neurosurgeons vs. orthopaedic surgeons

Hi all,

I asked this in another thread but I think it god buried--anyway, I can't find it.

Can anyone enlighten me on the difference between an OS and an NS, aside from the 'bone vs nerve' line? More importantly, what is the overlap as far as spine surgery is concerned? They both do spine surgeries to my knowledge.

I would assume that I'd get different answers from people in different countries. Very interested in the replies.

Trace

--------------------
2003 fusion C6-C7
discopathy/foraminal stenosis C5-C6
failed percutaneous nucleotomy, Paris, 10/2005
strongly considering cervical ADR

Hi Trace,

I don't have the answer for you but, i'm very interested, as I'm seeing a consultant tommorow who is an OS. I'm trying to gather as much info as I can. So that I can make an informed decision for any future op.

Amanda.

Here in Norway only neurosurgeons do the neck.
Both O.S. and N.S. do the lumbar area.

[annapurna]

In the US, effectively an orthopedic surgeon would be concerned with functional preservation of the skeletal structure and the neurosurgeon would be concerned with just neurological issues. Ideally you want one that has sufficient training and experience to look at a problem from both angles but realistically your problem will dictate which is better for you, assuming you have a choice in your area.

Laura went to a OS with her L5-S1 problems and got a "your disc is bad and fusion will screw up the rest of your spine" answer. She went to a neurosurgeon and got a "your disc is causing problems with your adjacent nerves, we need to fuse and get rid of the disc; don't worry about adjacent levels, they don't hurt now" answer. If her problem had been different, I suspect the local OS would have been wrong and the NS would have been the one to listen to.

Great, sounds like the patients needs to know just as much as the doctors here (I know, 'we all should', lol). Not an easy one here...would like to hear from people who have had surgery and what kind of surgeon performed it???

[Thomas]

Bottom line get multiple opinions from both an OS and NS to help you , Rather than just a OS see an orthopdpedic spine specialist(OSS) preferably at on of the "Spine Centers" around the country . After multiple visits to and surgeries from all three of these professionals I feel I get the best guidance/treatment from an OSS.

[Fortitudine]

Here in Calgary, NS for the c-spine...OS spine specialist for lumbar

Some interesting perspectives here--in Norway and Canada, only NS do the cervical spine? Here in France my NS is really pushing to do my ADR. I've already told everyone he's wonderfully skilled and gave me a perfect fusion.

But Jim's comments strike me as well-my NS also said he'd recommend ADR because I used to be highly active and no one can argue on the preservation of mobility concept, but he has yet to be convinced that it's better than fusion for adjacent discs over time.

This is where I'm stuck: I have a positive evaluation from ProSpine. Dr B wants to use a ProDisc, and the operation is completely out of my pocket.

My NS also says ADR is the solution, and wants to use the Mobi-C. This operation would cost me ZERO, and he's a very talented surgeon. While he hasn't done nearly as many ADR as Bertagnoli (17 to date), all his patients are doing well so far.

Both Prospine and my NS recommend doing the surgery sooner rather than later.

I'm torn.

BTW, I posted a link to a really short video on ADR surgical technique. It's on the cervical spine, but I bet lumbar isn't all that different. Interesting computer animation for anyone with 120 secs to kill--

Trace

[Fortitudine]

It was an excellent video, Trace. Thanks!

So many people here will tell you it's the surgeon that matters the most. It sounds like yours is terrific.

IMHO, the device is of much less concern. If I had a choice, I'd stay home. Besides, if it doesn't work, god forbid, you can still have a fusion.

[prodisc2005]

The differences (in the US) for Ortho Spine (OS) vs. Neuro (N) can vary greatly. Generally in their respective residencies they rotate through various "sub-specialties" in their field. For OS they will rotate through Sports Med, Pediatric Ortho,Hand, Foot and Ankle, Tumor, Trauma, Total Joint, and Spine. For N they will do Tumor, Neuro-Vascular, Trauma, Cranial (many areas here), and Spine. Generally (there are always exceptions) the N do more C-Spine than L-Spine and vice-versa for the OS while in their residency training.

A vast majority of OS (> 90 %) continue on to a Spine Fellowship where they spend time (generally a year) working specifically on the Spine. Very few N (less than 5 %)go on to a Spine fellowship.

Bottom line - It will all boil down to how comfortable you feel with your respective choice OS vs. N and the homework you do researching them.

Good Luck!