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Neurosurgeons vs. Orthopedic surgeons

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Old 01-24-2005, 11:15 AM   #1
Mr. Biswas
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Neurosurgeons vs. Orthopedic surgeons

A friend of mine is a pediatric neurosurgeon. That fact didn't mean much to me until I heard that seeing a neurosurgeon is the way to go for disc issues.

Anyway, he was in town this past weekend and I was able to pick his brain (heh heh) for a long time on the subject of my back.

I learned some general info, too, and thought I'd share, although I bet most or even all of you have heard this stuff before. My apologies if this is old to you. My friend was speaking more freely, I imagine, than he would if I was a patient.

He says:
--Neurosurgeons are absolutely the way to go if surgery is inevitable, and even if it is not. Generally, they've done far more work on the spine than an orthopedic specialist.
--Discograms are a waste.
--Orthopedic surgeons make nice coin on fusion surgeries, so some of them push them hard (indeed, the first guy I ever went to used the "F" word in our first meeting).

He looked at my MRIs (really looked at them, studying each shot rather than simply reading the report) and says it doesn't look as bad as the pain I'm describing--he said there wasn't any pushing up against the nerves. The question he couldn't answer to my satisfaction: why am I experiencing all this pain??!!

Does anyone know why a bulging disc not hitting a nerve would give me such pain and stiffness? My friend suggested I get a flexion/extension x-rays done (x-rays taken when you're bending, etc.). Anyone have one of those?

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Old 01-24-2005, 11:40 AM   #2
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Re: Neurosurgeons vs. Orthopedic surgeons

My thought is; one type is no better than another. I don't want to get into it further, but there is no way to say one is better than another. There are too many factors and this is a question or topic that I feel will never come to a close.

Old 01-24-2005, 03:59 PM   #3
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Re: Neurosurgeons vs. Orthopedic surgeons


Last edited by Quietcook; 07-16-2005 at 02:23 PM.

Old 01-24-2005, 04:12 PM   #4
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Re: Neurosurgeons vs. Orthopedic surgeons

I Have to agree with Mel and Quiet cook it is the doctor NOT the title. This is a subject that will be on the table for as long as time. Best answer see all kinds of physicians and when you get an answer with a doctor that feels right to YOU then that is the doctor for you. Good luck

Old 01-24-2005, 04:33 PM   #5
Mr. Biswas
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Re: Neurosurgeons vs. Orthopedic surgeons

I guess I should have prefaced my comment(s). And obviously this subject has been batted around a bit.

Of course, I don't think that the worst neurosurgeon is better than the best orthopedic surgeon. I'd take an experienced spine guy over an inexperienced neurosurgeon.

However, by the time a neurosurgeon is board-trained and all that, he's had more work on the spine than an orthopedic surgeon. The orthopedic guy add "spine specialist" to his title by doing relatively little (operative word is "relatively").

So, if you're just looking through the yellow pages for someone to do your discectomy or whatever (it's basically all I did due to the fact that I'm new in the place where I live), your odds would be better with a neurosurgeon.

The other variable is that my friend is invested in the argument, so what he says should be taken with that grain of salt. But if all things are equal, I'll take experience.

Old 01-24-2005, 04:35 PM   #6
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Rhonni HB User
Re: Neurosurgeons vs. Orthopedic surgeons

All I know is a neuro screwed me up badly and an ortho had to come along behind him and fix it.. now because of the ortho, I haven't felt this great in years.

Nuff said.

Old 01-24-2005, 05:03 PM   #7
Mr. Biswas
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Re: Neurosurgeons vs. Orthopedic surgeons

Oh, and I take a list of questions to the doctor, too.

And how about a personal anecdote about a misdiagnosis? I was seeing a gastroenterologist for a while and we talked about a lot of stuff. On a lark, I asked him about a six-year-old pain in my big toe. He said he thought it was an ingrown toe and suggested who I go to. That's what it was, and it was "fixed" in one visit. Four separate GPs told me it was an infection and had given me antibiotics!

Old 01-24-2005, 05:34 PM   #8
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Re: Neurosurgeons vs. Orthopedic surgeons

Want to say something about both kinds of doctors, the ortho can be just as good if they have training in the spine. And I agree it all depends on the doctor, and how well they listened in medical school. StarAngel.

Old 01-24-2005, 06:02 PM   #9
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mlachowicz HB User
Re: Neurosurgeons vs. Orthopedic surgeons

I had the flexion/reflexion Xrays done - I think they take them to see how far gone your discs are.... They were not a blast to have done. At least for me they weren't, the bending forward and then bending backwards was a chore all in themselves.... on top of it they are tough for the radioliogist to take... figures right! As for the neurologist or opthopedic dr's... my suggestion is to deal with who you are comfortable with!Best of luck!

Old 01-24-2005, 06:34 PM   #10
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Re: Neurosurgeons vs. Orthopedic surgeons

Hi, I almost always quite on these subjucts but can't say more loudly that it really depends on the doctor. Mine was a ortho who is very conservative, I went to him with the highest grade of spondylolisthesis there is. Although he did speak of fusion at the 1st visit he also said that I had lived with the pain for 20 years and could I live with longer. He did so much reseach before attempting he presented my studies to a national meeting, talked with head of his department and even had that surgen help him with the surgery. Beside all this nero make a pretty penny with surgey too.
This is very tough subuct for all us and I think that it really needs to be a personal decision. I am really sorry if this came out sounding to mean. Please keep posting here and reading what others have posted, I have learned so much from everyone here. They are a wonderful group of people.

Old 01-25-2005, 05:11 AM   #11
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Re: Neurosurgeons vs. Orthopedic surgeons

In my case, I had a weird formation that grew inside of my spinal cord at the c 7,T 1 level that was found when I had an MRI to determine just what disc was herniated.The choice was pretty much made for me as a NS was only type of doc that could do my surgery.I had two NSs that would not even touch my herniated disc with this glob inside the cord as the herniated disc was right below this lesion at the C 6-7 level.but from having seen an ortho for things and a whole slew of NSs, if i had any problems in the C spine or upper thorasic area, i would definitely see an NS not an ortho.There are just sooo many "extra" structures and really fine nerves that are located in the upper spine that i really do believe that the NSs have much more experience and knowledge of dealing with.For anything below that area, I would probably see an ortho for it.Just my opinion.marcia
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

Old 01-25-2005, 06:44 AM   #12
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flyonthewall HB User
Re: Neurosurgeons vs. Orthopedic surgeons

IMO an ortho with a spine fellowship beats a neuro without a spine fellowship. If they both have fellowships one might have to flip a coin.

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