Neurologist or Orthopedist for Herniated Discs Guidance You want to choose a neurosurgeon or orthopedic surgeon that can perform true minimally invasive spine surgery using tubular retractors and muscle sparing techniques. People who have severe sciatica with leg weakness and bowel or bladder changes may need immediate surgery. Dr Timothy Steel is a leading neurosurgeon and spine surgeon in Sydney with more than 21 years experience as a consultant neurosurgeon. As we will discuss later, training and outcomes are everything. A spinal disk is a structure that sits between the vertebrae of your spine and acts like a shock absorber. Most surgeons (Neurosurgeons and Orthopaedic Spinal Surgeons) will operate on sciatica secondary to bony or disc compression (microdiscectomy or decompression) Some neurosurgeons, whereas MOST Orthopaedic Spinal Surgeons, also do fusions when patients have a combination of sciatica WITH chronic lower back pain. Primary (Princeton) Office Location – 3836 Quakerbridge Road – Suite 203, Cervical Disc Replacement Surgery Revision, When a Pinched Nerve is a Pain in the Neck, How to Prepare for Your Consultation with a Spine Specialist. After medical school, neurosurgeons did neurosurgery residency. The symptoms of sciatica can be caused by irritation of the nerves from mechanical compression from bulging/herniated discs, or bone spurs in the low back. The ultimate goal of spinal surgery often involves the preservation or restoration of nervous function which is the main focus in neurosurgery training. Whereas orthopedic surgeons focus on problems of the musculoskeletal system (such as the lower back), neurosurgeons train to solve problems of the brain, spine and nervous system with surgical procedures 3. Pain that travels from your low back down to your leg is often a sign of sciatica, which is a common source of sudden, unexpected pain. Spinal Surgery, Non-Invasive Sciatica. A good portion of this time is spent with spinal disorders. At Ortho Illinois Spine Care our board-certified, fellowship trained orthopedic and neuro surgeons are experts in the diagnosis and treatment of spine disorders. An orthopedic surgeon is trained to deal primarily with the bones and joints - the residency training period after internship is 3 or 4 years - then a fellowship in spine may be an additional year. Sciatica may feel like a bad leg cramp, with pain that is sharp ("knife-like"), or electrical. Some common reasons for visiting a neurosurgeon include chronic back pain, stroke, and sciatica. Orthopedic Surgeon location in Pearland, Bellaire, & Lake Jackson, TX Sciatica may begin as an aggravating lower backache, but it can rapidly become the kind of debilitating and unrelenting pain that radiates down one of your legs, sometimes reaching as far as your toes. The orthopaedist is a surgeon and is formally trained for five years in a residency after four years in medical school. This causes inflammation, pain and often some numbnes… The most common cause of sciatica is a herniated or slipped spinal disc. In cases where sciatica fails to improve, specialized medical or surgical treatment may be recommended. A family doctor is a good place to start regardless of how serious the sciatica is, because if it is a complicated case, he or she will be able to refer a patient to a specialist. describes symptoms of buttock, leg or foot pain, numbness, tingling or weakness that results from an irritated or compressed sciatic nerve. There are almost 10 times more orthopedic surgeons than neurosurgeons currently practicing in the US which may explain why a significant number of spinal surgeries are performed by orthopedic surgeons. Sciatica, a radiating pain that travels down the leg, is a common condition that affects many people who struggle with chronic back pain. “It’s never easy to decide if surgery is the right course of treatment for your sciatica,” said Geisinger neurosurgeon Stanley Pugsley, MD, FACS. 2 comments. All this means that, while there are some areas of overlap between the orthopedic surgeon and the neurosurgeon, their specialized competencies diverge as much if not more than they converge. The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. Sciatica For more information, please visit our Integrated Spine Care site or our Neuromedicine Pain Management Program site. The orthopaedic spine surgeons come from a background of scoliosis and spine reconstruction, spinal fusion for instability. Sciatica that does not respond to non-surgical treatment, or cases of sciatica that stem from complicated problems, such as rare circumstances when the sciatic nerve threads through the pelvis the wrong way, are good cases to take to a neurosurgeon. Choosing Between a Neurosurgeon and an Orthopedic Surgeon for Spinal Surgery Spine surgery is often associated with orthopedics due to the familiar concept of the bony spinal column. A patient today can seek consultation with either a neurosurgeon or an orthopedic surgeon appropriately trained in residency and, possibly, in a post-graduate fellowship in spine surgery who has devoted his or her practice to spinal disorders. When selecting your surgeon, look carefully at their credentials for fellowship training. Diskectomy. Some sciatica back pain can be treated at home, but for more severe sciatica, you may need more advanced treatment. Do you have questions about picking a neurosurgeon spinal surgery? What Are the Treatments for Pinch Nerve in Lower Back? Specialists with these additional, voluntary credentials demonstrate excellence in their chosen sub-specialty. // Leaf Group Lifestyle, Doctors That Specialize in Fitness & Nutrition, Home Treatments for a Pinched Nerve Around the Sacrum. Much of his time as a neurosurgeon has been spent at the leading edge of spine surgery in Australia, helping people attain a better quality of life. Most often, sciatica is treated without surgery. Sciatica treatment includes a variety of methods, including medication, physical therapy, steroid injections, and surgery from an orthopedic surgeon. Our offices are located in Hamilton, NJ, serving the greater Princeton area. Spinal surgery is a delicate endeavor, largely due to the potential for the spinal cord to sustain irreversible damage. The medical term for sciatica is lumbar radiculopathy: pinching of a nerve as it exits the spine.. Radiosurgery. It results from the inflammation of the sciatic nerve in your lower back. Symptoms of sciatica are most common among 30 to 50-year-olds and are described as an enduring leg cramp that may extend upwards into the buttocks and lower back or to the foot. For example, if your pain is caused by a tight or pulled muscle, or osteoarthritis, your primary care physician or an orthopedic specialist, such as an orthopedic spine surgeon, may well be able to treat and resolve your pain. In other words, they take care of spine problems day to day, week to week, month to month, and year to year. "As your Neurosurgeon, I am committed to providing you a personalized approach using highly skilled training, experience and advanced technology. This condition is also called lumbar radiculopathy. Similarly, herniated discs may also compress the spinal cord and result in significant nerve damage. When should I see a neurosurgeon? AICA Orthopedics consists of multiple doctors that can provide all of the major treatment and solutions you’ll need for your sciatica symptoms. Neurosurgery of the spine covers the cervical, thoracic and lumbar spine. Job Title Educational Requirements Median Salary Job Outlook (2018-2028)* Neurosurgeon : Medical Degree : $409,361 (2020)** 7% for all Physicians and Surgeons: Orthopedic Surgeon … Patients today can seek consultation with either a neurosurgeon or orthopedic surgeon who is appropriately trained and who has devoted his or her practice to spinal disorders. And while both are very knowledgeable and qualified to perform spine surgery, there are some differences that can be helpful to understand when making a decision on who you choose for your back or neck pain treatment and care. But, this isn’t always the case. What You Should Know About Post-Operative Back Pain, Minimally-Invasive TLIF (Transforaminal Lumbar Interbody Fusion), Minimally-Invasive Lumbar Microdecompression, TLIF: Transforaminal Lumbar Interbody Fusion, Intraoperative Monitoring (IOM) of the Nerves. A damaged disc can pinch the roots of the sciatic nerve, which starts at the base of your spine, then branches down your left and right buttock and leg. You may also have weakness, "pins and needles" numbness, or a burning or tingling sensation down your leg. These incisions tend to be much smaller around 1 inch or less. It’s shaped like a donut, with a tough exterior and a soft “jelly-like” interior. I’m getting to the point where I may need to consider surgery to fix my herniated/bulging disc at L4/L5 and was wondering which type of surgeon is better to use? There are general orthopedic surgeons and are others who specialize in one area of the body such as: hand, foot and ankle, hip and knee, shoulder and elbow, or spine. If your sciatica results from cauda equina syndrome, spinal tumors, or infection, then immediate medical attention may be necessary. Our team periodically reviews articles in order to ensure content quality. All Rights Reserved. Sciatica is a condition in which pain radiates along the path of the sciatic nerve. Remember that many spinal conditions are blamed on a causative neurological component. The sources cited below consist of evidence from peer-reviewed journals, prominent medical organizations, academic associations, and government data. And most orthopedists perform much less surgery than a neurosurgeon. Certain postures may affect sciatica pain. Since most cases of sciatica result from compression in the lower back, a chiropractor is another option for non-surgical treatment. An orthopedic surgeon is more likely to have completed an additional five years of training in the field of spine surgery than a neurosurgeon. Selecting an appropriately experienced and skilled surgeon gives patients an improved chance … 100% Upvoted. © 2020 Princeton Neurological Surgery. The pain from sciatica is usually limited to one side of the body. We look forward to serving you! Find out when sciatica nerve pain means it's time to see a doctor. Diskectomy. Simple - because what DISC offers is not available anywhere else. Orthopedic surgeons are a popular choice for treatment of sciatica, mostly because they regularly treat lower back pain and problems of the spine 3. The two main surgical options for sciatica are diskectomy and laminectomy. Spinal fellowships may be pursued in addition to residency for purposes of obtaining intense specialized training dedicated to spinal surgery. The two main surgical options for sciatica are diskectomy and laminectomy. Neurosurgeons come from the tumor/decompression side. Treatment for sciatica may involve multiple specialists, but chiropractic is a great place to start for finding relief from sciatica … Orthopedic Spine Surgeon View Bio. Dallas Texas Orthopedic Surgeon Doctors physician directory - Read about sciatica pain treatment, symptoms, causes, therapy, and pain relief. The sciatica nerve is the largest single nerve in the human body. Sciatica surgery is still a very commonly exercised treatment option for patients with severe or chronic pain, although curative statistics are not at all promising. Therefore, access to a neurosurgeon is highly recommended for any patient undergoing complex or minimally invasive spinal surgery. I had an L5 discectomy and I went orthopedic. Meet the DISC Team . Most general cases of sciatica resolve themselves on their own; doctors will occasionally prescribe exercise and anti-inflammatory medications to help with the pain. Regardless of whether you refer to an orthopaedic spine surgeon or a neurosurgeon, it would be best if you always recommended a professional who is fellowship-trained and board-certified. When you consider surgery you can follow up with a neurosurgeon or an orthopedician experienced in back problems. These surgeries can be performed by either a neurosurgeon or an orthopedic surgeon. Sciatica may be the result of a pinched nerve, herniated disc, or spinal stenosis. Oklahoma City Oklahoma Orthopedic Surgeon Doctors physician directory - Read about sciatica pain treatment, symptoms, causes, therapy, and pain relief. These 1-2 year fellowships are largely elective for neurosurgeons since spinal surgery is part of their core residency training. You may have pain, especially when you move, sneeze, or cough. A neurosurgeon is trained to treat conditions of the brain and spine, while an orthopaedic spine surgeon specializes in treating the spine. Over the last ten years, the lines have been blurred, and in reality, there is minimal difference. He will have expertise in management of the pain and in handling the lower back issues that may be causing the sciatica. Many years ago, neurosurgeons were primarily responsible for spine surgery, but in the past 20 to 25 years spine surgery has evolved so that both neurosurgeons and orthopedic surgeons specialize in spine surgery, and for most of the typical spine operations both types of surgeons are equally well qualified. Treatment may involve rest, anti-inflammatories, steroid injections and physical therapy. In the past, orthopedic surgeons performed more surgeries on spinal deformities like scoliosis and neurosurgeons did more intradural surgery (surgery inside the spinal dura). Only a board-certified neurosurgeon is permitted to operate inside the dura mater of the spinal cord or on the brain. A sciatica surgeon is a doctor who is formally trained to perform invasive interventions for sciatic nerve pain relief. Since most cases of sciatica result from compression in the lower back, a chiropractor is another option for non-surgical treatment. The spinal column, comprised of multiple vertebrae, provides structural support and flexible mobility for the body. When a spinal condition is discovered or suspected, a primary care physician will usually refer the patient to either an orthopaedic spine surgeon or a neurosurgeon for further diagnosis and treatment. This is always an advantage, since herniated disc surgery should always be a last resort option. Surgery is one of the treatment options for sciatica, but it's not for everyone. Some indications for spine surgery include spinal cord compression resulting from trauma, arthritis of the spinal discs, or spondylosis. Copyright © 2020 Leaf Group Ltd., all rights reserved. Sciatica symptoms include pain along the sciatic nerve, from your lower back down to your leg. While sciatica typically only affects one side of the body, it is often reported as one of the most painful forms of back pain due, mainly due to the overall size of the nerve. In most cases, another provider will refer you to a neurosurgeon. See Abdominal Aortic Aneurysm Treatment . Another option for treatment of sciatica is to visit a chiropractor. Neurosurgeon or orthopedic surgeon for spine surgery? Sciatica -- American Academy of Orthopedic Surgeons. In addition, stabilizing the spinal column with instrumentation may be required which is commonly performed by both neurosurgeons and orthopedic surgeons. Additionally, I find neurosurgeons to be far more cautious in their recommendations to undergo surgical intervention than orthopedic surgeons. 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