Practice & Patient Guide

Choosing a Spinal Doctor: Why Patients Travel to Naples for Spine Care

By Dr. Mark Frenkel, MD, MA, FAANS, FCNS  |  Board-Certified Neurosurgeon & Spine Surgeon, Naples, Florida

Some of my patients drive three hours from Orlando or Tampa. Others fly in from Indiana, New England, and once, all the way from Hawaii. Not long ago, a man sat down in my exam room and said, “I’ve seen four doctors. Two wanted to fuse my back, one said do nothing, and one said I needed a pain pump. Which one is right?”

That question is why choosing a spinal doctor matters so much. Spine care has more variation in recommendations than almost any other field of medicine. The surgeon you choose often determines not just how your operation goes, but whether you have one at all, and which one.

In this article, I’ll explain the different kinds of spine specialists, what genuinely separates an excellent spine surgeon from an adequate one, why second opinions change so many plans, and why patients from across Florida and beyond choose to travel to Naples for their care.

What Kind of Spinal Doctor Do You Actually Need?

“Spinal doctor” can mean several very different specialists. Patients often lose months bouncing between them because no one explained who does what. Here’s how I describe the landscape.

Most people with back pain never need a surgeon, and I say that as one. But if you have progressive weakness, symptoms of spinal cord compression such as clumsy hands or poor balance, or pain that hasn’t responded to months of good conservative care, a surgical opinion belongs early in the process, not at the end of it.

Why seeing a surgeon early can save you surgery

This sounds backward, but it’s true in my practice. A careful surgical evaluation often confirms that surgery is not needed and gives patients the confidence to commit to therapy. It also catches the minority of conditions, like cervical myelopathy, where waiting can cause permanent damage.

Neurosurgeon vs. Orthopedic Spine Surgeon: Does It Matter?

This is one of the most common questions I get, and I’ll give you an honest answer rather than a territorial one. Both neurosurgeons and orthopedic spine surgeons can be excellent spine surgeons. The best of each specialty are very good.

How the training differs

Orthopedic surgeons complete a five-year residency covering the entire musculoskeletal system, then typically a one-year spine fellowship. Neurosurgeons complete a seven-year residency focused on the brain, spinal cord, and nerves, with extensive spine surgery throughout. My own seven years at Wake Forest included training under Dr. Charles Branch, one of the pioneers of modern spinal surgery, and I served as Chief Resident for two consecutive years.

In practice, neurosurgical training tends to emphasize the spinal cord and nerves themselves, which matters most in cases of cord compression, spinal tumors, and delicate revision work around scarred nerves. Orthopedic training often emphasizes alignment and deformity. There’s substantial overlap.

What matters more than the letters

• Focus: Does the surgeon spend most of their practice on the spine, or is it one part of a broad caseload?
• Range: Can they offer decompression, motion preservation, minimally invasive fusion, and complex reconstruction, or only one tool?
• Judgment: Do they explain why, and do they ever tell patients not to have surgery?

A spinal doctor with only one technique tends to see every problem as a fit for it. That’s the single biggest reason I’ve worked to master a wide range of approaches, from tubular microdecompression to motion-preserving implants to fusion techniques I developed myself.

What Actually Separates a Great Spine Surgeon

Patients tend to judge surgeons by bedside manner and online stars. Those matter, but they’re not the whole picture. Here’s what I’d look for if I were choosing a spine surgeon for my own family.

1. Verifiable credentials

Board certification in neurological surgery or orthopedic surgery is the baseline, not a distinction. Fellowship in the American Association of Neurological Surgeons (FAANS) or comparable bodies signals that peers have vetted the surgeon’s training and practice. Independent recognition, such as Castle Connolly Top Doctor selection, adds another layer of outside review.

2. Experience and volume

The research here is fairly consistent. A systematic review in the European Spine Journal found that higher surgeon volume was associated with fewer complications, shorter hospital stays, and fewer readmissions and reoperations. Ask how often your surgeon performs the specific operation you’re considering.

3. Who other surgeons send their hard cases to

This, in my view, is the most honest credential in medicine. Surgeons know who can handle a failed fusion, a multi-level deformity, or a revision through heavy scar tissue. A large share of my practice comes from other spine surgeons referring their most complex and revision cases. I take that trust seriously, because those patients have usually already been through a lot.

4. Contribution to the field

Surgeons who publish, teach, and innovate have to defend their ideas in front of peers. My work has appeared in journals such as the Journal of Neurosurgery: Spine, World Neurosurgery, and Scientific Reports, and I’ve authored textbook chapters for Elsevier and Springer. That process keeps a surgeon honest about what the evidence does and doesn’t support.

5. Willingness to say no

One of my patients wrote that she appreciated I was not rushing into surgery. I consider that one of the best reviews I can receive. A spine surgeon who operates on everyone who walks in the door is not being thorough. They’re being indiscriminate.

Why the First Opinion Isn’t Always the Right One

I encourage second opinions, including on my own recommendations. Spine surgery decisions are rarely black and white, and the data show how often opinions differ.

A scoping review published in Surgical Neurology International found that a majority of second opinions disagreed with the initial recommendation, and most of those disagreements favored less surgery, not more.

Bigger isn’t more thorough

A common assumption is that a larger operation is a more complete fix. In my experience, the opposite is often true. Unnecessary fusion levels add stress to neighboring segments, lengthen recovery, and can set up the next operation. The goal is the smallest procedure that fully solves the actual problem.

The revision patients I see

Many of the patients referred to me arrive after an operation that didn’t work. Sometimes the original diagnosis was incomplete. Sometimes hardware failed in weak bone. Sometimes too much or too little was done. Revision surgery is harder and riskier than getting it right the first time, which is exactly why the first choice of spinal doctor matters.

Why Patients Travel to Naples for Spine Care

Patients don’t drive across Florida or board a plane for routine care. They come when they want a specific kind of expertise, technique, or honesty they haven’t found closer to home.

Techniques not widely available elsewhere

I developed the CemLIF™ procedure, a rod-less, screw-less lumbar fusion technique that avoids pedicle screws entirely. I was also the first surgeon to use augmented reality in surgery, developing my own intraoperative navigation system. For selected patients with stenosis and mild slippage, I offer the motion-preserving TOPS™ Posterior Arthroplasty System. And for many patients, a small tubular minimally invasive decompression is all that’s needed.

What traveling patients tell me

One patient who lived in Indiana told me she nearly went home for surgery because she knew the medical community there, then changed her mind after researching her options. A Hawaii resident wrote that I explained her problem and its solution from her scan right away, after years of visits elsewhere without answers. And one family member put it this way:

“No need to travel to major cities anymore for serious back/neck issues when the best is in Naples.” — Joan M., verified Google review

Another patient, then 81, had been told by a second-opinion surgeon in Boston to expect at least six months of recovery from a traditional fusion with rods and screws. After his CemLIF™ procedure, he reported returning to golf without restrictions in about four months. Every patient is different, but stories like his are why people make the trip.

Naples is an easy place to recover

Southwest Florida is a comfortable place to heal: mild winters, flat walking paths, and quality accommodations close to the hospital. Many of my patients are seasonal residents who prefer to have surgery during their Florida months and recover here.

What the Process Looks Like for Out-of-Town Patients

Traveling for surgery can feel daunting, so we’ve built a program to take the logistics off your plate. Through our Concierge Spinal Surgery Program, here is how it typically works:

1. Inquiry and records review: my team gathers your history, imaging, and prior notes.
2. Telehealth consultation: I review your images with you remotely and discuss whether surgery is needed and which options fit.
3. Coordinated testing: we help schedule any needed MRIs, medical clearances, or diagnostic injections, often near your home.
4. Insurance and cost clarity: my team verifies coverage and explains costs upfront, including for out-of-network patients.
5. Travel support: help with flights and accommodations, with options ranging from oceanfront hotels to stays near the surgery center.
6. Surgery and follow-up: I personally contact your family after surgery, and follow-up visits can often continue by telehealth once you’re home.

Concierge patients also have direct email access to our team during business hours. For high-profile patients, private entrance and exam room arrangements are available.

For Referring Physicians: When to Send a Complex Spine Case

I’m grateful for the trust colleagues across Florida place in my practice. If you’re a primary care physician, pain specialist, or fellow spine surgeon considering a referral, these are the cases where I can usually add the most value:

• Failed back surgery and revision cases, including pseudarthrosis, adjacent segment disease, and hardware failure.
• Complex deformity, including adult degenerative scoliosis.
• Cervical myelopathy, especially multilevel or with cord signal change.
• Patients with poor bone quality, where screw-based fixation is risky.
• Spinal tumors and complex neurosurgical cases.
• Patients seeking a second opinion before major reconstruction.

My team communicates findings and plans back to the referring physician. Referrals can be sent by calling (239) 649-1662 or by fax to (239) 649-7053.

Questions every patient should ask a spinal doctor

1. What exactly is causing my symptoms, and how does my imaging prove it?
2. What happens if I wait or try more conservative care?
3. Why this operation, and why not something smaller?
4. How many of these procedures do you perform each year?
5. What does recovery realistically look like for someone like me?
6. If this doesn’t work, what’s the next step?

Conclusion: The Right Spinal Doctor Is Worth the Drive

Spine problems can take a great deal from you: sleep, mobility, independence, and time with the people you love. The spinal doctor you choose determines how much of that you get back. Look for honest judgment, deep experience, and a full range of options, not just the nearest office.

If you want a clear diagnosis or a second opinion, I’d encourage you to schedule a consultation or call my Naples office at (239) 649-1662. If you’re traveling from elsewhere in Florida, out of state, or abroad, inquire about our concierge program. We’ll start with telehealth and handle everything from there.

The information in this article is for educational purposes only and does not constitute medical advice. Surgical decisions are made on an individualized basis following a thorough consultation. Results may vary. Always consult a qualified physician before pursuing any surgical or medical treatment.

References

1. The impact of surgeon volume on patient outcome in spine surgery: a systematic review. Eur Spine J. 2018. PubMed
2. Second opinion in spine surgery: a scoping review. Surgical Neurology International. 2021. PMC