The spine (or backbone) is a skeletal system of bones, discs, ligaments, tendons, and muscles whose function is mechanical. The spine allows people to stand and walk upright and also protects the nerve roots that extend from the central nervous system.

Problems with the spine are usually mechanical and cause pain or limitation of ability to accomplish normal activities. If the nerves are compressed, weakness, numbness or radiating pain can occur.

Many spine problems can be treated with medication, physical therapy, or other conservative means.

When surgery is required, the operation includes a combination of decompression, realignment, stabilization, and fusion.

Decompression involves removing pressure from nerves or other sensitive structures.

Realignment involves restoration of normal relationships between bones and is similar to straightening or reduction of a fractured arm or leg bone.

Stabilization involves using implants to hold realigned vertebral bones securely in position.

Fusion involves application of bone graft so that structural living bone permanently holds realigned relationships.

Realignment, stabilization, and fusion of the spine are steps similar to treatment of a displaced hip fracture, in that the surgeon must restore alignment and use the implants to build a mechanical structure strong enough that a patient can bear weight. The surgeon must also create a biological structure that allows the body to heal the fractured bone.

A neurosurgeon is a surgical specialist dedicated to treatment of abnormalities of the central nervous system, including the brain and the spinal cord. Neurosurgical training is typically limited to teaching methods of nerve decompression.

An orthopaedic surgeon is a surgical specialist dedicated to treatment of abnormalities of the musculoskeletal system, including the bones, joints, discs, ligaments, tendons, and muscles. Orthopaedic surgical training teaches methods of decompression, realignment, stabilization, and fusion.

Because the spine is a mechanical structure and spinal problems are caused by mechanical weaknesses, spinal problems are primarily orthopaedic.

The specialty of orthopaedic surgery typically requires training for a period of five years after completion of medical school. During this time, the orthopaedic surgeon learns to use screws, plates, rods, artificial joints and implants of all types to rebuild damaged parts of the musculoskeletal system. The orthopaedic surgeon learns to master these skills in treatment of injuries and diseases of the arms and legs.

An orthopaedic spinal surgeon typically receives a year or more of training devoted exclusively to the spine and typically devotes the remainder of his professional attention and continuing education to the spine.

A patient who is selecting a surgeon to perform surgery on his spine should examine the training and experience of his surgeon in treating spinal conditions. It does not take a brain surgeon or a rocket scientist to operate on your spine. It takes an orthopaedic spinal surgeon.

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