”If I am consulting on a spinal problem or I need to undergo spinal surgery, should I see a neurosurgeon or an orthopedic surgeon?” A few simple facts will help interested patients gain a better understanding. It is important for patients to realize that both neurosurgeons and orthopedic surgeons perform spine surgery. There is now an emerging field of “spine surgery” that combines the two specialties. In the future, there may be a clear medical specialty of “spine specialist” with its own board certification. However, this is not the case at present. Today, neurosurgeons are board certified by the American Board of Neurological Surgery, while orthopedic surgeons are certified by the American Board of Orthopaedic Surgery, which is currently the “parent” of the board – the American Board of Medical Specialties – does not The American Board of Medical Specialties, the board’s “parent,” has not yet begun to certify “spine specialists. It is more important for patients to know if their primary care physician has passed a high standard of practice examination and has received professional recognition. Neurosurgeon training: Neurosurgeons in the United States generally complete a six- to seven-year residency in the diagnosis and treatment of spinal disorders (both surgical and non-surgical). Some physicians successfully complete their neurosurgical training, and they usually have a better understanding of the procedures used in the diagnosis and treatment of spinal disorders. If they wish to obtain more advanced training, they may choose to pursue a further fellowship in spine surgery. This intensive, focused training usually occurs after one or two years of residency training. Most patients mistakenly believe that a neurosurgeon is a “brain surgeon” when, in fact, most neurosurgical procedures are spine surgeries. Of course, in some hospitals, especially university hospitals, there are physicians who specialize in brain surgery and rarely perform spine surgery. But in these well-defined departments, there will also be physicians who specialize in spine surgery working together. Orthopedic surgeon training: All orthopedic surgeons are exposed to spine surgery as part of their 4-5 year training program. Some orthopaedic residents study at institutions with one or more orthopaedic surgeons who specialize in spine surgery. At these institutions, the residents will have no less spine surgery training than neurosurgeons. Some orthopaedic residency training focuses on trauma or bone and joint surgery and sports medicine. Some orthopaedic surgeons who wish to specialize in spine surgery and who want to obtain further training can continue their spine surgery fellowship after residency, similar to the situation in neurosurgery. Both neurosurgeons and orthopedic surgeons can practice spine surgery: There are now many physicians who specialize in spine surgery in both orthopedics and neurosurgery, unlike many years ago. More and more often we refer to each other as “spine surgeons,” and it is becoming less and less obvious that there is a difference between the two disciplines. Both neurosurgeons and orthopedic surgeons who specialize in spine surgery can treat bulging discs, degenerative discs, spinal stenosis, spinal fractures, spondylolisthesis, scoliosis, spinal bone tumors, and many other conditions. For young patients under the age of 15, there is also a group of specialists who specialize in the pediatric spine. The difference between a neurosurgeon and an orthopedic surgeon: There are still differences between the two in some areas. Only neurosurgeons are exposed to diseases within the dura mater during their 6 to 7 years of residency training. Therefore, the management of spinal cord tumors, arachnoid cysts, spinal cord cavernosa, Chiari malformations, spinal cord arteriovenous malformations, spinal cord longitudinal bifida, spina bifida or spinal cord spondylolisthesis, fatty spinal cord spondylolisthesis, craniocervical junctional area and upper cervical medullary tumors, nerve root tumors, and some other disorders are still classified as neurosurgeons. Similarly, pediatric and adult scoliosis, as well as other spinal deformities, are still treated by orthopedic spine surgeons. Shared professional interests: The exciting news is that orthopaedic and neurosurgeons are already working together productively in the field of spine surgery. We no longer see each other as competitors, but rather as collaborators with common pursuits. Many international disciplinary organizations, including the North American Spine Society, the Scoliosis Society, and the Cervical Spine Society, have now opened their doors to physicians from both specialties. The friendship and professional collaboration between the two will greatly benefit patients. Patients have a choice: Currently, patients are not limited to a neurosurgeon who “does mostly brain surgery and rarely spine surgery” or an orthopedic surgeon who “does mostly joint surgery and rarely spine surgery” to treat your spinal disorders. Today, patients can seek consultation with a physician who has had residency training in spine surgery or who may specialize in spine disorders. This is regardless of whether they were originally in neurosurgery or orthopedic surgery. In other words, these physicians are treating spinal conditions day and night, month after month, year after year. The common goal of advancing spine medicine breaks down the boundaries that separate these two specialties. Don’t be afraid to ask your physician about his or her training, focus, training for the procedure being recommended, and whether he or she is informed of all treatment options to choose from (whether or not your surgeon is able to practice them). Don’t be afraid to speak your mind, because it’s your body, your spine. The surgeon should make every effort to keep the patient fully informed so that both parties can make a satisfactory decision and begin to implement treatment.