether to select an orthopedic surgeon or neurosurgeon, but rather, "What specific surgeries does this surgeon specialize in?" For example, some surgeons have a deep expertise in certain kinds of cervical spine surgeries."
I was gonna paraphrase this, but copy and paste is easier-lol.
http://www.spine-health.com/treatme...hopedic-surgeon-vs-neurosurgeon-spine-surgery

 

[Cyberdyne 101]

Academic ortho spine surgeon example:
http://www.hss.edu/physicians_girardi-federico.asp#.U6eNPom9LCQ

Academic neurosurgeon that specializes in spine:
http://neurosurgery.ucsf.edu/index.php/about_us_faculty_mummaneni.html
As you can see, there is some overlap.

 

[RJGOP]

This is why I miss Uncle Harvey... Classic ortho vs neuro spine debates:
Neurosurgeon A (thinks he's talking to an ortho surgeon): "we do the same as you plus more. What happens when the patient has a tethered cord? Face it, you guys are useless."
Neurosurgeon B: "I'm not an orthopod you $&%#"

In all seriousness, there is a lot of overlap between the two. In many cases they work together. The spine fellowship at the Cleveland Clinic is available to both neurons and orthopods.
http://my.clevelandclinic.org/neurological_institute/spine/medical-professionals/fellowships.aspx

In the case of the patients, it depends on the experience of the specific surgeon.
The following is a direct quote from the spine health website:
"For most types of spine surgery, the real question to ask is not whether to select an orthopedic surgeon or neurosurgeon, but rather, "What specific surgeries does this surgeon specialize in?" For example, some surgeons have a deep expertise in certain kinds of cervical spine surgeries."
I was gonna paraphrase this, but copy and paste is easier-lol.
http://www.spine-health.com/treatme...hopedic-surgeon-vs-neurosurgeon-spine-surgery

Thank you, this information looks to be very helpful. Also, perhaps I dint phrase it well, but the question What specific surgeries does this surgeon specialize in, Is what I was suggesting the patients might do. Thanks again.

 

[Cyberdyne 101]

Thank you, this information looks to be very helpful. Also, perhaps I dint phrase it well, but the question What specific surgeries does this surgeon specialize in, Is what I was suggesting the patients might do. Thanks again.

Sorry if I didn't answer it well before. Were you asking more in terms of patient preference? Or if one or the other is "better" for spine surgery?

For the overlap procedures (such as fusions) I don't think there is an overall patient consensus on ortho vs neuro. In fact, some academic hospitals have spine centers in which neurons and orthopods are part of the same team:
http://www.ucsfhealth.org/clinics/spine_center/
http://www.vanderbilthealth.com/spinecenter/27604
And in such departments, orthopods and neurons do many of the same procedures with success. But as you mentioned, some cases are more specific. In an ideal world, a spine surgeon (whether ortho or neuro) will only recommend and perform the surgeries that she or he does on a more regular basis. And I guess it's best for the patient who has condition A to ask the surgeon how often she or he deals with this.

 

[touchpause13]

Hello!
I figured I'd throw my patient experience in here just for a different perspective. I recently had spine surgery and it was done by an ortho. I had a consult with an orthopod and a neuron. I chose the ortho because I felt more comfortable with him, his bedside manner was a million times better and the surgery was one he does on a much more regular basis than the neuro. The neurosurgeon also wanted to force me into doing a much more invasive surgery that I was not comfortable with. So from a patient perspective it's not all about bone vs. Dura, but more about which physician you trust more.

 

[Cyberdyne 101]

Hello!
I figured I'd throw my patient experience in here just for a different perspective. I recently had spine surgery and it was done by an ortho. I had a consult with an orthopod and a neuron. I chose the ortho because I felt more comfortable with him, his bedside manner was a million times better and the surgery was one he does on a much more regular basis than the neuro. The neurosurgeon also wanted to force me into doing a much more invasive surgery that I was not comfortable with. So from a patient perspective it's not all about bone vs. Dura, but more about which physician you trust more.

Thanks for sharing. I hope you had the best possible outcome.

 

[RJGOP]

Hello!
I figured I'd throw my patient experience in here just for a different perspective. I recently had spine surgery and it was done by an ortho. I had a consult with an orthopod and a neuron. I chose the ortho because I felt more comfortable with him, his bedside manner was a million times better and the surgery was one he does on a much more regular basis than the neuro. The neurosurgeon also wanted to force me into doing a much more invasive surgery that I was not comfortable with. So from a patient perspective it's not all about bone vs. Dura, but more about which physician you trust more.

Thank you for the insight. I'm glad you were able to make a decision which allowed to be comfortable with the procedure and the doctor. I guess, in your case, it comes down to the personality of the doctor and the procedure he/she wishes to perform. Thanks for the insight and I hope you are recovering well, or have already successfully recovered.

 

[RJGOP]

Sorry if I didn't answer it well before. Were you asking more in terms of patient preference? Or if one or the other is "better" for spine surgery?

For the overlap procedures (such as fusions) I don't think there is an overall patient consensus on ortho vs neuro. In fact, some academic hospitals have spine centers in which neurons and orthopods are part of the same team:
http://www.ucsfhealth.org/clinics/spine_center/
http://www.vanderbilthealth.com/spinecenter/27604
And in such departments, orthopods and neurons do many of the same procedures with success. But as you mentioned, some cases are more specific. In an ideal world, a spine surgeon (whether ortho or neuro) will only recommend and perform the surgeries that she or he does on a more regular basis. And I guess it's best for the patient who has condition A to ask the surgeon how often she or he deals with this.

Thanks again. You did answer my question very well by the way, I was just clarifying what I said. I very much appreciate the additional information as well. Thanks so much.