This page is a practical guide for individuals exploring private spinal surgical care in Vancouver, British Columbia. You'll find an overview of public wait times, regulatory considerations, and accredited surgeons practicing in BC.
Note: in general, as a BC resident, you cannot pay privately for surgical care within BC. The only exception is if the surgeon is opted-out of MSP. Otherwise you will need to travel out-of-province.
Orthopedic spine surgeons and neurosurgeons are both spine surgeons—they diagnose and treat problems of the cervical, thoracic, and lumbar spine that can cause neck/back pain, nerve compression, and spinal cord symptoms. The right fit often depends on your diagnosis, the type of operation you may need, and the surgeon’s training and case volume.
Orthopedic surgeons come from a musculoskeletal background. In spine care, they often focus heavily on the mechanics and structure of the spine, including:
Neurosurgeons train in the nervous system. In spine care, they often focus heavily on:
Important: There is major overlap. Many neurosurgeons do fusions; many orthopedic spine surgeons do decompressions and disc replacements. For most common spine operations, the best predictor of a good experience is usually the surgeon’s subspecialty spine training, procedure volume, and outcomes, not whether they started in orthopedics or neurosurgery.
People typically seek a spine surgeon’s opinion for:
It may be time to see a spine surgeon if:
Rather than picking based only on “neuro vs ortho,” choose the surgeon who:
More than 373,000 surgeries are performed in British Columbia each year, thousands of which are spine surgeries ranging from emergency trauma care to elective decompressions for chronic pain. The vast majority are delivered through the publicly funded Medical Services Plan (MSP), where wait lists for "elective" conditions—such as sciatica, cervical radiculopathy, or spinal stenosis—can be lengthy.
Private spine surgical options exist in BC, but they are rare and strictly regulated. Under the Medicare Protection Act, surgeons enrolled in MSP cannot charge patients for medically necessary services. However, a surgeon who has formally 'opted-out' of MSP may treat patients privately.
The challenge for spine surgery specifically is infrastructure. Unlike minor day procedures, spine surgery often requires hospital-grade facilities, overnight monitoring, and specialized equipment. Consequently, there are very few private facilities in BC equipped for major spine work, and few spine surgeons who have fully opted out of the public system to operate in them.
The reality is that most BC patients seeking timely private spine care will travel out of province (often to Alberta or Québec).
Current regulations: While BC permits opted-out surgeons to treat residents privately, the regulatory environment remains strict following the Supreme Court’s dismissal of the Cambie Surgery Centre challenge, which upheld the ban on extra-billing for insured services by MSP-enrolled doctors.
It depends on the surgeon’s status. For medically necessary spine surgeries—such as discectomy, laminectomy, fusion, or disc replacement—BC residents generally cannot pay privately to a surgeon enrolled in the Medical Services Plan (MSP).
That is why most British Columbians seeking timely private spine care go out-of-province (typically to Alberta or Québec).
The exception within BC is when a spine surgeon has formally opted out of MSP. In that specific case, they are permitted to bill patients directly, though you must pay the full cost out-of-pocket and cannot claim reimbursement from the government.
Yes. Note: the surgeon will likely require medical information and diagnostics (imaging, lab tests, etc.) before the consultation.
Generally, private surgeries performed in Canada are paid for out-of-pocket or via private insurance/ employer benefits.
Provincial plans (like OHIP, MSP, or AHCIP) typically do not cover procedures at private clinics, though some exceptions exist for WCB (Workers' Compensation) claims or specific inter-provincial programs.
Private insurance
Standard extended health benefits (e.g. Sun Life, Manulife) typically do not cover the cost of the surgery itself. However, they often cover related costs such as:
Health spending account
If your employer provides a Health Spending Account (HSA) or "flex account," you can often use these funds to pay for the surgery. Unlike standard benefits, HSAs are usually flexible enough to cover CRA-eligible medical expenses, including private facility fees.
Tax Credits (Federal & Provincial)
You may be able to get some financial relief at tax time.
Please consult a tax professional before claiming any private surgery fees on your taxes.
The costs for spine surgery are substantial.
They vary considerably depending on the procedure, your underlying health conditions, the experience of the surgeon, type of anesthesia, etc., and can cost anywhere from $15,000 to $80,000+.
For an overview on private surgery costs, see our Resources on Private Surgery Costs.
Private surgeons typically charge a consultation fee because a surgical consult involves clinical work before, during, and after the appointment.
A surgical consultation isn’t a “meet and greet.” It’s a formal medical assessment where the surgeon may:
In a private setting, the surgeon generally isn’t billing MSP for that time, so the consultation fee compensates them for expert assessment and diagnostic decision-making.
Private clinics also cover operating costs that public hospitals don’t fund in the same way, including:
The consultation fee helps support these resources and the infrastructure required to provide timely, organized care outside publicly funded hospital operations.
Wait times depend on urgency, imaging, and OR capacity.
If you have stable chronic back pain or sciatica, you may be triaged differently than a patient with progressive weakness (e.g., foot drop) or signs of spinal cord compression (myelopathy). The fastest path usually comes from: clear MRI/CT imaging + documented neurological deficit + failed conservative care (physio/injections).
In the Canadian medical system, wait times are divided into two distinct stages:
Note: 'Wait 1' wait times are not always reflected in publicly available records. The numbers below do not because BC does not have a centralized database to track the Wait 1 stage. There are approximately 1.2 million BC residents currently in Wait 1.
In BC, there are ~1,600 patients on Wait 2, waiting for procedures like spinal decompression or fusion, with cases split between neurosurgery and orthopedic spine surgery depending on the hospital.
Note: there are no procedure-level breakdowns for spine surgery in BC.
