My wife had spine surgery two months ago. We finally got the bill and I see charges for a vascular surgeon we've never even met. Is that normal in this kind of operation?

Your wife may have had anterior lumbar surgery (ALS). In this operation, the vascular surgeon goes through the front of the body to the spine. This avoids a posterior approach (from the back) and prevents damage to the spinal cord.

The ALS does put blood vessels at risk for compression and accidental cuts. Blood clots and bleeding can occur as a result. The vascular surgeon is an expert in moving the blood vessels out of the way without damaging them.

When problems occur during the operation, the vascular surgeon works with the spine doctor to treat the patient quickly and safely. Delays can result in serious long-term problems.