Laser Spine Surgery
If spine pain becomes so severe that it disrupts daily life or is accompanied by swelling, tenderness, or redness, it’s important to seek medical attention.
At Complete Orthopedics, our expert spine specialists are adept at treating spine pain through both surgical and non-surgical means. We examine symptoms, diagnose the condition, and recommend suitable treatments, including surgery if necessary.
Serving New York City and Long Island, we partner with six hospitals to offer cutting-edge spine surgery and comprehensive orthopedic care. You can schedule a consultation with our orthopedic surgeons online or by phone.
Learn about the common causes of spine pain and the treatment options available, including when surgery might be the best choice.
Overview
A laser is a powerful focussed beam of light that is commonly used for cutting or burning tissue in the medical field. While laser surgeries have become popular and primary tools in areas such as eye surgeries, their role is limited in spine surgery. Laser spine surgery can be used in a limited subset of patients for treating conditions such as pinched nerves. They are generally not used in more common degenerative spine conditions.
Laser spine surgery may be used to treat herniated intervertebral disc as seen on this axial MRI section of the lumbar spine.
Traditional Approach
Traditional spine surgeries involve an incision in the back, side, or front of the spine’s affected segment. The surgeon carefully dissects and separates the tissues to reach the involved segment. The surgeon may then correct the problem using instruments that may involve cutting, removing, or fusing bones.
While there are benefits of adequate visualization by anatomical landmarks in the traditional open approach, there may be increased postoperative pain and slower recovery. The more tissues are cut during the surgery, the longer the body takes to recover from the surgery.
Minimally Invasive Surgery
With the advent of newer instruments and tools, open spine surgeries have mainly been replaced with minimally invasive techniques. The minimally invasive procedures utilize smaller incisions and minimum trauma to the soft tissues to reach the spinal segment. Minimally invasive cervical fusion and minimally invasive lumbar fusion are done using tunnels that separate the tissues instead of cutting.
The minimally invasive spine surgery (MISS) techniques lead to a faster recovery and rehabilitation than open surgery. Endoscopic spine surgery is another form of minimally invasive spine surgery where an operating microscope can visualize the operating area through a keyhole incision.
Another advantage of minimally invasive surgery is that it may be performed in an outpatient setting, and the patients may go home the same day of the procedure. The rates of infection, post-operative pain, and other complications are also significantly less than an open technique.
Laser Spine Surgery
Laser spine surgery is a form of minimally invasive surgery that utilizes the laser’s heat energy instead of traditional instruments. A laser discectomy is a common laser spine surgery to shrink the size of the herniated intervertebral disc. The laser may also be used to remove structures other than discs, such as ligaments that may impinge upon the nerves.
A typical laser discectomy procedure may be performed in an outpatient setting. A local anesthetic may be used to numb the skin overlying the affected segment. The surgeon then introduces the laser probe through a percutaneous incision to the site of the affected spine. The laser probe’s position is determined via an intraoperative image intensifier.
The laser is then used to heat the targeted tissue to relieve the pressure off the impinged nerve. The target may be an intervertebral disc or any soft tissue structures such as ligaments. Laser spine surgery may also be used to target spinal tumors selectively.
The patients can quickly get back to their daily routines and report less postoperative pain compared to traditional surgery. The risks of intraoperative bleeding and post-op infection are also less as minimal tissue is cut during the surgery.
However, laser spine surgeries are not inherently safer than traditional or minimally invasive techniques. While less tissue is dissected or separated during laser spine surgery, the laser’s heat may damage the nerves/spinal cord if not appropriately directed. The laser energy also cannot maneuver around the tissues, adding to the dangers of inadvertent cartilage, bone, ligament, or nerve damage.
The laser energy cannot cut through the bone, so the patients with conditions such as spinal canal stenosis are not candidates for laser spine surgery. Similarly, laser spine surgery is not beneficial in patients with spinal deformity and other spine degenerative conditions.
While laser spine surgery may be successfully used to treat conditions such as discectomy, frequently, patients may need more laser procedures. Although laser spine surgery is promising, there is limited data to prove its efficacy over other surgical techniques such as minimally invasive spine surgery.
Advantages and Risks of Laser Spine Surgery
Laser spine surgery offers several advantages over traditional and other minimally invasive techniques. Patients often experience less postoperative pain and quicker recovery times. The risk of intraoperative bleeding and postoperative infection is lower due to the minimal tissue cutting involved.
However, laser spine surgery is not inherently safer. The heat from the laser can potentially damage nerves or the spinal cord if not correctly directed. Additionally, the laser energy cannot maneuver around tissues, posing risks of inadvertent damage to cartilage, bone, ligaments, or nerves. Moreover, lasers cannot cut through bone, making this surgery unsuitable for conditions like spinal canal stenosis or spinal deformities.
While laser spine surgery can be effective for procedures like discectomy, patients often require additional laser treatments. Despite its promise, there is limited data proving its efficacy over other surgical techniques like minimally invasive spine surgery.
Conclusion
Laser spine surgery represents a fascinating and evolving field in medical technology. It offers a minimally invasive option with potential benefits like reduced postoperative pain and quicker recovery. However, it also carries risks and limitations that need to be carefully considered. Traditional spine surgeries and other minimally invasive techniques continue to be vital for treating a broad range of spine conditions. The decision to use laser spine surgery should be based on a thorough evaluation of the patient’s specific condition and a balanced consideration of the potential benefits and risks.
Do you have more questions?
How does laser spine surgery differ from traditional spine surgery?
Laser spine surgery uses a focused beam of light to remove or shrink tissue, whereas traditional spine surgery involves cutting through tissue with instruments. Laser surgery is less invasive and often results in quicker recovery times.
What are the risks associated with laser spine surgery?
Risks include potential damage to nerves, spinal cord, cartilage, bone, or ligaments if the laser is not precisely directed. The inability of lasers to cut through bone also limits their applicability.
Is laser spine surgery safer than traditional spine surgery?
Not inherently. While laser spine surgery involves less tissue cutting and thus less risk of infection and bleeding, it requires precision. Improper use can damage nerves or the spinal cord.
How long is the recovery period after laser spine surgery?
Recovery is typically quicker than with traditional surgery. Many patients return to their daily activities shortly after the procedure.
Can laser spine surgery be used for spinal canal stenosis?
No, laser spine surgery cannot cut through bone, making it unsuitable for treating spinal canal stenosis.
Is laser spine surgery effective for long-term relief?
While it can provide immediate relief, some studies suggest that patients might need additional procedures. Long-term efficacy varies and should be discussed with a surgeon.
Can laser spine surgery be performed on an outpatient basis?
Yes, it is often performed in an outpatient setting, allowing patients to go home the same day.
How is the laser probe guided during the surgery?
The position of the laser probe is guided using an intraoperative image intensifier to ensure accurate targeting of the affected tissue.
What type of anesthesia is used for laser spine surgery?
Typically, a local anesthetic is used to numb the skin over the affected spine segment.
What are the advantages of minimally invasive spine surgery (MISS) over traditional surgery?
MISS involves smaller incisions, less tissue disruption, faster recovery, reduced postoperative pain, and lower infection rates compared to traditional open surgery.
. Are there any specific post-operative care instructions for laser spine surgery?
Patients should follow their surgeon’s instructions, which may include avoiding strenuous activities, taking prescribed medications, and attending follow-up appointments to monitor recovery.
What are the common symptoms that might lead to considering laser spine surgery?
Symptoms include chronic back pain, leg pain due to pinched nerves, and pain from herniated discs that have not responded to conservative treatments.
How does laser discectomy work?
In laser discectomy, a laser is used to shrink the herniated part of the intervertebral disc, reducing pressure on the nerve and alleviating pain.
Are there any contraindications for laser spine surgery?
Contraindications include spinal conditions that require bone removal, such as spinal stenosis or severe spinal deformities. Each patient needs to be evaluated individually.
What is the success rate of laser spine surgery?
Success rates vary based on the condition being treated and the patient’s overall health. Discuss specific success rates with a surgeon based on individual cases.
Can laser spine surgery be repeated if necessary?
Yes, patients can undergo additional laser procedures if necessary, although repeated surgeries might indicate the need for alternative treatments.
What are the potential complications of laser spine surgery?
Complications can include nerve damage, infection, and insufficient relief of symptoms, requiring further intervention.
How does laser spine surgery compare in cost to traditional spine surgery?
Laser spine surgery can be more expensive due to the specialized equipment and technology used. Costs vary depending on the healthcare provider and location.
Can laser spine surgery address multiple spine issues at once?
It depends on the specific issues and their locations. Laser surgery is typically focused on one area at a time, so multiple procedures might be necessary for multiple issues.
What pre-operative assessments are required before laser spine surgery?
Pre-operative assessments may include imaging studies like MRI or CT scans, a physical examination, and a review of the patient’s medical history to determine suitability.
. Are there any lifestyle changes required after laser spine surgery?
Patients are often advised to maintain a healthy weight, practice good posture, and engage in exercises that strengthen the back and core to prevent future spine issues.
What other minimally invasive spine surgeries are available?
Other minimally invasive surgeries include endoscopic spine surgery, minimally invasive cervical fusion, and minimally invasive lumbar fusion, which use small incisions and specialized instruments.
Is there a risk of recurrence of symptoms after laser spine surgery?
Yes, there is a risk of recurrence, especially if the underlying causes of the spine issues are not addressed. Long-term management and follow-up care are essential.
How should one choose between traditional, minimally invasive, and laser spine surgery?
The choice depends on the specific spine condition, the patient’s overall health, and the surgeon’s expertise. A thorough discussion with a spine specialist is crucial to determine the best approach for each individual case.
My name is Dr. Suhirad Khokhar, and am an orthopaedic surgeon. I completed my MBBS (Bachelor of Medicine & Bachelor of Surgery) at Govt. Medical College, Patiala, India.
I specialize in musculoskeletal disorders and their management, and have personally approved of and written this content.
My profile page has all of my educational information, work experience, and all the pages on this site that I've contributed to.
