Spine specialists are professionals in the healthcare industry who treat spine conditions. Common specialists in this field may include orthopaedic surgeons, rheumatologists, neurologists, and chiropractors, among many others. Choosing the most appropriate spine specialist, or team of specialists, depends largely on the severity of the problem, nature of the problem, and patient’s symptoms.
When problems of the spine go beyond what can be addressed in an office environment, clinic or out-patient settings, and surgery is recommended, a highly-qualified spine surgeon will be called in. Most often, surgery of the spine will be performed by either a neurosurgeon or an orthopedic surgeon. Both are considered "spinal surgeons.”
What is a Spinal Surgeon?
It is important to recognize that both orthopaedic surgeons and neurosurgeons perform complex spine surgery. The emerging field of “spinal surgery” incorporates both specialties, but in the future there may be a more well-defined specialty of spine specialists. However, that is not the case today.
As the spine is a central point of both the nervous system and the skeletal structure, it is a relevant area for both types of surgeons. Both orthopedic surgeons and neurosurgeons will treat a single type of condition, exclusively, such as, herniated discs or spinal fractures. Or, they may prefer to sub-specialize and treat, say, only younger patients.
In general, Neurosurgeons focus on diagnosis and treatment of the brain and nervous system. Neurosurgeons must complete a five to six year training program in a neurological surgery residency program. While, orthopedic surgeons diagnose and treat bone and joint disorders, orthopedic surgeons complete a five to six year training program in an orthopedic surgery residency.
Neurosurgeons gain board certification from the American Board of Neurological Surgery. Orthopedic surgeons gain certification from the American Board of Orthopedic Surgery. It is important when choosing a surgeon, to make sure that the doctor is certified by the appropriate board. This not only ensures that the doctor has met the highest standards, and passed both oral and written examinations, but it also will give a patient the confidence knowing the surgeon is well-qualified, and meets the highest standards in his or her field.
For years, spine surgery has been performed as an “open surgery” on the spine through a long incision. However, with advances in technology, neurosurgeons and orthopaedic surgeons can now treat many conditions with minimally invasive techniques. Because minimally invasive spine surgery (MISS) does not involve long incisions, poking and prodding of the muscles and tissue surrounding the spine is avoided, leading to a shorter operation and a faster recovery.
The Atlantic Neurosurgical Specialists states that many spine conditions can be treated using minimally invasive spine surgery. For example:
It is important to point out that not all spine conditions can be treated using minimally invasive surgery, and not all patients are good candidates for minimally invasive procedures. A doctor and patient need to discuss the benefits vs. the risks prior to making a decision.
Understanding the Educational Path to Become a Spinal Surgeon
Earn a Bachelor’s Degree
As with all doctors or surgeons, the first step to becoming a spinal surgeon is to earn a bachelor’s degree from an accredited college or university. Students must choose a degree that weighs heavy in the sciences, and includes biology, chemistry, anatomy, physiology and physics. Successfully completing these courses will help students gain entrance into medical school, and also prepare them for the Medical College Admissions Test (MCAT).
During this time, it is also recommended that an aspiring surgeon work in a health-care setting; a hospital or clinic, to gain valuable experience that will help make a student a stronger candidate for medical school.
Enroll in Medical School
Since both an orthopedic surgeon and a Neurosurgeon are considered spinal surgeons, it is best to determine early in medical school which sub-specialty to pursue. It should be noted, however, that if in the future a more well-defined specialty — spinal surgeons — is realized, a future spine surgeon may take a variety of classes to prepare for this specialty, which will include those most often recommended for either an Orthopedic surgeon or a Neurosurgeon.
Medical school is a four-year program that prepares a student to work as a medical doctor. A student will spend the first two years of the program in the classroom in and laboratories. Typically, a student will take advance studies in pharmacology, anatomy, microbiology, and physiology. A student’s final two years will consist of clinical rotations in his or her chosen medical specialty. Students also have the opportunity to complete a rotation in neuroscience and orthopedics, in addition to other specialties.
Complete the Licensing Exam
After successful completion of medical school, a doctor must pass the United States Medical Licensing Exam (USMLE). This exam is divided into three parts, which ensures a doctor understands the scientific principles needed to practice medicine. The exam also includes patient care skills, and ambulatory preparation. Prior to taking the test, it is wise to study the practice materials provided on the USMLE website.
Both an orthopedic surgeon and a neurosurgeon must be licensed to practice.
Complete Residency
An Orthopedic Surgery or Neurosurgeon residency program is a five-year commitment. Generally, this program prepares a doctor to work in the field, and offers the opportunity to complete rotations in many areas of surgery, as well as sub-specialties. As a doctor gains additional experience and responsibilities, he or she can begin focusing on orthopaedic surgery or neurosurgery.
It is important to understand the differences between an orthopedic surgeon and a neurosurgeon. Orthopedic surgeons complete five years of residency in the treatment and diagnosis of all musculoskeletal disorders, including those of the spine. Neurosurgeons, on the other hand, complete residency training in disorders of the brain and spine.
In simpler terms: Neurosurgeons can be medical doctors (MD) or Doctors of Osteopathic Medicine (DO). They complete a five- to six-year residency, most often focused on the surgical treatment of neurological conditions.
Orthopedic surgeons can be medical doctors (MD) or Doctors of Osteopathic Medicine (DO). They too, have completed a five-year surgical residency focused on the treatment of musculoskeletal conditions.
Spinal Surgeon Fellowships
Both Neurosurgeons and Orthopedic Surgeons have the opportunity to extend their training after residency by completing a spine fellowship program. A fellowship provides specialized training for orthopedic surgeons and Neurosurgeons who have completed their residency training and earned board certification in their specialty.
Understanding the Career Path
Critical Skills
A few important skills that both Orthopedic Surgeons and Neurosurgeons (Spinal Surgeons) must have include:
They must also be willing to keep abreast of new and advancing technologies in their field, as well as embrace continuing education opportunities as they arise.
Work Environments
Spinal Surgeons typically work in a well-lit and sterile environment in a variety of settings, including a hospital operating room, a trauma ward, in private or multi-specialty practice, an outpatient clinic, in academia and research. As with any surgery, a spinal surgeon will never perform surgery without a team of assistants or other surgeons present. In instances of injury or illness, spinal surgeons may be called in on short notice to perform emergency surgery.
Spinal Surgeons can also find satisfaction by volunteering in clinics and hospitals around the world, where they can perform surgeries — both evasive and minimally-evasive — on underserved patients.
Career Outlook
The Bureau of Labor Statistics predicts that job prospects for a Spinal Surgeon —- Orthopedic Surgeon or Neurosurgeon — will increase at a rate of 18 percent each year, until 2022. This increase may be due to an increase in minimally-evasive techniques that allow a patient to enter an outpatient clinic, undergo surgery, and recover quickly. It may also be due to the fact that injuries of the back and spine have increased nearly three-percent each year, since 2001.
Average Salary of a Spinal Surgeon
Although salary for a spine surgeon will vary depending upon location, work environment, and years' experience, the average salary is $249,000 annually. However, there is a wide range of salaries for spine surgeons, with a mean salary of 250,000, and a high average of over $300,000 annually. An average Orthopedic Spinal Surgeon salary is 317% higher than average salaries for all job postings nationwide.
Making a choice between a Neurosurgeon and an Orthopedic Surgeon may depend on the necessary surgery to be performed. A less complex surgery may be performed by an Orthopedic Surgeon, while a Neurosurgeon might perform a more complex spinal surgery. While both surgeons perform, and specialize in “Spinal Surgery,” there is one area where there still is a difference. Only neurosurgeons are trained to perform procedures inside the lining of the spinal canal, called the dura. Still, one doctor is not necessarily better than the other, as both are qualified to treat injuries and disease of the spine that may require spinal surgery.
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