The human spine requires highly specialized care when surgical intervention is necessary. When persistent pain or neurological symptoms demand an operation, people often wonder what kind of doctor performs back surgery. The answer is that two distinct surgical specialties are fully qualified and commonly treat spinal conditions.
The Two Primary Surgical Specialties for the Spine
The two main types of medical doctors who perform surgery on the spine are Orthopedic Surgeons and Neurosurgeons. Historically, orthopedic surgeons were primarily experts in the musculoskeletal system, concentrating on bones, joints, and ligaments throughout the body. Their expertise was traditionally applied to the structural aspects of the spine, such as correcting deformities or stabilizing fractures.
Neurosurgeons, by contrast, focus their practice on disorders of the entire nervous system, including the brain, spinal cord, and peripheral nerves. Their original work on the spine centered on procedures that directly involved the delicate neural tissue, such as removing tumors or decompressing the spinal cord. Today, the practice of spine surgery has evolved, and both specialties are highly trained to perform a wide variety of spinal procedures.
How Training and Focus Differentiate Spine Surgeons
The initial training pathways for orthopedic and neurosurgeons differ significantly in length and focus. An orthopedic surgery residency lasts five years and provides broad exposure to all areas of the musculoskeletal system, including trauma and joint reconstruction. A neurosurgical residency is longer, spanning six to seven years, with a focus on the brain and nervous system, emphasizing precise microsurgical techniques.
The primary factor that creates functional overlap in modern practice is the Spine Fellowship. Following residency, both orthopedic surgeons and neurosurgeons can pursue an additional one or two-year fellowship dedicated entirely to advanced spinal surgery techniques. This specialized training bridges the historical gap, equipping both types of surgeons with expertise in both bony reconstruction and intricate nerve decompression. Consequently, a fellowship-trained orthopedic surgeon or neurosurgeon specializing in the spine will have a similar skill set and a comparable scope of practice.
Common Surgical Procedures Performed by Back Surgeons
Spine surgeons perform procedures aimed at relieving nerve compression, stabilizing the spine, or restoring mobility. A microdiscectomy is a common procedure used to remove a small portion of a herniated disc that is pressing on a nerve root, often performed using minimally invasive techniques. Laminectomy, also known as decompression surgery, involves removing a section of the vertebral bone called the lamina to enlarge the spinal canal and relieve pressure on the spinal cord or nerves.
Spinal fusion is a procedure where two or more vertebrae are permanently joined together to eliminate motion between them, used to treat instability or severe degenerative disc disease. This stabilization is achieved by placing bone graft material and utilizing metal hardware like screws and rods. Another option is artificial disc replacement, where a damaged disc is removed and replaced with a prosthetic device to preserve motion at the affected level.