Who Treats Back Pain: Neurosurgeons or Back Surgeons?

Learning about the skills of neurosurgeons and back surgeons can help you choose the right specialist.


Research tells us that medical specialists deliver better treatment outcomes. But when your back hurts, which specialist should you call? We associate back pain with damaged nerves; is that something best treated by neurosurgeons? But orthopedics has an entire specialty devoted to spine surgery; does that make an orthopedic back surgeon the right choice? We asked orthopedic spine surgeon Dr. Trevor Wahlquist to explain the difference between neurosurgeons and orthopedic back surgeons. He also provides guidelines to help you select the right medical expert for your back condition.

Understanding the difference between neurosurgeons and back surgeons

“There used to be a very big difference between neurosurgeons and orthopedic spine surgeons,” acknowledges Dr. Wahlquist. “Twenty-five years ago, if you needed a fusion or another surgery involving placement of screws to help bones grow together, you had to see an orthopedic spine surgeon. For a decompression or microdiscectomy to address nerve pain, on the other hand, you would choose a neurosurgeon. These two specialties trained in different residencies, and that’s what distinguished them. After medical school, neurosurgeons did neurosurgery residency. Orthopedic spine surgeons like me did an orthopedic residency.”

With time, however, both specialties began to cross-train, and the expertise of these two specialties became more similar. “Today,” explains Dr. Wahlquist, “both kinds of specialists do fusions and decompressions; we both do many of the same surgeries, with just a few exceptions. Orthopedic surgeons are typically more comfortable dealing with degenerative deformities like scoliosis and spondylolisthesis. Although we access the nerves along the spine regularly, we don’t do procedures inside the dura—the lining of the spinal canal that surrounds the nerves. With their training emphasis on nerve issues, neurosurgeons specialize in the treatment of these intradural problems and rare injuries like thoracic disc herniations. For example, if you have a tumor in or around the dura, I would refer you to a neurosurgeon.”

Dr. Wahlquist’s tip for selecting a spine expert

“I would typically tell people to get a recommendation from their primary care physician,” says Dr. Wahlquist. “Because the specialties are so similar, there are very few cases where neurosurgeons have a skill set that orthopedic surgeons can’t match. Unless you have a tumor or another special need, either specialty can treat you with equal skill. This is where your family doctor or primary care physician’s guidance can really help. Your doctor has trusted relationships with these specialists and can direct you to the right expert.”

The advantages of choosing a Summit orthopedic spine surgeon

“It’s hard to think of anything more personal or important than choices about medical care,” says Dr. Wahlquist. “I think an informed decision is a better decision, and I certainly think there are some compelling reasons to choose a Summit Orthopedics back surgeon for spine care. I have a list of considerations that can help people to make knowledgeable choices about their care.”

  • Surgical safety. Whenever appropriate, the Summit spine care team performs procedures at Summit’s Eagan Surgery Center. “At Summit, we have the advantage of working out of a surgery center with quicker access to care both from a clinic and surgical perspective,” points out Dr. Wahlquist. “Complications occur with less frequency in these settings as well.  That said, we are also fortunate to partner with excellent hospital systems when surgery is more appropriate for that setting.”
  • Nationally certified quality of care. “Summit’s Eagan Surgery Center is the only surgery center in the country to receive Joint Commission Certification for spine surgery,” says Dr. Wahlquist. “I can’t overemphasize how important this is. Independent certification recognizes the high caliber of care our patients receive. Our nursing staff is amazing. Our hand-selected anesthesia team has designed a comprehensive program for perioperative spine management that prioritizes patient safety and comfort. Patients have the best-trained orthopedic professionals around them, keeping an eye on them overnight and making sure they’re safe.”
  • “When you are in pain, you don’t want to wait three months to get in to see a specialist,” observes Dr. Wahlquist. “At Summit, we can get you in for an evaluation and onto our operation schedule faster because we offer more convenient locations and much more schedule flexibility. This is important because some outcomes are time sensitive.”
  • Luxurious Care Suite recovery rooms. “For surgeries that require an overnight stay, patients recover in the comfort of a private suite that also accommodates their family members. The rooms offer the care of highly trained orthopedic healthcare professionals and the comfort of a fine hotel.
  • Advanced medical technology. “I operate at both St. Joseph’s Hospital and at our Eagan Surgery Center,” says Dr. Wahlquist.“Our Eagan Surgery Center is equipped with the same advanced technology that you’ll find in a hospital operating room. Our imaging navigation enables us to use an interoperative CT scan and instrumentation with live feedback when we place screws and rods. This improves the safety and efficacy of our surgeries. I use the same equipment when I operate St. Joe’s. I can operate at the hospital when that’s more appropriate for the patient, but our Surgery Center offers everything the hospital offers.”
  • Dedication to patient care. “If you come to see us with a tumor or another problem that requires the unique skills of a neurosurgeon, nobody here has an ego,” says Dr. Wahlquist. “We will be happy to refer you to the specialist you need.”

“I want to make sure that you know that your story was heard,” concludes Dr. Wahlquist. “Of course, you are going to get a thorough evaluation, but I also want you to feel that you can talk to me and trust me. A trusting, confident relationship is a priority when you are going to operate on someone. You need to be able to trust me, so I’m going to do everything I can do to establish good communication and interaction from start to finish.”

Summit Orthopedics offers comprehensive spine expertise

Our back specialists diagnose spine problems and design custom treatment plans built on a conservative, nonsurgical approach. Most patients find relief through treatments including guided injections, specialized physical therapy, biofeedback, exercise, activity modification, and medication. When conservative care does not relieve symptoms, our highly skilled surgeons offer proven, evidence-based surgical options. Together with you, we will determine the right course of action.

Start your journey to a healthy spine. Find your spine expert, request an appointment online, or call us at (651) 968–5201 to schedule a spine consultation.

Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MNPlymouth, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.

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  • Trevor Wahlquist MD

    Trevor Wahlquist, M.D.

    “Ensuring people are living healthy and active lifestyles is important to me. I strive to work together with patients to find non-operative and operative solutions for their pain, getting them back to the activities and the people that matter most to them.”

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