What is a Neurosurgeon?
A neurosurgeon is a physician who specializes in treating conditions and diseases related to the nervous system using surgical intervention to repair and correct the problems causing the conditions. The nervous system includes the brain, the spine, the spinal cord, as well as the peripheral nerves. Neurosurgeons are trained in providing both surgical and nonsurgical treatments to patients of all ages. Neurosurgeons are extensively trained in proper diagnosis of conditions, options for treatment, indications for different types of treatment as well as neurosurgery procedures.
What Kind of Training is Required to Be a Neurosurgeon?
Neurosurgeons have extensive training in both medicine and surgery. Their educational experience and clinical training is one of the longest of any medical or surgical specialty. Following graduation from college, four years of medical school is required. After completion of medical school, the neurosurgeon and training enters a residency that, on average, last seven years. Some neurosurgeons go on to more extensive training with a one to two-year fellowship focusing on a particular field within the specialty of neurosurgery.
Once residency is completed, neurosurgeons enter into practice but continue updating their training throughout their career with continuing education programs, conferences, scientific articles, and professional society meetings. This continued education is required because the field of neurosurgery continues to change with new scientific discoveries and technological advancements.
What is Board Certification?
Once they have been in practice for a period of time, most neurosurgeons become board-certified. This usually occurs after 2 to 3 years of practice. Board certification is accomplished by completing extensive written and oral exams administered by the American Board of Neurological Surgery (ABNS). Once a neurosurgeon has achieved board certification, they must maintain continued education and training throughout their career to maintain their board certification status.
Do Neurosurgeons Work with Other Health Providers?
Neurosurgeons coordinate their care with other physicians and healthcare providers. Although some conditions require immediate or emergent neurosurgical intervention, other conditions can often be managed with nonsurgical means. Because of this, the neurosurgeon often refers patients for physical therapy, interventional pain management, or medical management prior to proceeding with surgical intervention for those patients that do not get adequate benefit from the more conservative treatment options.
Many neurosurgeons work closely with other spine specialist such as interventional pain management physicians in order to optimize conservative care as well as to assure the most accurate diagnosis possible. In addition to medication and physical therapy, treatment such as epidural steroid injections, facet blocks, sacroiliac joint injections, and nerve blocks can help many patients with their conditions while avoiding the need for surgical intervention. In other cases, diagnostic procedures such as myelograms, selective nerve root blocks, medial branch nerve blocks, diagnostic joint injections, or discography studies can give the neurosurgeon valuable diagnostic information to help plan the surgery that will most likely help a person recover from a particular condition. This team approach can help assure that a person suffering from a spinal condition or nerve problem is able to get a care plan that is customized for their particular situation.
What Kind of Problems do Neurosurgeons Treat?
Over the years, most neurosurgeons are doing less brain surgery than in previous years. This is partly due to advancements in the fields of interventional radiology which can treat problems such as aneurysms with minimally invasive catheter guided techniques. Many brain tumors which were once treated with surgical excision are now treated with radiation therapy options such as the Gamma knife. Due to these advancements in medicine, the brain surgeries that are now required are less common. There are, however, still many problems dealing with the brain that require the specific skills of a neurosurgeon. Issues such as removing tumors that are not amenable to more conservative measures, decompressing acute bleeds in the brain, and placing surgical devices such as ventricular shunts or deep brain stimulator of leads required skills and expertise of a neurosurgeon.
Most neurosurgeons spend the majority of their time dealing with issues regarding the spine and peripheral nerves. Addressing issues such as spinal fractures, herniated discs, spinal deformities, spinal stenosis, spinal instability, and nerve compression make up most of the cases in the modern neurosurgery practice.
For those patients who continue to suffer with chronic pain even after conservative and surgical options have been utilized, neuromodulation options such as intrathecal pain pumps and spinal cord stimulators are possible options available in the realm of neurosurgery.
Many advances continue to develop in the field of neurosurgery. Improvements in surgical technique have allowed for smaller incisions and faster recovery. Technologies such as kyphoplasty has allowed rapid and effective improvement in painful conditions such as compression fractures of the spine. Advances in neuromodulation using spinal cord stimulators has allowed for a significantly larger percentage of chronic spinal pain patients to find relief. Improvements in spinal stabilization hardware have allowed for more stability and/or less invasive approaches to accomplish surgical goals. Technological advancements focusing on preserving motion of the spine such as artificial discs instead of fusions are showing a great deal of promise in improving long-term results for patients suffering with chronic spinal pain.
The field of neurosurgery, as in all fields of medicine, is constantly changing and advancing. If surgery is required, and experienced neurosurgeon focused on staying abreast of the latest developments and technology available can help give the individual suffering with a brain, spine, or nerve condition the best odds of a favorable outcome.