How to Choose a Spine Surgeon

Patients with neck and back pain usually seek medical care first from their family doctor or primary care physician. However, many patients require the services of a spine specialist. A spine specialist is a physician who has completed additional years of medical training in the diagnosis and treatment of spinal disorderssuch as scoliosis, osteoarthritis, osteoporosis, herniated discs, stenosis, spine injuries, fractured vertebrae, spinal deformity, tumors, infections, and congenital abnormalities. Most spine surgeons are either orthopaedic surgeons or neurosurgeons who are fellowship-trained in spine.
What to Look for in a Spine Surgeon
It is important for patients to be as involved as possible in their own medical care. This includes the choice of doctors. Some managed care programs leave little room for choice, but if you are able to choose your physician, here are some guidelines on what to look for in a spine specialist:
Make sure the spine surgeon is board certified (or board eligible) and fellowship trained in spine. This means that in addition to the usual surgical residency requirements, he or she has completed a fellowship program in spine that included at least one additional year of training specific to spine surgery.
Choose a spine surgeon who devotes at least 50% of his or her practice to the treatment of spinal conditions. A physician who sees mostly spine patients will be more up-to-date on newer technologies and techniques than a physician who only sees spine patients occasionally.
In addition to the physician's credentials, make sure the physician you choose is someone you feel comfortable with. After all, finding a physician you can trust is almost as important as his or her experience. Good communication is essential in a doctor/patient relationship, so ask yourself these questions:
• Does the doctor answer all of your questions and provide you with enough information about your condition?
• Does he or she spend enough time with you?
• Is the physician reachable? Open-minded? A good listener?
• Does he or she welcome a second opinion?

Talk to the physician about his or her experience with the latest techniques and technologies in spine surgery. How many procedures has he or she performed? Is the doctor willing to refer you to any former patients who may be available to share their experiences with you?
• Talk to the physician, or someone in the office, about your medical insurance to find out what is covered and what you may be responsible for.
• Choose a physician who is referred to you by a reliable source such as your primary care physician, or a friend, or relative.
The physician visit
The best specialists within a given niche will typically provide all the appropriate nonsurgical and surgical treatment options for your problem, along with the pros and cons of each approach. In some cases, treatment may include watchful waiting. If your doctor is unwilling to answer questions about your diagnosis or treatment, you’re in the wrong place. Go find another doctor.
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Things to Look Out For
There are also a few things you should be cautious of when selecting a spine surgeon. Avoid any doctor who does the following:
• Discourages, or does not allow second opinions.
• Does not answer all of your questions, or makes you feel bad about asking them.
• Tries to influence your decision to have surgery. Remember, it is totally up to you whether or not you have surgery. Your doctor's job is to provide you with enough information to comfortably make that decision.
• Bypasses conservative treatment options. Surgery should always be the treatment of last resort—when other non-surgical options have been exhausted.
• Is not forthcoming about treatments, techniques, costs, outcomes, and expectations for recovery.
If you have concerns about a particular physician, you can contact your state Medical Board to find out whether the practitioner has ever had disciplinary action taken against his or her license.
General Considerations
In addition to specific questions, there are three general considerations that can help guide your selection from different spine surgeons:
1. When considering surgery, every patient should keep in mind that spine surgery is almost always an elective procedure, and there are very few times that spine surgery is absolutely essential. You are the only one who knows how bad your pain is, and the decision to proceed with surgery is absolutely your decision.
The surgeon's role is to educate you and assist with the decision-making process - providing you with information about your full range of options, and describing what is technically possible, the difficulty and risk of the procedure and potential benefits. Therefore, it's important that you select a surgeon who is helpful in providing you the information you need to decide whether or not to proceed with surgery.
ation you need to decide whether or not to proceed with surgery.

2- Patients often ask what kind of surgeon should do their spine surgery: a neurosurgeon or orthopedic surgeon? While each specialty has a different focus in training, both are equally qualified to do the majority of spine surgery (there are some exceptions to this rule: for example, a neurosurgeon is generally better suited for tumor surgery and an orthopedic surgeon for deformity). Neurosurgeons and orthopedic surgeons frequently work together on a case and even in the operating room.

In addition to the usual surgical residency requirements, both neurosurgery and orthopedic surgery specialties offer fellowship programs in spine that include an additional year of training specific to spine surgery. At the very least, your surgeon should be board certified or board eligible in orthopedic or neurological surgery.

3- Another very important factor is the amount of the surgeon's practice devoted to spine surgery. A physician who focuses on spinal surgery is going to be far more adept and current in newer surgical techniques then one who performs spine surgery only occasionally. For example, the North American Spine Society requires that at least 50% of a physician's practice be devoted to spine treatment as inclusion criteria for the society, which is probably a pretty good benchmark.
You can generally gather the above information about the referred surgeon from reliable sources, such as your family doctor, family, or friends who have been treated for back pain, and local hospital physician-referral services or universities, and from the physician's practice web site.
Be a good patient
After all the searching, if you have found a good doctor, the rest is in your hands. To be a good patient, you must comply with the physician’s recommendations and prescriptions. Too many times, it’s natural to want a magic pill or miracle surgery to provide an easy route back to activity. However, you should always view surgery as the last card to be played, after all nonsurgical options are explored.
For nonsurgical treatment alternatives to work, the patient must often follow physician and therapist prescriptions, which may include a commitment to therapy. For spine and joint problems, this may mean incorporating special strengthening exercises that rebuild supporting muscles, so that surgery is not necessary. While athletes are familiar with the required commitment and pain associated with the exercise gym, others may not. It can be new territory for many people, but it is essential if you are to give nonsurgical options a chance to work.