Laser Spine Surgery: A Few Words of Caution
Remember the old adage, “If it sounds too good to be true, it probably isn’t always correct?” It also perhaps happens to be best way to summarize the utility of the laser in the setting of spinal conditions. The laser captures a spectrum of thoughts and directs our imaginations to many wonderful memories that are both real and fictional. With respect to our imagination, we conjure thoughts of light sabers and medical doctors on starships. It is natural that as patients we seek these “latest and greatest treatments.” The laser has created a few and substantial medical advances in the field of medicine. However, NOT in the setting of spine surgery. The spine team at Spine Physicians Institute advises all of its patients throughout it’s our offices conveniently located to the Dallas, Irving, Red Oak, Plano, Southlake, Grapevine, Colleyville and Duncanville areas to take caution when it comes to “advanced” laser spine surgery procedures.
Both surgeons and many more non-surgeons are currently aggressively marketing this concept, utilizing words like laser spine institute, laser spine surgery, minimally invasive laser spine surgery, etc. Primarily they discuss utilizing the laser as means to burn away disc material and thus remove pressure off the nerve and thus improve the patients underlying pain. This has resulted in substantial marketing in the form of billboards, TV commercials, and pop-up add seen throughout the internet that the consumer encounters on a daily basis.
In reality, however, there is no substantial medical data to support the surgical efficacy or safety of these procedures. Most of the medical literature available to date is driven by the manufactures of these devices. There are no well-regarded double-blinded studies that are independently performed without industry support. The most well respected spine surgeons in the world are not touting let alone utilizing these technologies. In my personal training within reputed academic centers such as the Thomas Jefferson University and the Mayo Clinic we have never utilized any of these gimmick methods.
Those who aggressively market the use of the laser in spine surgery describe it being performed through incisions that are 10 mm or less. There are primarily two laser procedures that are being marketed to the consumer. In one method, through either a needle or small incision the disc is accessed and then burned with a laser. The other utilizes a fiber optic endoscope that enters the spinal canal through the sacrum to give access to the disc that is then burned with the laser.
Through these approaches, the surgeons are less adept to visualizing and directly decompressing a compressed nerve. Furthermore, it much more difficult to handle cerebrospinal leaks, excessive bleeding, or unexpected extruded disc herniations. In addition, there is much literature documenting the in the ineffectiveness of the laser in treating large disc herniations. There is also substantial literature demonstrating a higher failure rate and higher complication rate.
In comparison, a standard microdiscectomy is performed through a 25 mm incision. When utilizing a standard microdiscectomy, visualization is not compromised and safety is optimized while working on the very delicate structures that control our body’s sensation, strength, and bowel & bladder function.
In summary, I personally would never undergo a laser procedure and would opt for standard microdiscectomy. In summation, I refer you to the table and links below so you can make your own decision. As always if you have any additional questions please feel free to give us a call at any of our office locations conveniently located to the Dallas, Irving, Red Oak, Plano, Southlake, Grapevine, Colleyville and Duncanville areas.
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