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What's Real And What's Fake About Laser Spine Surgery?

A lot of patients who have back pain have seen the ads: laser spine surgery is proposed to be an outpatient alternative to "traditional" spine operations. Sometimes, patients ask me about this "band aid" spine surgery: would it work for them?

Let's start with the basics. A laser -- like a scalpel, or anything else in the operating room -- is simply a tool. And as a tool, it can be useful in the right situation. In the wrong situation, however, it may be not do the job, or potentially be harmful!

Secondly, the laser is only useful and relevant when you are doing the work on the spine -- say, removing a herniated disc -- and has little or nothing to do with HOW you get to the site of the pathology in the first place. And people often conflate the laser with minimally invasive surgery. They may not be the same thing. For example, the laser is often used in brain tumor removal procedures that may require an open surgical approach, but the laser aids in the precision of the surgery: https://www.texasoncology.com/types-of-cancer/brain-cancer/surgery-for-brain-tumors/

All types of minimally invasive spine surgery: endoscopic, microscopic, percutaneous, laser, and others, have a very simple objective: get to the spine pathology and take care of it with as little disruption of the surrounding tissues (muscles, ligaments, nerves) as possible. Some techniques are less disruptive to the tissues than others. On the other hand, some patients' spine problems need a wider surgical technique than can be achieved with a tiny incision, or an endoscope, or a laser.

For example, in the image below on your right, the stenosis (spinal compression) is so severe that a laser may be an inappropriate instrument for dealing with the problem.

Bottom line: the surgeon ought to use the MOST appropriate technique for the patient's individual problem, and then apply less invasive techniques wherever and whenever it is safe and possible.

Dr. Mohammad S. Shukairy

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