Discover what makes a good spinal surgeon and how to choose the best one for your situation.
The human spine is a marvelous structure consisting of 33 bones stacked neatly atop one another. Tendons, ligaments and muscles connect to the spine, which provides a flexible yet strong scaffolding for the body. The spine allows you to stand upright, bend and twist – all while protecting your spinal cord, the communications highway that threads a vast network of nerves from your brain to all corners of the body.
Most of the time, the spine and its many components work together harmoniously. However, as with any complex system, it’s relatively easy for one piece to shift out of optimal alignment or incur an injury. When that happens, you may need the services of a spinal surgeon, a type of physician that subspecializes in neurosurgery and/or orthopedic surgery.
Here, we’ll unpack everything you need to know about finding the right surgeon for your situation.
Key Takeaways
- A spinal surgeon can treat several conditions, such as slipped or compressed discs, joint pain and inflammation, scoliosis, pinched nerves, spinal stenosis and spinal deformities.
- As you’re choosing a spinal surgeon, consider four key areas: surgical training, clinical abilities, patient reviews and provider referrals, and communication style and bedside manner.
- Patient and procedure volume matter: Look for a surgeon who takes their time with patients and doesn’t recommend invasive surgery right away.
Conditions a Spinal Surgeon Treats
Several conditions may require help from a spinal surgeon, including:
- Slipped, ruptured or compressed discs
- Joint pain and inflammation
- Degenerative conditions, such as arthritis and osteoporosis
- Spinal deformities, such as scoliosis (an abnormal sideways curvature of the spine)
- Sciatica (pain radiating from the lower back into one or both upper legs)
- Spinal tumors
- Pinched nerves
- Sprains and strains of ligaments or muscles
- Fractured or dislocated vertebrae
- Spinal stenosis
- Injuries and trauma
These conditions can arise for various reasons, from auto accidents to autoimmune diseases, and each needs to be treated individually.
Factors to Consider When Selecting a Spinal Surgeon
There are several factors you should consider when looking for a spinal surgeon, including:
1. Training background
Spinal surgeons aren’t all the same. Some specialize in treating only certain parts of the spine – such as the cervical spine (the neck) or the lumbar spine (the lower back). Others focus on a specific type of patient, such as children or people with cancer.
“Spine specialists should meet all of the prerequisites, like being board certified and having the necessary credentials, but they should also have a high level of knowledge about spine surgery and the latest advances in the field,” says Dr. Hooman M. Melamed, a board-certified orthopedic spine surgeon in Beverly Hills, California.
In some situations, you may fare better with a spine surgeon with a neurosurgery background. This is especially true if you have a spinal cord tumor or another condition that affects the dura mater inside the spinal cord. For other conditions, particularly those that impact the bones of the spine, an orthopedic surgeon with a spinal surgery subspecialty may be the better option.
2. Ability
In the operating room, a spine surgeon must be confident and precise and move expeditiously.
“(They) need to have the clinical skill to diagnose and appropriately plan a surgical course. They also must understand when surgery is not the answer and a more conservative approach (such as physical therapy or medication) is appropriate,” says Dr. Jeremy S. Smith, chief of spine surgery and director of the spine surgery fellowship at the Hoag Orthopedic Institute in Irvine, California.
You should ask whether the surgeon tracks patient outcomes from procedures and if they’ll share that information with you.
Surgeons who collect this information are “honest about how their patients do and continuously strive to improve,” says Dr. Stephanus Viljoen, a board-certified neurosurgeon specializing in the treatment of adult spinal deformity and complex reconstructive spine surgery at the Ohio State University Wexner Medical Center in Columbus.
3. Reviews and referrals
During your research, you’ll likely come across reviews and testimonials about spine surgeons you may be considering. Melamed recommends looking for a doctor with stellar patient reviews, but read everything you can find – even the negative reviews – to help you gain insight into how a doctor practices and what to expect.
Word of mouth is also a good way to assess which doctor is right for you. Viljoen recommends asking your friends, relatives and primary care physician who they would make an appointment with if they had the same problem.
If the procedure you will have is especially complex, Melamed suggests asking for references and whether you can speak with another patient who’s had that same surgery.
4. Personality and communication skills
As with any doctor, your surgeon’s personality and communication skills matter. You should meet with at least two prospective surgeons to see if your personalities mesh and you can communicate well.
“Like all people, all physicians have different personalities. Patients should certainly seek a physician or surgeon who is compassionate, caring and candid,” says Dr. Ronald A. Lehman Jr., chief of degenerative, minimally invasive and robotic spine surgery at New York-Presbyterian’s Allen Hospital.
In addition, good surgeons listen to patients’ symptoms and don’t just look at films to decide treatment options.
“They take a personalized treatment process because spine surgery is not one-size-fits-all,” Viljoen adds.
Your surgeon should be able to give you the risks and benefits of the procedure so you understand why this treatment approach is the right course for you.
What to Watch Out For
There are red flags and warning signs to pay attention to when considering your options.
For instance, watch out for spinal surgery practices that are “spine surgery mills, where profit-motivated practices and hospitals book as many procedures as possible,” Melamed notes.
One way to guard against ending up with a disreputable practice is by asking the surgeon’s staff about patient and procedure volume.
“If the surgeon sees more than 20 patients maximum in a full day, then most likely patients are not getting quality time with the surgeon,” Melamed says.
A surgeon performing more than eight procedures a week is also a red flag.
“Any invasive procedure should be the last resort,” Melamed underscores. “Most spine surgeries can be done electively and are not emergent or urgent, so if your surgeon is recommending surgery right away, make sure to get a second opinion.”
Bottom Line
Although back and spine issues are common, most do not require surgery. Many doctors prefer taking a conservative approach, exhausting all nonoperative routes first before pursuing surgical options.
“Many studies have shown that a course of physical therapy, nonsteroidal anti-inflammatory medications and sometimes injections will alleviate low back pain,” Lehman says.
When you need surgery, your outcome will depend on the reason for surgery, the type of procedure, your surgeon’s skill and other factors, such as physical therapy and pain management, after the procedure.
“If surgery is recommended, a great spine surgeon will walk you through the diagnosis, explain and show the imaging studies, outline conservative and surgical treatment options and do so in a manner that is collaborative, nonconfrontational and understanding,” Smith says.
