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Old 02-07-2005, 03:51 PM   #1
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Nuerosurgeon vs Orthopedic surgeon from Microdiskectomy?

I've suffered from back pain for years. Over the last year I've developed pain in my left leg, sciatica, that has been acute. The MRI shows a 6/7mm herniation of the L5/S1 to the left side, which explains why my left leg aches and my right is fine. I've seem chiro's, acupunturinsts, somatic healers, Phys therapy, etc....I've had 3 epidurals and 2 nerve root blocks, a percutaneous diskectomy, and diskogram that revealed a "shoddy" disk.
It now looks like I'm headed towards a microdiscectomy, which I welcome, but now question the quality of my doctor, which is an ortho-surgeon. i'm told that He is not a "spinal fellow". I'm looking at finding a good neurosurgeon, getting his opinion, and if the outcome is to have a microdiskectomy, having him do it rather than a orthopedic surgeon. All opinions are welcome.

 
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Old 02-07-2005, 04:50 PM   #2
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Re: Nuerosurgeon vs Orthopedic surgeon from Microdiskectomy?

I had my microdiscectomy done in September by a neurosurgeon. I was very happy wiht the quality and expertise of my surgeon, but as you will probably hear in future replies, it really does depend on the doctor. I don't think a neurosurgeon is necessarily better than an orthopedic surgeon.

 
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Old 02-07-2005, 08:44 PM   #3
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Re: Nuerosurgeon vs Orthopedic surgeon from Microdiskectomy?

My wife had a micro-d 11 years ago by a neuro and was very pleased with the results, the doctor, and the care.

Fast forward to current time and my back and the need for a fusion. I got opinions from everyone and everywhere, both medical professionals and people that have had the surgery. My pain mgt doc's opinion was that for lumbar issues, not much difference between an ortho or a neuro. Now, if we were talking head or neck surgery, neuro would be the way to go. I ended up in an artificial disc trial (lost the FDA lotto and got a fusion anyway) and an ortho did the surgery. I felt more comfortable with him than the neuro that did my wife. I guess it comes down to the matter of their experience and your comfort level with the person you're going to let frolic in your spine.

 
Old 02-07-2005, 09:21 PM   #4
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Re: Nuerosurgeon vs Orthopedic surgeon from Microdiskectomy?

dont' mind the profession, mind the doctor. I had a Ortho that did my micro in 2002, a neuro did my fusion Dec 2004. My neuro was nicer but the ortho was older with more experience. Both did a supurb job. Find a dr that you are comfortable with. Don't mind so much what profession of surgery. Though, the more in tune they are with backs and spines the better. That is my opinion.

 
Old 02-08-2005, 04:53 AM   #5
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Re: Nuerosurgeon vs Orthopedic surgeon from Microdiskectomy?

Either ortho or neuro should have a spine fellowship. I went to a neuro without and he had a very negative outlook and couldn't help me. Then I went to an ortho with and he was so current that he did an off-label procedure, posterolateral BMP on sponges, and I'm doing great!
fly

 
Old 02-08-2005, 06:42 AM   #6
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Re: Nuerosurgeon vs Orthopedic surgeon from Microdiskectomy?

Find a surgeon that specializes in spines. Fly had a good suggestion about the spine fellowship, whether it's an ortho or a neuro. I had an ortho do my discectomy last March, and it was very successful (till I got in a car accident 3 weeks post-op ). A different ortho did my fusion 5 weeks ago, and so far I'm very pleased with the results. The only reason I changed docs was because I moved out of state. I had opinions from neuros and orthos both times, and picked the docs I felt most confident and comfortable with. It was just coincidence that they were both orthos. My aunt had a microdiscectomy done by a neuro and she was very pleased with her results. Good luck!

 
Old 02-08-2005, 08:04 AM   #7
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Re: Nuerosurgeon vs Orthopedic surgeon from Microdiskectomy?

IMHO....

Get at NEUROSURGEON to perform the procedure. The analogy I've been given is: Think of your body as a house. Your bones and spine as the support, and your nerves as the electrical wiring. The NS is very concerned with the wiring and pays attention to the foundation and support, while an OSS may gloss over the electrical wiring.

Who wants a house without electricity?

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Old 02-08-2005, 08:56 AM   #8
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Re: Nuerosurgeon vs Orthopedic surgeon from Microdiskectomy?

[QUOTE=whackedback]IMHO....
The NS is very concerned with the wiring and pays attention to the foundation and support, while an OSS may gloss over the electrical wiring.
whackedback[/QUOTE]

A neuro without a spine fellowship.... I could hardly walk because of stenosis and the neuro told me I didn't have enough pain for surgery and he didn't know/couldn't do anything about my legs. As I walked out the door he said he was sure I could find someone to operate but I would be worse off. I went to an ortho with a fellowship and he fixed my legs with a laminectomy and he stabilized my back with a fusion. The neurosurgeon had no clue!
fly

 
Old 02-08-2005, 10:27 AM   #9
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Re: Nuerosurgeon vs Orthopedic surgeon from Microdiskectomy?

Key words fly... IMHO....

I also believe in second opinions, too.

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Old 02-08-2005, 10:44 AM   #10
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Re: Nuerosurgeon vs Orthopedic surgeon from Microdiskectomy?

[QUOTE=whackedback]IMHO....

Get at NEUROSURGEON to perform the procedure. The analogy I've been given is: Think of your body as a house. Your bones and spine as the support, and your nerves as the electrical wiring. The NS is very concerned with the wiring and pays attention to the foundation and support, while an OSS may gloss over the electrical wiring.

Who wants a house without electricity?

whackedback[/QUOTE]

It all comes down to the doctor and their experience. The spine fellowship is a good suggestion. The ortho that did my fusion has years of experience and has modified his surgical procedure as time progressed to the benefit of his patients. He knows where the nerves are. He knew how to cut back muscle to minimize discomfort, injury, and to maximize recovery.

Docs know their limits and aren't going to attempt something beyond their capabilities (at least those not actively seeking malpractice suits). All the neuros and orthos I consulted with all used Vascular surgeons for the anterior (front) approach ... no one wanted to chance nicking my main artery and have me bleed to death on the OR table since it wasn't their specialty. And, that's how my fusion occurred. An ortho surgeon and his full surgical team and a vascular surgeon and his full surgical team ... boy, that OR was crowded that a.m. before they knocked me out. The vas did the opening and "clearing the path to the spine" (i.e., they pulled my intestines out to have access to L3/L4 and then shoved everything back in when done) and then the ortho took over and did his spine thing and when he was done, the vas closed.

 
Old 02-08-2005, 11:11 AM   #11
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Re: Nuerosurgeon vs Orthopedic surgeon from Microdiskectomy?

I've also heard of good results when both a NS and a OSS are involved in the procedure. It's good to have a structurally sound house, but if it isn't wired for lights.... It's a shack.

whackedback

 
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