Clinical neurosurgery as it relates to the lumbar spine: what it does versus what it says

Neurosurgeons may derive as much as 62% of their professional income from and perform proportionately as large a number of procedures on the lumbar spine. Publications in neurosurgical journals, presentations at national and international neurosurgical meetings, and participation in organized neurosurgical symposia are, however, relatively sparse in this area of activity. It appears, therefore, that the lumbar spine must have minimal academic interest to neurosurgeons, as compared with the surgical areas where they have clinical domain, i.e., the brain and spinal cord. In that this clear discrepancy between what they do (their source of income) and what they talk about and publish is apparently not well known to neurosurgeons or their professional society directors, this paper is presented as objective, awakening evidence. The potential impact on future patient draw, professional prowess, and income, which may result from a continuation of this wide gap, is also discussed.