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ASK THE EXPERT: Is Laser Spine Surgery Right For Me?

Although laser spine surgery has recently received increasing attention and publicity (along with many minimally invasive spinal surgery techniques), it has been used during spine surgery since the 1980s.

Laser is an acronym for Light Amplification by Stimulated Emission of Radiation. A laser is merely a tool used in place of a scalpel. Laser surgery shouldn’t be confused with minimally invasive surgery.

Minimally invasive spine surgery offers the same post-surgical benefits as traditional spine surgery–but with much less trauma. A smaller incision is not the only advantage. Using an endoscope, the surgeon minimizes the disruption of spinal muscles. The use of a laser and or microscope further limits the damage to supporting structures. As a result, patients are spared the pain and scarring that can develop after muscle injury. Patients also require much less anesthesia during minimally invasive procedures. In addition, hospital stays are dramatically shorter, enabling many patients to go home the same day after endoscopic spine surgery.

Laser spine surgery is often touted as being non-invasive and free of risk. However, with any procedure there is always some level of risk, additionally procedures utilizing the laser still require incisions and can pose serious risk and/or complications. With laser spine surgery the incision is generally much smaller than with traditional spine surgery. The benefits are that with a smaller incision the scar would be smaller and less tissue and muscle would be disturbed, the downside is the smaller incision lessens the surgeon’s view of and around the spine. If the use of a laser makes sense based upon the patient’s biology or pathology and their biomechanics, then it may be an option for certain conditions.  The challenge is that the laser seems to be getting overused to treat far too many conditions which are not amenable to solving the patient’s diagnosis.  This leads to a high rate of failure not because the laser is bad, but because the decision making leading to surgery is wrong. In general, the laser has very limited application in solving spinal issues.  The laser can be used in some cases to deaden nerves causing back pain if it is coming from the facet joints or joints in the back of the spine.  This can also be successfully accomplished with deadening the same nerves with a wire heated by electricity (Radiofrequency Ablation).  This is the same result, just different technology to obtain the result.  This highlights the fact that laser is not the answer, but the proper procedure is the answer.

The spinal specialists here at the Virginia Spine Institute are well versed in the latest techniques and technology when it come to providing our patients with a diverse range of treatment options that are best suited for an individual patient’s treatment plan. Like any other procedures, laser surgery is not appropriate for all patients. It is important to discuss the details of your surgical procedure at length with your surgeon and to understand options prior to moving forward with any procedure.

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