Frequently Asked Questions

The Spine Center


What is a neurosurgeon?

A neurosurgeon is a highly trained specialist physician who’s primary focus is addressing conditions affecting the peripheral nerves and the main nervous system. This type of doctor will work on areas of the body that include the brain, the spine, potentially the arteries in the neck, and the nerves in the body. Since the neurosurgeon is a trained surgeon, he or she is usually focused on surgical methods of treating disorders on the above mentioned areas of the body. However, these doctors also consult on whether surgery is necessary, and they perform other minimally invasive or non-surgical procedures as needed.

The time and training involved in preparing to become a specialty surgeon, requires years. These doctors will usually complete residencies after medical school that are at least six years in length. Many neurosurgeons specialize further by working on one area of the body like the brain or spine, and they might train a few more years in order to become experts in a particular area. In total, it can take from the beginning of college to the end of training, anywhere from 14 to 16 years to be fully trained as a neurosurgeon.

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What is the difference between a neuorsurgeon and an orthopedic surgeon?

What’s The Difference between Neurosurgeons and Orthopedic Surgeons?

A recent study published in Spine examined how surgeon specialty may impact elective spine surgery outcomes. But first let’s define each surgeon: Neurosurgeons may be MDs or DOs (medical doctors or doctors of osteopathic medicine). They must complete a residency of around 5-6 years with focus of surgical treatment for neurological conditions of brain, spine and spinal cord, nerves, and intracranial/intraspinal vasculature. There are some neurosurgeons that pick one discipline and exclusively specialize in brain surgery, or back surgery. Some may focus on both.

Orthopedic Surgeons may also be MDs or Dos. Their surgical residency is usually just 5 years and is focused on musculoskeletal conditions. Orthopedists mainly focus on diagnosing and treating most all bone and joint disorders including spinal, arthritis, sports injury/sports medicine, trauma, bone tumors, hand or wrist injuries/abnormalities, total joint replacement. Some orthopedic surgeons may focus on a specialization such as spine surgery, joints (such as hips, knees, shoulders), or both.

As far as spinal issues and surgery: Orthopedic surgeons tend to focus more on spinal abnormalities of the bone such as scoliosis and other musculoskeletal conditions. Neurosurgeons tend to have more expertise to perform intradural surgery (inside spinal cord) as well as spine surgery.

Key findings from the study: The researchers analyzed data from the American College of Surgeons National Surgical Quality Improvement Project Database. There were 50,361 patients included in the study. Neurosurgeons performed surgery on 66 percent; the remaining were treated by an orthopedic surgeon.

Top 3 findings from the study include: 1. The only differences between the surgical subspecialties were diagnosis and outcomes. 2. When orthopedic surgeons performed the elective spine surgeries, patients were twice as likely to have a prolonged hospital length of stay as when neurosurgeons were performing the procedure. 3. Patients who underwent treatment by orthopedic surgeons were also more likely to receive a perioperative transfusion, have complications, and require discharge with continued care.

In a nutshell: Both neurosurgeons and orthopedic surgeons can specialize in spine surgery, and in most typical spinal surgeries either surgeon may be qualified. And in both specialties, either surgeon can have a core focus of specialization such as cervical spine, lumbar spine, and more. However, neurosurgeons have more time in surgical residency and are typically fellowship trained, which means having additional specializing post residency and has earned board certification. This extra training helps the neurosurgeon truly hone his or her skill, and based on the recent study, may also impact patient surgical outcomes.

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Why should I consult with a neurosurgeon?

As mentioned above, a neurosurgeon is the most highly trained physician in his field to handle any disease or malady of the main nervous system, the peripheal nerves, the brain, the spine, the arteries in the neck and the nerves in the body.

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I don’t need surgery. How can Dr. Theofilos help me?

There are several ways in which a consultation with Dr. Theofilos can be of assistanceto you. Most of our patients do not require surgery! We have developed a program, working with the top therapists in the area, to assist patients in avoiding to have invasive surgery. We recommend strengthening the core muscles that are often the culprit behind many of the ailments we see.

We offer a spine health specific supplements which support growth and healing of spinal muscles, ligaments and bones.

We feature an in-house MRI center, 2 out-patient procedure suites for acute pain management, including epidurals and other minimally invasive procedures.

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What types of insurance does The Spine Center accept?

Please call our office to discuss the options. We will guide you through the process and often work with device manufacturers to facilitate the most effective outcome for your claim approval. We often obtain approvals from insurance carriers for procedures.

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How will I be restricted after surgery or a minimally invasive procedure?

Depending on the procedure, the staff of The Spine Center will advise you about how to care for yourself after surgery or another procedure.  Normally with a minimally invasive procedure you may be back to normal activity within a few weeks.

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How long will I have to be in the hospital?

Most of our minimally invasive procedures are done on an out-patient basis. But for those who must be admitted to the hospital, a stay of 1-2 days is usually required.

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Will I be able to exercise after my surgery?

The level of physical activity always depends upon the type of procedure you are undergoing. We always recommend exercise on a daily basis, and will work with you to determine a program that best fits your physical structure and any limitations you have after you have cleared for activity by your physician.

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What do I do about prescription refills?

For prescription refills, please call our regular office number and listen for the Prescription Hotline. Please leave your name, date of birth, name of medication, strength of medication, pharmacy name and phone number. Please allow 24 hours for a response to your call, and please remember to leave us a phone number to call you back.

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How does smoking affect surgical outcomes and how quickly I heal after my surgery?

Smoking decreases the blood supply to the bones and muscles. So, for example if a patient undergoes a spinal fusion, which requires blood flow to support the regeneration of the bone , the fusion may not heal effectively. Smoking may also increase the degeneration of vertebral discs.

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How can I educate myself regarding the risks of my surgery?

We offer DVDs for our patients as well as brochures and other helpful links on our website which provide the information necessary to learn about your surgery.

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How do I know I am choosing a qualified surgeon to perform my spinal surgery or minimally invasive surgery?

Your surgeon should provide you with information regarding his/her background. A neurosurgeon’s education is 8 years and focuses on brain and spine reconstruction as well the nerves in those areas of the body. An orthopedic surgeon is educated and trained focusing on joints in the body. They may do a rotation in medical school that focuses on the spine for a few months. However, some orthopedic surgeons do go on to fulfill fellowships in specialized spine training.

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