Neurosurgeon

What is a neurosurgeon?

A neurosurgeon is a specially trained medical doctor who diagnoses and treats conditions that affect your nervous system — your brain, spinal cord and nerves. Neurosurgeons perform surgery on your nervous system, but they can also provide nonsurgical treatments. They typically try all nonoperative treatment methods — like medications, steroid injections and physical therapies — before recommending surgery.

Neurosurgeons can also diagnose and treat conditions that affect the structures that support your nervous system, including:

• Your skull.
• Spinal vertebrae.
• Spinal disks.
• Blood vessels.
• Protective membranes and soft tissues.

Other healthcare providers often consult neurosurgeons due to their extensive training on the nervous system.

What is the difference between a neurologist and a neurosurgeon?

A neurologist is a medical doctor who diagnoses, treats and manages conditions that affect your nervous system (brain, spinal cord and nerves). A neurologist doesn’t perform surgery.

A neurosurgeon diagnoses and treats nervous system conditions through both surgical and nonsurgical therapies.

If you have a medical condition or injury that affects your nervous system, you may see a neurologist for evaluation and diagnosis. If your neurologist thinks your condition requires or may benefit from surgery, you’ll meet with a neurosurgeon for further medical advice and surgical treatment.

What does a neurosurgeon do?

A neurosurgeon assesses, diagnoses and treats conditions that affect your body’s nervous system, which includes your brain, spinal cord and spinal column, and all of your nerves that extend from your spinal cord.

While neurosurgeons can perform complex surgery in your spine and brain, they often suggest nonsurgical or conservative care first. For example, if you have chronic back pain, your neurosurgeon may first recommend anti-inflammatory drugs and/or physical therapy. If your pain doesn’t respond to these treatments, your neurosurgeon may recommend surgery, if possible.

A neurosurgeon is skilled in several surgical and procedure techniques, including:

• Open surgery.
• Minimally invasive surgery.
• Endoscopic surgery.
• Microsurgery.
• Radiosurgery.
• Endovascular surgery.
• Chronic pain interventional procedures.

Neurosurgeons also have thorough training in the tests needed to diagnose and treat neurological conditions. They’re skilled at operating and analyzing the following testing machines:

• CT (computed tomography) scans.
• MRI (magnetic resonance imaging) scans.
• PET (positron emission tomography) scans.
• Magnetoencephalography (MEG).
• Electroencephalograms (EEG).

What conditions do neurosurgeons treat?

Some of the most common neurologic conditions a neurosurgeon treat include:

• Brain tumors.
• Carpal tunnel syndrome.
• Cerebrospinal fluid (CSF) leak.
• Chronic pain in your back or neck.
• Congenital brain conditions, such as Chiari malformations and arachnoid cysts.
• Congenital spinal column conditions, such as spina bifida and tethered spinal cord.
• Essential tremor.
• Herniated disks.
• Hydrocephalus.
• Intracranial aneurysms.
• Multiple sclerosis (MS).
• Parkinson’s disease.
• Pinched nerves.
• Sciatica.
• Seizure disorders, such as epilepsy.
• Spinal bone spurs (osteophytes).
• Spinal stenosis.
• Spinal fractures.
• Spinal tumors.
• Spinal deformities, such as scoliosis and spondylolisthesis.
• Traumatic head, brain, neck or spine injuries.

What kind of surgeries do neurosurgeons perform?

Neurosurgeons perform several kinds of surgeries and procedures depending on the part of your nervous system — or supporting tissues and structures — that’s affected.

Types of brain surgery include:

• Blood clot removal.
• Aneurysm repair.
• Tumor removal.
• Brain bleed (hemorrhage) stoppage.
• Trauma repair.
• Shunt insertion.

Types of peripheral nerve surgery include:

• Carpal tunnel release.
• Ulnar nerve release.
• Vagus nerve stimulation.

Types of spine surgery include:

• Stereotactic spine radiosurgery.
• Diskectomy.
• Laminectomy.
• Spinal fusion.
• Vertebroplasty and kyphoplasty.
• Spine stabilization and reconstruction.

Why would I need to see a neurosurgeon?

In most cases, your primary healthcare provider or your neurologist will refer you to see a neurosurgeon if you have a neurological condition that requires or would benefit from an in-depth assessment.

Neurosurgeons have extensive knowledge about your brain, central nervous system, peripheral nervous system and spine, and the conditions that can affect them.

Just because your healthcare provider recommends you see a neurosurgeon, that doesn’t necessarily mean surgery is around the corner.

Instead, it means you’ll receive a comprehensive neurological exam, a review of your symptoms and medical history, and detailed diagnostic imaging to determine the underlying cause of your symptoms. From there, your neurosurgeon — and in some cases, other specialist providers — will determine and discuss the best treatment options for you, whether that’s a nonsurgical treatment, surgical treatment or a combination of both.

What questions should I ask my neurosurgeon?

It may be helpful to ask your neurosurgeon the following questions during your appointment:

• What’s your experience in doing this type of surgery?
• How soon do I need to have surgery?
• What are the possible risks of this surgery?
• What are the benefits of this surgery?
• How’s the surgery performed?
• Should I get a second opinion?
• What other specialists will be a part of my surgical team?
• What other specialists will be part of my team after surgery?
• How long will I be in the hospital, and where will I recover?
• How fast and fully will I recover?
• What do I need to do to prepare for surgery?

What can I expect during an appointment with a neurosurgeon?

To get the most out of your appointment with your neurosurgeon, it’s helpful to be prepared. Ways to prepare include:

• Bring a list of the most important issues you want to discuss with your neurosurgeon.
• Discuss any changes in your overall health.
• Discuss your new symptoms or changes in existing or prior symptoms.
• Bring copies of test results, including images and lab work ordered by other healthcare providers outside of your neurosurgeon’s healthcare network.
• Bring a list of all the current medications and supplements you take. Include prescription medications; over-the-counter medications; and any vitamins, supplements and herbal products.
• Bring a list of your known allergies.
• Bring a friend or relative with you to the appointment to take notes and be another set of ears and eyes. This person can help review your neurosurgeon’s discussion, ask questions, and remind you about scheduling tests and follow-up appointments.
• Ask if you should schedule another appointment to discuss any additional concerns.

How does someone become a neurosurgeon?

Neurosurgeons complete several years of medical school and residency and undergo extensive training before performing complex surgical procedures involving the nervous system.

To be qualified to perform neurosurgery, a person must successfully complete:

• Four years of pre-medical education at a college or university, resulting in a bachelor’s degree.
• Four years of medical school, resulting in a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree.
• One year of internship in general surgery.
• Five to seven years of residency (post-graduate training) in a neurosurgery program.

Some neurosurgeons complete a fellowship after residency to specialize in a particular area of neurosurgery, such as the spine or pediatric neurosurgery.

Like all medical professionals, neurosurgeons also need to complete continuing education, such as conferences, research and classes, throughout their career to keep up with advances and technology in their field of medicine.

How many years does it take to be a neurosurgeon?

It takes approximately 14 to 16 years to become a neurosurgeon, including pre-med (undergrad) education, medical school, internship and residency.

Neurosurgeons undergo one of the longest training periods of any medical specialty due to the complexity of the field of medicine.

What are some neurosurgery subspecialty fields?

Some neurosurgery subspecialty fields include:

• Cerebrovascular surgery.
• Endovascular surgical neuroradiology.
• Epilepsy surgery.
• Functional neurosurgery.
• Neuro-oncology.
• Pediatric neurosurgery.
• Spinal surgery.

A note from Cleveland Clinic

Getting a diagnosis can be overwhelming. But if you have a condition that affects your nervous system, such as chronic pain or Parkinson’s disease, a neurosurgeon can help you manage and treat your condition. They’re experts in their field and have up-to-date knowledge on medications, procedures and surgery that can help you. Your neurosurgeon will work with you to determine a treatment plan that works best for you.