Best was like 5:15-5:30 for 6am table rounds. Althoug… You can't be trying to find yourself still probably (still thinking about what medicine fellowship you're gonna do). The technical skills, for the most part, can be taught. Question/Advice. A neurosurgeon is trained to treat conditions of the brain and spine, while an orthopaedic spine surgeon specializes in treating the spine. Unruptured aneurysm cases (either endo or open) are sweet because it's like pulling a human off train tracks just in time. A lot by rotation. And there were certainly a few examples where I'd go 48-72 hrs without seeing her awake. And while patients may not get back to where they were, the vast, vast majority are incredibly happy to be alive and be where they are and are grateful for what you did for them. can you touch on this a little more - how often are you able to be physically present with your family, and did that change throughout residency and fellowship? Some fellowships overlap with other specialties; for instance there are a number of neuro/ortho spine fellowships or I know neurosurgeons who have done fellowships with ortho spine surgeons. Endovascular procedures, various new tumor treatment modalities (LITT, focused u/S, radiotherapy), intraoperative navigation, intraoperative imaging, exoscopes, endoscopes, etc. I'd say most of them average around 1.1-1.2 mil. New comments cannot be posted and votes cannot be cast, This is a subreddit for news, sites, information and events that may interest veterans. Except for my research year. But if you do the surgery, know that you won’t know for several months if it actually heals. But in terms of hours it was awesome. 2  Generally, neurosurgeons operate on conditions that affect the spinal cord, which is composed of nerves, while orthopedic surgeons operate on the spine, which surrounds the spinal cord and is composed of bone. Income is another way in which neurosurgery and orthopedic surgery differ. We averaged 5-6 new consults a day typical things were head and spine trauma, hypertensive hemorrhages, hemorrhages from aneurysms and malformations, brain tumors, herniated discs, congenital malformations. Becker’s Hospital Review found neurosurgeons earned an average of $767,627 in 2010. You meet your patient in pre op you start your OR you keep going to your OR is done. Has anyone here had a similar surgery with a neurosurgeon? I really don’t want to get surgery, I’m pretty depressed about it to be honest, but I’m holding out hope that the surgery will fix it and I won’t be in constant pain anymore. But 10 months later the pain came back. Reasons why to do X specialty: It's cutting edge. That and their surgical techniques are generally hammer and chisel as opposed to finessed. The pain went away. I miss sleep so badly. On away rotations worst I experienced was arriving at the hospital at 4:00 - 4:30 with the Jr's. Coming from an EM resident who has done many months of icu and trauma, how do you deal with the "vegetable gardening" aspect? There are honestly a lot more relatively good outcomes than people think overall. The most comprehensive study ever performed assessing whether surgeon specialty, i.e., orthopaedic surgeons, and neurosurgeons, contributes to a significant difference in spine fusion surgery outcomes has found “ there is no difference between orthopedic spine surgeons and neurosurgery … Personally, I found it amazing. My program did a dedicated lab year - it was stupid because I have no interest in bench or translational research and if they would've just cut a year off of residency I would've taken it. Another example is neuroendovascular/neuro IR where neurosurgeons and neuroradiologists and neurologists all mingle. Cookies help us deliver our Services. That's when you sleep at the hospital or your car if it's more comfy. In Conclusion. Inpatient vs Outpatient: In training we were lucky, we didn't have to cover a lot of faculty clinics. Thanks in advance for any advice/insight. In academic neurosurgery and orthopedic surgery departments, there are specialized surgeons who practice only spinal surgery and provide this important training to residents as part of their core curriculum. TRUE SPINE EXPERTS Offering State-of-the-Art Non-Surgical, Surgical & Rehabilitation Treatments. I am in the Army, active duty. Also, despite what I said above, there are some bad outcomes. They thought I said Ortho because I'm a pretty big guy (definitely big for an Indian guy) and a big Lakers fan. I spent the greatest amount of time at the county hospital which was a moderately busy trauma center and stroke center. He wanted to do a fusion and would do the surgery with a neurosurgeon. Not specific to back surgery, but my uncle recently had surgery done on his hip by an ortho, and ended up with drop foot, a neuro condition where you lose some foot control. Out in private practice I'm anticipating, if I successfully build a practice, 2 days clinic/2 days OR/angio a week. Cerebrovascular surgery or skull base tumors can be the most micro of microsurgery; the antithesis of spine surgery. We did pretty well about getting our post call guys out, even 5 or 6 years ago I probably got out of the hospital by 10am most post call days. The hands-on experience also varies among neurosurgical and orthopedic training programs. Some results: rheumatologists are happiest, dermatologists are healthiest, 1/3 of docs were … 5. Good luck with whatever decision you make. Hell, a good neuro might even recommend some minimally invasive procedure (ie a stimulator) as opposed to a full blown discectomy. We'd average about 1 door busting emergency surgery a week when on call. Looks like you're using new Reddit on an old browser. 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 … Sometimes the fellowships can be combined for instance skull base/cerebrovascular + endovascular. The site may not work properly if you don't, If you do not update your browser, we suggest you visit, Press J to jump to the feed. If I stop moving for too long, I fall asleep, then my cognitive function are screwy for a long time. A deep, angry, hot thrumming down my leg. All of day team including students/jrs would show up at 6 to table round and then round at 6:30 with attending. Neurosurgeon vs Orthopedic Surgeon: Which is Right For You? The most I ever got was 23/24 hours. To get an idea of the typical range of successful USMLE Step 1 scores, the National Resident Matching Program (NRMP) publishes some useful statistical data. I'd try to touch base with the faculty who had anyone sick in the ICU or for whom any patients I had concerns on. When removing a brain tumor, there often isn’t a super clear cut demarcation between tumor and healthy tissue. I feel for you. Neurosurgeons are more focused on the neural elements. Bottom line is that the fusion transfers stress to the discs above and below it, so now they’re showing wear and tear. I get up, move around, and lie down again, and hope I can sleep. I do this maybe 5, 6 times a night. You have to be very self driven and proactive and organized; its a small specialty with small teams with big censuses. Background: I'm fresh out of an neuroendovascular fellowship and finished my residency last June. During the first two years of employment, orthopedic spine surgeons bring in $400,000, according to Allied Physicians. Recovery was a pain in the ass, but I had no issues until this past September, when a muscle strain in my lower back turned into numbness in my left quad and I decided to get ahead of it this time. After table rounds we'd split up to round. The site may not work properly if you don't, If you do not update your browser, we suggest you visit, Press J to jump to the feed. The pain has gotten much worse. Also, we see a lot of badness it is true. Census was only 20ish though lol, At my institution, I've seen the residents finish OR cases at 1 am, have to round and tuck things in. I go over how I decided between neurosurgery, orthopedic surgery, and plastic surgery on my vlog channel. Neurosurgeons and Orthopedic Surgeons can Specialize in Spine Surgery. Also, documentation, especially for endovascular procedures; what am I a radiologist? Private practice spine neurosurgeons can make >$1,500,000/yr if they're real productive. This is my feeling. Every time it seemed like it was getting better I’d do a ruck march or pt test and it would be hurting again. I’m working with a pain management specialist and physical therapist to resolve it without surgery this time. Veteran Crisis Hotline Dial 1-800-273-8255 Press 1, Looks like you're using new Reddit on an old browser. The pain is horrible. Academic tumor/vascular/functional neurosurgeons ~$500,000-700,000/yr. you sound like youre in a similar situation where having a neuro surgeon would be pretty helpful, I call it the devil's bassline. In peds tethered cords and benign tumors can be excellent outcomes with decades of followup where you get to see them grow into healthy and happy adults. About half of them consults. Posted by Legacy Neurosurgery When a patient begins to experience back pain that will require a specialist’s attention, many consider making an appointment with an orthopedic surgeon to be the natural next step. This is actually a big reason I opted for plastic surgery instead. Early on you come in super early because it takes you 20 minutes to put in a Tylenol order incorrectly. You can be in the angiosuite playing video games with catheters. 2. You can do a lot of good for people with really serious conditions. Income: I anticipate I'm about to be with my income guarantee and pretty good per diem call contracts. Those who specialized in pediatric neurosurgery earned $643,188. Some of these injuries and diseases take a long time to recovery. Orthopedic spine vs. neurosurgeon for ACDF: 3 key findings Laura Dyrda - Monday, September 22nd, 2014 Print | Email A study published in Spine examines whether surgeon specialty makes a difference for single-level anterior cervical discectomy and fusion. why even bother tucking things in at 1am when youre going to be rounding again in 4 hours? If you're reading this and you're a resident who wants to share your specialty experience, check out this post to see some requests, and then start your own "Why you should go into X" thread in the sub. A crossover between the two specialties often occurs in the operating room. Spine Surgery Expert: Neurosurgeon vs Orthopedic Spine Surgeon If you are considering having spine surgery , choosing a surgeon can be a daunting task. This is pretty self-explanatory. Orthopedic surgeons see the spine much more biomechanically because that's what there field does. Well, my perception of the neurosurgeon lifestyle is, unfortunately, mixed. We'd meet back up between 5-6pm to do hand out to the on call junior/chief and debrief and make sure no new issues/concerns and dole out OR cases for the next day. It's stuff like this that makes me very adamant that there are fates far worse than death in this world. The expertise of neurosurgeons and orthopaedic surgeons overlaps significantly, and although ‘spinal surgery’ is not a recognized field of its own in terms of having a regulatory body it is emerging as a viable career option for those interested.Whilst some neurosurgeons perform only brain surgery and call on other specialists when the spine is … Call: As above at my county hospital it was q 4 - 5 in house as a junior and q 2 - 3 from home as a chief. I spoke to my primary care manager, and she has referred me to a neurosurgeon that’s at Fort Campbell so I can have the surgery there, since it’s much closer to Fort Knox than where I am now. Orthos are terrible for back injuries because most have the mindset to cut first, and ask questions later. They tell me they have to be back at 5 am for rounds. We'd average 5 or 6 new consults a day. otherwise we are beating around the bush. I’m happy to share more if you need. Our surgeons specialize in Knee, Hip, Shoulder, Foot & Ankle, Back Neck & Spine, Hand Wrist & Elbow, and Total Joint Replacement. I hurt my back while I was in and saw a civilian neurosurgeon who did a discetomy. Then you're tired but you nap, pick your daughter up from day care, play with her. Procedures: To me it sometimes seemed like neurosurgery is so specialized that it shouldn't be this way but you do all different *types* of surgery. When this happens more day in a row it can be pretty soul crushing but it makes sleeping on your day off so, So sweet. Make sure you get this stuff documented in your med records for when you do get out and deal with the VA on disability benefits. Typical day: As a resident my days varied quite considerably. The neurosurgeon also stated that I had pretty bad nerve damage that never healed. But we had rotations at other hospitals with home call where that schedule varied. Lifestyle: Neurosurgery residency has a reputation as a difficult one. Don't be a snowflake and be able to take some criticism but I'm friends with plenty of the faculty who trained me and my former co-residents. This expansion of learning has led to the subspecialty of spinal surgery. It also didn’t help that my PCM at the time wouldn’t sign off on an MRI and kept telling me I just needed to stretch more and do yoga. I’m traveling back to Fort Knox in 2 weeks, and won’t be able to see this orthopedic surgeon to have the surgery done. Crazy. Close. Overall, most neurosurgery residents probably see more spine procedures in their residency than do orthopedic residents/ fellows combined, depending on the program. I am in the Army, active duty. Neurosurgery residency length: 5-7 years (includes 1 year of general surgery and neurosurgical training in cerebrovascular disease, pediatric neurosurgery, spine surgery, trauma, and tumors). Vail-Summit Orthopaedics & Neurosurgery. As you get better at rounding in general you can come in later and get everything done. Yeah dawg, that's gonna be a no from me... JK, really admire everyone who is willing to go through living hell for something they love. Renowned Orthopaedic Surgeons & Sports Medicine Specialists. Almost all — 82.74 percent — of the neurosurgery patients and 48.81 percent of the orthopedic surgery patients said they preferred a surgeon trained in neurosurgery. did it get better, or did it get worse? Long story. 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. Fellowships: Like a lot of surgical subspecialties neurosurgical fellowships were a pretty unregulated bit; except for pediatrics which always seemed more organized. At the county hospital as a junior we got out post call pretty reasonable usually. If it were my back I’d go with a neurosurgeon for sure. Background: I'm fresh out of an neuroendovascular fellowship and finished my residency last June.I had a small attending practice and took general cranial neurosurgery … You did a great job capturing the highs and lows of the specialty! I can speak to a sample of 1, uncle, Jeff, who I’ve written about before: Handsome fellow, right? What Are the Variations in Operations Performed Between Orthopaedic Surgeons and Neurosurgeons? When removing a brain tumor, there often isn’t a super clear cut demarcation between tumor and healthy tissue. If you are visiting r/veterans for the first time please read the rules. What Are the Variations in Operations Performed Between Orthopaedic Surgeons and Neurosurgeons? Downsides: Some spine surgery, which is such a big part of private practice neurosurgery, is painful and, of questionable overuse. A neurosurgeon specializes in injuries or situations involving the brain and spine. There may be some truth to neurosurgery being particularly wearing; the hours are long compared to some training and perhaps as important is that some of the disease processes can be very acute. Dr. Jonathan Rasouli, MD, is a sixth-year neurosurgery resident at the Mount Sinai Hospital in New York, NY. We are here to support one another, and help resolve any VA / Veterans related issues. An orthopedic surgeon specializes in injuries involving bones, joints, ligaments, and muscle tissue. I mean spine surgery is basically orthopedics and hammers and bones and little bit of grunt work. Someone dropped a free-fall ramp on me in the motor pool. When people met me in med school they assumed that they misheard me when I said Ophtho. (I already stretched a lot, and I tried the yoga for 2 - 3 months), For the first year and a half it was off an on, as in it always hurt a bit, but was manageable. Just be aware that it may not help and it could make things worse. Thing is, the medics said that the only people who call out with back problems are shammers trying to get out of duty. The brain is one of the last great frontiers. Orthopedic spine surgeons in Los Angeles earn $456,000 a year while in New York City surgeons make $484,000, according to Salary.com. While an orthopedic surgeon is a better choice if you need a new hip, knee, shoulder, or have a severely broken bone, anything related to the spine is best treated by a skilled neurosurgeon. Indications for L5 S1 fusion are debilitating pain and dysfunction arising from degenerative disc disease, slipped disc, fractures, recurrent herniations, sciatica, scoliosis, and spinal canal narrowing. We started the day at 6am with table rounds. Archived. An orthopedic surgeon is also an MD or a DO, and completed specialty training. Wake up, change into backup underpants and scrubs, get a big ass coffee and power through. To answer your question, I’d go with the neurosurgeon over the ortho for any operation on your spine, because that’s his specialty. By the time I went to the doc (after I got out) my L4/5 disc had ruptured and fusion surgery was pretty much my only option. Sure, severe neurotrauma / big bleeds on Coumadin are rough, but often you just do the best you can do and hope for the best. Primary (Princeton) Office Location – 3836 Quakerbridge Road – Suite 203 Hamilton, NJ 08619 (609) 890-3400. Just ask if Dr Torres and Dr Sheppard could both scrub in on the surgery. Neurosurgeon VS. Orthopedic Surgeon for lower back surgery. The University of Florida Department of Neurosurgery offers a full range of neurosurgical services. From PGY-1 you have to identify problems and fix them. Absolute admiration for the most dedicated among us pursuing one of the most trying jobs in existence. 1. Posted by 2 years ago. Press question mark to learn the rest of the keyboard shortcuts. Absolutely not how I want to spend my years on this earth. How verbose do I need to be? How do you know if X specialty is right for you? This post will be cataloged on the wiki for posterity. There is no cure for GBM, neurotrauma can be bad, high grade subarachniod hemorrhage can be bad. I chose the surgery because they were threatening to put me on the med board. A new Medscape poll probes doctor lifestyles. I go over how I decided between neurosurgery, orthopedic surgery, and plastic surgery on my vlog channel. New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community. I can tell you that surgery may be the only option based on the issues you have. He said if a neuro surgeon was leading/working on the surgery, this would have likely not happened due to the neuro surgeon being able to pay better attention to the nerves around the area of operation. Your symptoms sound pretty much identical to mine, but mine were less severe and in the left leg. 13. Of course, if there's something cool as a first start you want to see and you didn't get slaughtered the night before, then stick around. I had a guy in my platoon that I particularly disliked, a loud-mouthed asshole who went on sick call to avoid going out, so I never went on sick call for my back. 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. We'd have two to three ORs "starting" at 7:30. Accreditation of fellowships is getting a little more standardized with SNS stepping up (although the process has some growing pains). But people catch only glimpses of recovery. Base median salary: $575,000. Great place to be in academic neurosurgery if you wanna do neuro research and have a clinical practice. I am a bot, and this action was performed automatically. Good luck! If you have a back issue or severe back pain, seek out a neurosurgeon for their evaluation and diagnosis for proper treatment. I miss being rested. I’ve been dealing with the pain in my lower back for almost 2 years, and in the last 6 months it’s moved into my right hip, and down my right leg. I hate meetings. Neurosurgeon. Indications for L5 S1 fusion are debilitating pain and dysfunction arising from degenerative disc disease, slipped disc, fractures, recurrent herniations, sciatica, scoliosis, and spinal canal narrowing. Welcome to /r/MedicalSchool: An international community for medical students. There was a half day resident clinic at county every Friday. We'd try to keep the junior holding the call pager out of the OR except for emergencies. I have been working with a orthopedic surgeon who wants me to have a discectomy on my lower back, I have a herniated disc, L4-L5 that’s pushing on a nerve causing back and leg pain. Some junior would be on peds and walk to that tower to round. I can only think of a handful of days, maybe 4 or 5, in all of residency when I *needed* to go to the OR, then you might be there til the afternoon. Vail, Edwards & Summit County, Colorado. All with better schedules than the trauma hospital. Your situation is similar to mine. The ortho was there to fuse a piece of bone around the nerve. There are usually only two residents per year in a neurosurgery training program. They thought I said Ortho because I'm a pretty big guy (definitely big for an Indian guy) and a big Lakers fan. Neurosurgeons vs. Orthopaedics. Less frequent but still some cases as a second year. do you expect it to change when you are an attending? This is then repeated. Neurologist for Herniated Discs Neurologists also come in many areas of focus with spinal and brain experts being at … Thanks for the great write-up! We spent time at the VA, a Children's hospital and a hospital my faculty had a private practice. Take a message to Garcia. : You need to really want to be doing surgery on the brain and spine I think cause its a long road. Varies with programs of course, but on my neurosurg rotation there was a night resident, and day team. The night resident would "preround" at 4am, skeleton notes, and then sign out/round together with day team. you've gotta go more in depth about income because that's one of the biggest factors in people's decisions along with lifestyle. Orthopedic surgeons performed spinal deformity surgery such as scoliosis as well as joint and trauma surgery. It is fascinating. What’s the difference between an orthopedic surgeon and a neurosurgeon regarding this type of surgery?
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