Wondering what a neurosurgeon actually does and when you need one? Here is everything you need to know in plain English.

Have you ever heard someone mention a neurosurgeon? Maybe your family doctor or another specialist suggested you go see one. Or perhaps you read about one in the news or saw a medical drama on television.

So, who exactly is a neurosurgeon? What do they do all day? And when might you need to schedule an appointment with one? Let us talk about all of this today in simple words that make sense to you.

Navigating health concerns about your brain or spine can feel scary and overwhelming. Knowing what to expect helps you feel more in control of your care. Let us explore the world of neurosurgery together.

Who Exactly Is a Neurosurgeon?

Put simply, a neurosurgeon is a specially trained medical doctor who diagnoses and treats conditions affecting your nervous system. Your nervous system includes your brain, the spinal cord running down your back, and the nerves that branch out to every part of your body. Think of it as the master computer system and wiring of your body.

These surgical specialists perform operations on your nervous system when necessary. However, they do not only do surgery. Most of the time, they try to treat your condition using non-surgical methods first. For example, they might use prescription medicines, steroid injections, or physical therapy before considering an operation.

Surgery is usually saved as a last resort or used when it is the only safe way to help you. Besides the brain and spinal cord, neurosurgeons also treat problems in the structures that protect and support your nervous system:

• Your skull bones that cover and protect your brain.
• Your spinal bones, known as vertebrae, that protect your spinal cord.
• The soft discs sitting between your spinal bones.
• The blood vessels that supply blood to your brain and spine.
• The protective membranes and soft tissues surrounding your nervous system.

Even other primary care doctors and specialists often consult neurosurgeons for expert advice when dealing with difficult nerve or brain issues.

Neurologist vs. Neurosurgeon: What Is the Difference?

This is a very common point of confusion for many patients. A neurologist is a medical doctor who diagnoses, manages, and treats disorders of the nervous system using non-surgical methods. However, a neurologist does not perform surgery.

On the other hand, a neurosurgeon is trained in both surgical and non-surgical treatments for nervous system conditions. They can evaluate your condition and perform complex operations if your medical needs call for it.

Imagine you are having severe neurological symptoms. You might first visit a neurologist, who will examine you, order scans, and perhaps prescribe medicine. If the neurologist discovers a structural problem that medicine cannot fix, they will refer you to a neurosurgeon.

What Does a Neurosurgeon Actually Do?

A neurosurgeon evaluates, diagnoses, and treats conditions that affect your brain, spinal cord, peripheral nerves, and supporting structures. While they are experts at performing delicate brain and back operations, they always explore non-surgical options first.

For instance, if you suffer from chronic lower back pain, a neurosurgeon might first recommend anti-inflammatory drugs or physical therapy. If these conservative treatments fail to relieve your pain, they will discuss surgical options with you.

Neurosurgeons use many different types of surgical and medical techniques. Some of the most common methods include:

• Open surgery: Traditional surgical procedures using standard incisions to access deep areas.
• Minimally invasive surgery: Operations performed through very small cuts using specialized tools for faster healing.
• Endoscopic surgery: Procedures using a thin, lighted tube with a camera to see and operate inside the body.
• Microsurgery: Extremely delicate operations performed with the aid of a high-powered surgical microscope.
• Radiosurgery: Using precise beams of radiation to target and destroy tumors without a traditional skin cut.
• Endovascular surgery: Treating blood vessel problems by threading tiny tubes through blood vessels from a small cut in the leg.
• Chronic pain procedures: Interventions like targeted spinal injections to block ongoing pain signals.

Neurosurgeons are also experts at operating advanced diagnostic imaging tools. They know how to run these machines and interpret the detailed pictures they produce:

• Computed tomography (CT) scans.
• Magnetic resonance imaging (MRI) scans.
• Positron emission tomography (PET) scans.
• Magnetoencephalography (MEG) tests.
• Electroencephalograms (EEG) to check brain wave activity in conditions like epilepsy.

What Medical Conditions Do Neurosurgeons Treat?

Neurosurgeons treat a wide variety of medical conditions. Here is a closer look at many of the common and rare disorders they manage:

• Brain tumors: Abnormal growths of tissue inside the skull that can be benign or cancerous.
• Carpal tunnel syndrome: A pinched nerve in the wrist causing numbness and tingling in your hand.
• Cerebrospinal fluid (CSF) leaks: A tear in the membranes holding the fluid around your brain and spinal cord.
• Chronic back or neck pain: Long-lasting pain that does not improve with standard rest or basic care.
• Congenital brain disorders: Structural brain issues present from birth, such as Chiari malformations or arachnoid cysts.
• Congenital spine disorders: Spinal problems present at birth, such as spina bifida or tethered spinal cord.
• Essential tremor: A neurological disorder causing rhythmic shaking in your hands or voice.
• Herniated disks: Slipped or ruptured cushions between your spinal bones that press on nearby nerves.
• Hydrocephalus: A dangerous buildup of excess fluid inside the cavities of the brain, often seen in infants.
• Intracranial aneurysms: Weak spots in brain blood vessels that bulge outward and risk bursting.
• Multiple sclerosis (MS): An immune-mediated disease where neurosurgeons sometimes assist with symptom management or surgical interventions.
• Parkinson’s disease: A movement disorder that sometimes benefits from specialized brain surgery called deep brain stimulation.
• Pinched nerves: Nerves compressed by surrounding bones, muscles, or cartilage.
• Sciatica: Sharp pain radiating from your lower back down through your leg along the sciatic nerve.
• Seizure disorders: Conditions like epilepsy where abnormal electrical brain activity causes seizures.
• Spinal bone spurs: Rough bony projections that develop along the edges of spinal bones.
• Spinal stenosis: Narrowing of the open spaces within your spine that puts pressure on your spinal cord.
• Spinal fractures: Broken bones in your spine caused by injuries or weak bones from osteoporosis.
• Spinal tumors: Growths developing within or near your spinal cord or spinal column.
• Spinal deformities: Abnormal curves like scoliosis or slipped vertebrae like spondylolisthesis.
• Traumatic injuries: Severe damage to the head, brain, neck, or spine caused by accidents or falls.

What Types of Surgeries Do Neurosurgeons Perform?

The specific type of surgery a neurosurgeon performs depends on which part of your nervous system is injured or diseased. We can group these procedures into several major categories:

Brain Surgeries

• Blood clot removal: Clearing dangerous blood collections inside the skull.
• Aneurysm repair: Securing bulging blood vessels in the brain to prevent life-threatening bleeding.
• Tumor removal: Safely taking out brain growths while protecting healthy surrounding tissue.
• Hemorrhage control: Stopping active bleeding inside the brain tissue.
• Trauma repair: Rebuilding and repairing damage caused by severe head injuries.
• Shunt placement: Inserting a flexible tube to drain excess fluid away from the brain in hydrocephalus.

Peripheral Nerve Surgeries

These surgeries focus on nerves located outside of your brain and spinal cord:

• Carpal tunnel release: Cutting a tight ligament in the wrist to relieve pressure on the median nerve.
• Ulnar nerve release: Relieving pressure on the nerve running near your elbow.
• Vagus nerve stimulation: Implanting a small device to help control severe seizures or treatment-resistant depression.

Spine Surgeries

• Stereotactic spine radiosurgery: Directing focused radiation beams at spinal tumors without traditional cutting.
• Disketomy: Removing all or part of a damaged spinal disc pressing on a nerve root.
• Laminectomy: Removing a small portion of the spinal bone to widen the spinal canal and relieve nerve pressure.
• Spinal fusion: Permanently joining two or more spinal bones together to stop painful movement.
• Vertebroplasty and kyphoplasty: Injecting special medical cement into cracked or broken spinal bones to stabilize them.
• Spinal reconstruction: Rebuilding damaged spinal columns after severe injuries or major deformities.

Why Might You Need to See a Neurosurgeon?

Usually, your primary care doctor or your neurologist will refer you to a neurosurgeon. This happens when your condition requires an expert evaluation of your nervous system or when surgery is a potential treatment option.

Remember that being referred to a neurosurgeon does not mean you are definitely going to have surgery.

Instead, it means your medical team wants a thorough review of your symptoms and medical history. Your neurosurgeon will look at your imaging scans, determine the exact root cause of your problem, and discuss all available options with you. Treatment might involve simple observation, lifestyle changes, medicine, physical therapy, or surgery if necessary.

Questions to Ask Your Neurosurgeon

Going to a specialist appointment can feel intimidating. Asking clear questions helps you understand your diagnosis and treatment plan. Consider asking these helpful questions during your visit:

• What is your level of experience in performing this specific procedure?
• How urgently do I need to make a decision about this treatment?
• What are the potential risks and complications associated with this surgery?
• What are the expected benefits of moving forward with this treatment?
• Can you explain the surgical steps in simple terms?
• Would it be wise for me to seek a second opinion from another specialist?
• Who else is part of your surgical team?
• What kind of support team will help me recover after the operation?
• How long will I need to stay in the hospital, and what does recovery look like at home?
• When can I expect to return to my normal daily activities and work?
• What steps should I take to prepare my body before the surgery date?

Do not hesitate to ask your doctor to repeat or explain anything that feels confusing.

What to Expect and How to Prepare for Your Neurosurgeon Visit

Preparing ahead for your neurosurgery appointment helps you make the most of your time with the doctor. Follow these helpful preparation tips:

• Write down a list of your most important questions and concerns before you arrive.
• Bring notes about any recent changes in your overall health and medical condition.
• Describe your symptoms clearly, noting when they started and how often they happen.
• Bring physical copies or digital files of all recent test results, lab work, and imaging scans.
• Bring a complete list of every medicine you take, including prescription drugs, over-the-counter pills, vitamins, and herbal supplements.
• Bring a written list of any known drug allergies or medical sensitivities.
• Ask a trusted family member or close friend to accompany you to the appointment to help take notes and remember details.
• Ask your doctor if you will need any follow-up appointments to discuss further testing or treatment choices.

How Does Someone Become a Neurosurgeon?

Becoming a neurosurgeon requires immense dedication, time, and hard work. It is truly one of the longest and most rigorous educational paths in all of medicine:

• First, students complete four years of undergraduate study at a college or university to earn a bachelor's degree.
• Next, they attend four years of medical school to earn a medical degree, such as an MD or DO.
• Following medical school, they complete a one-year internship in general surgery.
• After the internship, they complete a grueling five-to-seven-year residency program focused entirely on neurosurgery.

During residency, trainees gain extensive hands-on surgical experience under the direct supervision of experienced attending neurosurgeons.

Some neurosurgeons choose to complete an additional period of specialized training called a fellowship. This allows them to master advanced subspecialties, such as pediatric neurosurgery or complex spinal procedures.

Throughout their entire careers, neurosurgeons must participate in continuing education. They attend medical conferences, review ongoing clinical research, and learn new technologies to stay at the cutting edge of medicine.

How Many Years Does It Take to Become a Neurosurgeon?

In total, it takes roughly 14 to 16 years of rigorous education and training after graduating from high school to become a fully qualified neurosurgeon. This lengthy training period reflects the extreme complexity and delicate nature of the human nervous system.

Subspecialty Fields in Neurosurgery

Even though all neurosurgeons train extensively in general brain and spine care, many choose to focus their expertise on specific subspecialty areas:

• Cerebrovascular surgery: Treating complex blood vessel disorders like aneurysms and strokes inside the brain.
• Endovascular surgical neuroradiology: Performing minimally invasive catheter treatments inside blood vessels.
• Epilepsy surgery: Operating on specific brain tissue to stop or reduce uncontrollable seizures.
• Functional neurosurgery: Performing deep brain stimulation and treatments for movement disorders like Parkinson's disease.
• Neuro-oncology: Treating cancerous and benign tumors of the brain and spinal cord.
• Pediatric neurosurgery: Caring for infants, children, and teenagers with nervous system conditions.
• Spinal surgery: Focusing exclusively on complex conditions affecting the spine and spinal nerves.

Comparing Neurologists and Neurosurgeons

Review this helpful table to understand the differences between neurology and neurosurgery specialists: