Laser Spine Surgery - A Myth?

 A common misconception among patients is that spine surgery can be exclusively done using lasers. While minimally invasive surgical technology has grown by leaps and bounds, lasers have actually been around for a long time. In fact, lasers have been used in medicine since 1973. Yet, there is no compelling argument for its use in spine surgery.

The reality is that lasers are practically useless when it comes to spine surgery. Let us examine this a little more closely to see why. Spinal surgery is usually done to relieve pain and other difficulties by either decreasing pressure on a compressed nerve or by stabilizing the spine. In case of disc herniations (protrusions) or rupture, the damaged portion of the disc is removed in a procedure known as discectomy. A laminectomy is done to remove bone spurs or growths that may be impinging on a surrounding nerve. Spine stabilizations or fusions are done by securing two or more vertebral bones together using metal or plastic implants. While these surgeries can be performed with minimal access- through a small incision that reduces blood loss, risk of infections and reduces recovery time, the use of lasers is not relevant and can actually be counter-productive.

It is becoming increasingly evident that laser spine surgery is purely a marketing pitch, assuring patients of painless procedures with virtually no side-effects, promising a quick return to normal life. While the fact remains, laser surgery actually involves a surgical incision to access the spine. The laser is then used only to remove the soft tissues over the spine. Impinging bone fragments or ligaments are removed using specialized instruments. Therefore, the laser in laser spine surgery actually plays a very minor role.

Another very important aspect about laser spine surgery is that while lasers can cut damaged or protruding parts of discs, it is far more reliable to mechanically remove the disc fragment to relieve nerve compression. Moreover, it is also a safer option as the laser risks the chance of damaging the nerve root located near the disc. Lasers cannot be used to decompress patients with spinal stenosis as it cannot cut bone. An electrocautery is a more preferred tool used in spinal surgery and is a relatively safer option.

Marketing "safe" spinal surgery with the use of lasers is clearly without merit and has gained popularity only by making false assurances to patients, playing on their fear of surgery and promising ease of recovery. The truth is, most neurosurgeons do not use or recommend the use of lasers for spine surgery because there are no clear benefits over other procedures. In addition, there are no well-established studies to prove the effectiveness of lasers over more modern and established spine surgery techniques. Therefore, ensure that you completely understand the procedure prior to undergoing any elective surgery. Consult with a qualified spine surgeon to get the correct information on spine surgery.