A neurosurgeon is a medical doctor who specializes in diagnosing and treating conditions of the central and peripheral nervous system. To find out more about what a neurosurgeon does, read our guide.
What is a neurosurgeon?
Neurosurgeons are highly-specialized MDs who are trained to find surgical treatments for neurological disorders. They may be part of the process of diagnosis, or they may be called in as part of a multi-disciplinary team after diagnosis to explore treatment options. The diseases or disorders they treat could relate to the brain, the spine or the nervous system more generally. Neurologists are similar in terms of what they diagnose and treat, but they are trained in non-surgical interventions. Neurologists and neurosurgeons often work very closely together. This is because they may need to assess whether surgical or non-surgical treatment offers the most benefits to the potential patient. A combination of both may well be required, meaning both neurologist and neurosurgeon would act as treating doctors.
Neurosurgeons are not tied to the operating theatre as you might expect. Because they are experts in the nervous system, they will be consulted frequently by other doctors, and will take part in rehabilitative work even if a patient has not had surgery for their condition.
What does a neurosurgeon do?
Some of the duties performed by a neurosurgeon include seeing and diagnosing patients, offering consultations to other MDs, performing surgery, and taking part in a patient’s recovery and rehabilitation. Some of the common conditions they might diagnose and treat are as follows:
Tumors of the brain, spine and the skull
Cancerous or non-cancerous tumors of the brain are one the most common conditions a neurosurgeon will consult on. If the tumor is of the brain, its size, position and location all make it more or less likely that neurosurgery will be an effective method of treatment. With other treatments options on offer, a neurosurgeon working on a case like this will be part of a much bigger team around the patient.
Traumatic brain damage will often require a neurosurgeon to operate, sometimes in an emergency context. Commonly, a neurosurgeon might deal with either hemorrhage or hematoma that create pressure within the brain and threaten function, cerebral contusions or skull fracture. In an emergency — such as following an accident — it’s likely more than one procedure will be required. If any of the above are critically threatening brain function, they will be operated on with the minimal intervention possible to save life and preserve as much function as possible. Further tests would be needed to assess whether later surgery would present any benefits to the patient.
Spinal disk herniation
This is one cause of lower back pain that can be dealt with surgically with a great deal of success. As neurosurgeons will know all too well, much chronic back pain is lifestyle induced and there are no quick fixes. Fortunately, dealing with a herniated disk is often a quick procedure that the patient recovers from quickly, enjoying much lower levels of pain and disability.
There is still no cure for Parkinson’s, but it is possible in some instances to relieve a patient of some of their more intrusive symptoms. Some patients notice that over time the medication that does the lion’s share of symptom control becomes less effective. The uncontrollable writhing movements (dyskinesias) become far more pronounced. One possible treatment is an operation that targets the deep brain structures that control motion. The result is a reduction in uncontrolled movement. However, it is an invasive procedure for the patient and must be weighed up against possible benefits.
Again, most patients find that a drug protocol enables them to manage their condition, but anti-seizure medication doesn’t work for everyone. Some patients may have epilepsy that is caused by one specific part of the brain — rather than generalized epilepsy — meaning that a surgical intervention can be more precise and thus have a better outcome.
Of course, there are many other conditions that will form part of a neurosurgeon’s caseload, and none of these conditions are specific to adults either. Pediatric neurosurgery is another level of specialty which you can read about later on.
What is the difference between a neurosurgeon and a neurologist?
As mentioned above, there are some key differences between neurologists and neurosurgeons but broadly you would experience the following differences in responsibility and specialty:
- Neurologists are not trained to perform surgery. They will, however, undertake procedures such as lumbar punctures, nerve conduction studies and electromyography.
- Many neurosurgeons will be attached to an ER in case someone with severe trauma to the head, neck or spine comes in. If life-saving treatment is required, they will operate immediately. That is not to say a neurologist won’t be involved later down the line for any rehabilitation and recovery needs.
- Neurologists might specialize in areas that it would be extremely unusual for a neurosurgeon to be involved in. These include sleep disorders, Alzheimer’s and dementia, and functional disorders.
How to become a neurosurgeon?
Neurosurgery is one of the most demanding specialties in medicine and it takes a long time to become a specialist. It’s not the sort of specialty you fall into. It will require top grades and valuable extra-curricular activity all the way through college and medical school. Your residency program will be twice as long as the 3 years that family practice MDs undertake, plus an additional year on general surgery.
After your 7-year residency, many neurosurgeons take an extra year to specialize still further. If you want to be a pediatric neurosurgeon, an oncological neurosurgeon or a trauma specialist you’ll need to commit an extra year.
How long does it take to become a neurosurgeon?
All told, 4 years of college, 4 years of medical school, and up to 7 years of residency take it to at least 15 years. It is a long time, but at the end of it, you will be rewarded with one of the most respected positions in the health system and a very attractive salary.
How much is a neurosurgeon's salary?
As an MD in the USA, you can expect to have an attractive salary no matter which specialty you decide upon, but neurosurgeons are of extremely high status even within the medical sector more generally. At different stages in your career you can expect to earn the following:
During your residency: The average neurosurgery residency salary is approximately $74,000 per year. This is higher than the standard residency salary because surgical residencies tend to have better recompense more generally.
Early-career neurosurgeon, years 1–4: In your first 4 years as a fully qualified neurosurgeon, you can expect to receive $385,000 on average.
Mid-career neurosurgeon, years 5 and above: As your career matures, you can look forward to earning roughly $433,000 on average.
Experienced neurosurgeon up to 15 years: At this point, you could be earning up to $500,000. Your time and expertise will become more and more sought after at this point.
Top-paid neurosurgeons: There will always be positions for extremely well-respected neurosurgeons that pay more. It might have something to do with your career specifically, or because you are involved with particularly high-end private health care. Some neurosurgeons are earning in excess of $800,000.