What is laser spine surgery?

Laser spine surgery, a term popularized largely by advertising, refers to the use of a laser for various routine minimally invasive surgical spine procedures. Examples include bulging or herniated discs, sciatica, spinal stenosis and other chronic spine conditions. In this surgery, a laser is used to cut and access the spine instead of a scalpel or other microsurgery instruments.

Laser–which stands for “light amplification by stimulated emission of radiation”–has been in wide use for decades, and laser spine surgery has been around since the early 1970s. A laser works by creating a very high-intensity light beam. The laser light is absorbed by the tissue and heats the area, thus enabling the cutting of that tissue.

However, the laser has more limited use for spine surgery, particularly regarding those procedures listed above and for which it is commonly advertised.

What is laser spine surgery used for?

Although lasers are an important part of surgical care as a cutting device, the laser is best used for spinal conditions for which it is appropriately indicated, such as removing spinal cord tumors or removing soft tissue around a nerve. For the other procedures that are commonly advertised, such as laser surgery for removing herniated disc material or a bone spur in spinal stenosis, the laser is not recommended.

Lasers aren’t as precisely controlled as a scalpel, and could potentially injure surrounding structures or cause nerve damage. Also, lasers can’t cut through bone, so they aren’t always applicable.

Major organizations and medical centers, such as the National Institutes of Health (NIH) and the Mayo Clinic, state that lasers are unproven for spinal surgery conditions for which they are being advertised.

At UOA, we follow the advice of the North American Spine Society (NASS), which cautioned consumers about laser spine surgery in a 2014 position paper. According to that paper, “Laser spine surgery in the cervical or lumbar spine is NOT indicated at this time. Due to lack of high-quality clinical trials concerning laser spine surgery with the cervical or lumbar spine, it cannot be endorsed as an adjunct to open, minimally invasive or percutaneous surgical techniques.”

How did laser spine surgery become so popular?

Despite a lack of endorsements from experts and organizations, laser spine surgery is big business in the U.S. That business is fed by advertising. If you look at the paid advertising on the Internet, the terms “laser” and “spine surgery” are big buyers. Laser spine surgery is promoted as being less invasive, resulting in less blood loss and being more effective. However, those are also the defining features of the more proven minimally invasive spine surgery commonly done for the procedures in question. If you were to take a survey of orthopedic surgeons or neurosurgeons, you would find that most, if not all of them, do not routinely use laser technology for spine surgery.

What is the best way to determine which spine surgery is right for me?

At UOA, we always encourage our patients to be very thorough in exploring any surgical procedure. The best way to do that is to read and study all the options, and then question the surgeon whom you are considering. Below are some suggested questions. Make sure you are satisfied with the doctor’s answers, as well as the attention that he or she pays to your concerns.

• What type of surgery do you recommend?
• Can you explain that surgery?
• What is the success rate of the surgery you recommend?
• What are the risks of that surgery?
• Will a laser be used? Why or why not?
• Are there other types of surgical and non-surgical options for my condition?
• What is your experience with this surgery, particularly for a situation like mine?
• Are you board certified?
• Are there any other options for nonsurgical treatment?
• What can I expect if I don’t have this surgery?
• What is the recovery like for this surgery?
• What type of results can I expect from this surgery?

Buyer Beware

Due to the lack of scientific evidence for the use of lasers in spine surgery, health insurance carriers do not provide coverage for it at this time. So choosing this surgery can be costly for patients and with no proven added benefit. 

At University Orthopaedic Associates (UOA), we bring 45 years of experience to the diagnosis and cutting-edge treatment of spine conditions. Our record of successful spine surgeries speaks for itself. Contact us for a consultation.