Ortho vs. Neurosurgery

I have been suffering from severe pain in my lower back for a few years now.  I have recently had an MRI.  The impression on the MRI was as follows. !. L3-L4 disc level showa a 3 mm posterior disc protrusion present. Moderate Hypertrophic facet changes are present. 2. L4-L5 disc level shows a 3mm posterior disc protrusion present. Moderate Hypertrophic facet chages are present.L5-S1 disc level shows a 7 to 8 mm central disc protursion present.  Sisc dessication (desiccation) is present.  Hypertrophic facet changes are present.  Lateral recess stenosis is present, left greater than right.  The possibility of a focal left posterior disc herniation at the l5-S1 level measuring 4mm in thickness cannot be excluded.  There are findings that are suggestive of an annular tear at this level.

I have been to two Orthopeadic Surgeons who have told me that I am a candidate for a spinal fusion.  I then chose to get a second opinion from a Neurosurgeon, he also informed me that I would need a spinal fusion in order to resolve this problem.  I have been told that the only fix for my back injury is to have the spinal fusion surgery.

Speaking with the 2 Ortho surgeons they say that they are the Dr.'s who should fix this problem.  As a Senior Claims Examiner processing California Workers' Compensation claims, I feel that the best Dr. to do a spinal fusion is a neurosurgeon, due to the fact that they are more knowlegable about working around the spinal cord.

Both the Ortho Surgeon and the Neurosurgeon say they can do the surgery.  I suppose my biggest question to you is if you can advise me on which surgeon should I be more confident in to do this spinal fusion, an Orthopaedic Surgeon or the Neurosurgeon?  If you can tell me which surgeon I should go with and why I would sure appreciate some advice.  Thank you for your time.

[sonu78]

Hi,
Your dilemma is understandable. Both orthopaedic and neurosurgeons are good at doing spine surgery. Ideally speaking an orthopaedic surgeon with good spine surgical skills would be the right person to choose. Neurosurgeon would be highly sorted person if anything has to be done in relation to nerves.

[painkiller99]

Hi.

Spine surgery is where the skill and expertise of orthopedic surgeons and neurosurgeons overlap. Before, spinal operations dealing with the nerves and discs were handled by neurosurgeons.  On the other hand, orthopedic surgeons handled operations on the bony spine, such as during spinal fusion. However, training of surgeons of both specialists has come to include the whole range of spinal surgery. When choosing a surgeon to handle your spine surgery, take into consideration a surgeon's experience, training and judgement in that particular field, and not just what subspecialty he/she belongs.