One of the more common questions that my partners and I hear from patients is whether we perform laser spine surgery. When told that we don’t, the typical response is a mixture of disappointment, confusion and frustration. At this point during a patient consultation, I explain that, in my professional opinion, laser spine surgery is a slick marketing campaign designed to entice vulnerable people to buy into a questionable proposition at a significant upfront personal cost. The truth is that, while laser surgery has many valid applications in medicine and surgery, there is currently very little scientific evidence to support its use to address most spine problems.
A laser is a highly focused beam of light energy that has a variety of practical applications. These range from cutting diamonds and guiding missiles with pinpoint accuracy to reading bar codes on shopping cart purchases and lighting up dance floors. In medicine, its surgical applications include cosmetic surgery, the excision of certain types of soft tissue tumors and the correction of eye refractive errors, such as nearsightedness and astigmatism. The beneficial outcomes of laser treatments are very well documented in these instances.
It seems intuitive, therefore, that the laser should provide spine surgeons with a better way of tackling the most common problems we face, such as disc herniation or spinal stenosis (that is, when herniated disc material or thickened ligaments and bones cause pressure on nerves within the spinal canal). The problem, and the reason lasers should not be used to solve this medical problem, is that lasers cannot cut through bone without potentially injuring the spinal nerves that are found in very close proximity.
At a recent international spine conference I attended with hundreds of spine surgeons from around the world, the moderator asked for a show of hands from those surgeons who incorporated laser spine into their practices. Not one hand went up.
Laser technology does not appear to offer a safe and predictable alternative to conventional surgical techniques.
So what are the options for dealing with stenosis or herniations that have failed conservative treatment modalities? Traditional open or minimally invasive spine surgery both allow the trapped nerves to be freed up, however the latter approach requires less tissue disruption and removal to complete the job. Many of these life-altering operations can be performed on an out-patient basis. The additional good news is that these are covered by all major insurance plans, without the exorbitant up-front fees that some laser clinics require.
If you are experiencing severe leg pain or weakness, difficulty walking for more than a few hundred yards before you have to rest or if you have limited range of motion in the spine due to unrelenting back or buttock discomfort, consider getting a consultation from a Board Certified Spine Surgeon, including myself or my colleagues Brian Sullivan and Tim Burke. We will review your latest MRI scan and offer an opinion. Your decision could be one of the best you make and may save you a lot of money.