Orthopedic Surgeon vs. Neurosurgeon for Spine Surgery – Which is Better?

When patients are considering spine surgery and they are exploring spine surgeons, they often want to know whether they should choose an orthopedic surgeon or a neurosurgeon. If you are wondering which one is better, the answer is not that simple because both specialties can be considered for most types of spinal surgeries. So which one do you choose?
The answer depends on what condition you have and which doctor is more qualified to treat it.

Both orthopedic surgeons and neurosurgeons may be Medical Doctors (MD) or Doctors of Osteopathic Medicine (DO) who have completed a 5-6 year surgical residency. The difference between their residencies are as follows:

Orthopedic Surgeons
Orthopedic surgeons focus on musculoskeletal (i.e. bones, joints, and muscles) conditions and they specialize in the diagnosis and treatment of almost all bone and joint disorders, such as:
• Spinal disorders
• Arthritis
• Sports injuries
• Trauma
• Bone Tumors
• Hand injuries and deformities
• Total Joint Replacement

Neurosurgeons focus on neurological conditions and they specialize in the diagnosis and treatment of disorders involving:
• Brain
• Spine and spinal cord
• Nerves
• Intracranial and intraspinal vasculature

After completing their residencies, both doctors may choose to extend their training by participating in fellowship programs where they get additional training in specialized surgeries. Orthopedic surgeons may choose to focus exclusively on one type of surgery such as spine, hips, knees, shoulders, feet, ankles, hands, wrists, elbows, or they can split their practice among two or more of these areas for a broader field. Neurosurgeons may choose to focus exclusively on brain surgery, spine surgery, or both. In addition to the specialties they choose, orthopedic surgeons and neurosurgeons may also narrow their specialty even further by choosing to treat a certain category of patients such as children (pediatrics) or trauma.

So How Do You Choose the Right Spine Surgeon?

The real question you should be asking is not “which doctor is better” but rather “which doctor is better FOR ME?” Here are some factors you should consider:

Spine Fellowships
Choose a surgeon that participated in fellowship programs specialized in spine surgery because it shows that the surgeon was willing to make the extra investment in training to become more skilled and spent more time focusing primarily on spine surgery. You should also choose a surgeon that completed their fellowships at hospitals considered to have great orthopedic/neurosurgery spine programs.

Although both orthopedic surgeons and neurosurgeons are able to complete fellowship training in spine surgery, there are a few types of spine surgeries which one specialist may be more qualified in than the other. For example, orthopedic surgeons tend to be better qualified to perform spinal deformity surgery to treat conditions such as scoliosis, whereas neurosurgeons tend to be better qualified to perform intradural surgery to treat conditions such as thecal sac tumors.

Choose a surgeon that specializes in specific surgeries you need or conditions you have. Instead of choosing a neurosurgeon that specializes in brain and spinal conditions or an orthopedic that specializes in spine and other extremities, choose a surgeon that specializes primarily in spine surgery. Some surgeons may have a deep expertise in either cervical, lumbar, or thoracic surgeries or they may devote some of their practice to certain disorders. All types of spine surgeries have a steep learning curve so it is more likely that you will have better results with a surgeon that has more experience in the surgery.


Don’t be afraid to ask your surgeon these important questions:
• How much of your practice is focused on this specific type of surgery?
• How many of these specific surgeries do you do each year?
• What is your personal success rate with this type of surgery?

Surgical Advancements
In addition to choosing a surgeon that specializes in a certain type of spine surgery, you also want to choose a surgeon that will perform minimally invasive procedures so you may have a quicker recovery with maximum relief. Be careful of surgeons that say they are “minimally invasive” spine surgeons because there are a lot of them out there that will use that as marketing deception. Traditional open back surgeries require an incision over 6 inches and some surgeons will claim to perform “minimally invasive” procedures just because they may make a slightly smaller incision like 4 inches, but that is not true minimally invasive surgery. You want to choose a spine surgeon that can perform TRUE minimally invasive spine surgery, endoscopic spine surgery, and laser spine surgery.

To make sure you are choosing a surgeon that performs true minimally invasive surgery, read this article with a video that will give you an idea of what the procedures should consist of and how they are more beneficial in comparison to open back surgeries: 8 Benefits of Minimally Invasive Spine Surgery.

You must then find out which surgeon will accept your coverage. Whether you are covered by health insurance or you are under a personal injury case, you must make sure that the surgeon will see you under your coverage. Some surgeons may choose to be in-network or out-of-network with certain insurance companies, and some may or may not accept Medicaid, Medicare, personal injury or workers’ comp cases.

Dr. Marc A. Cohen is a leader in minimally invasive and endoscopic laser spine surgery and one of the only spine surgeons in the nation performing endoscopic laser surgery for all spine-related cervical and lumbar procedures. He completed his residency at Montefiore Medical Center/Albert Einstein College of Medicine, and a spine fellowship at the Hospital for Special Surgery, Cornell Medical Center and Memorial Sloan-Kettering Cancer Center.

To complement his comprehensive training in the surgical treatment of spinal disorders, Dr. Cohen studied abroad with the pioneers of minimally invasive spinal procedures and laser spine surgery. He continues to augment his knowledge base and seek newer, more advanced methods to provide his patients with safer, reliable and affordable options.

For more information about Dr. Cohen’s training and expertise, click here.

Please contact the Spine Institute at 973-538-4444 to schedule a consultation with Dr. Marc Cohen at one of our New Jersey locations.