The most common question
The most common question I am asked when I see a patient who is a surgical candidate is, “You’re an orthopedic surgeon, right?”. “Yes”. “Well….should I have you do my surgery or a neurosurgeon?”. I often try to help my patient by restating the question for them. They are nervous and are trying to ask this question without upsetting their doctor. The question might be, Should I have a neurosurgeon or an orthopedic surgeon do my surgery? My answer “Neither!”. You don’t want an orthopedic surgeon that does sports medicine, joint replacement and/or hand surgery. You also don’t want a neurosurgeon that does brain tumors, peripheral nerve releases and carotid surgery. You want an orthopedic surgeon or neurosurgeon who has completed their residency in their respective primary field of training and then gone on to complete a minimum twelve month fellowship in spine surgery and limits their practice to surgery of the spine.
This is important for a number or reasons. The single highest risk factor for surgical complications is the training level of the operating surgeon. Those surgeons performing spine surgery without having a fellowship in spine surgery will have the highest complication rates. Of course any surgeon can have a complication of surgery such as infection, neurologic deficit, failure of fusion etc…. The issue is one of risk for the patient and our opinion is that the risk is the lowest when the surgery is performed by a fellowship trained surgeon.
So if you are contemplating having a spine surgery to correct a problem not amenable to nonsurgical care, make sure your surgeon has a fellowship in spine surgery and limits their practice to surgery of the spine.