About laser spine surgery

Q. Do you perform laser spine surgery or use lasers when performing spine surgery?

A. It’s natural for Americans to be easily attracted to new technology or gadgets as the miracle cure for any ailment.

The concept of a laser with surgery certainly sounds high tech. However, consider that industrial lasers are often used to burn through metal doors and steel. One might consider if you really want that type of burning device near your spinal cord?

There are differing opinions about the use of lasers with spine surgery, just as there are differing opinions about many advances in technology in medicine. The North American Spine Society which has many of the world’s fellowship-trained spine surgeons as members, produced a position paper for its spine surgeon members that concludes:

  • "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.” Source: https://www.mayfieldclinic.com/PDF/LaserSpineSurgery_NASS.pdf

The Cochrane Review, which summarizes complex medical research, also hasn’t cited any superior benefit for the use of laser spine surgery.

In my practice, I simply haven’t seen a benefit for those patients who’ve had laser spine surgery and then are referred to our practice with subsequent spine symptoms. So I don’t believe laser spine surgery provides an advantage over minimally invasive spine surgery.

The spine surgery process for minimally invasive spine surgery and laser spine surgery both involve a “laminectomy” or “laminotomy” where parts of the bone in the spinal vertebra are removed to provide a window for the surgeon to access the damaged disc. Under traditional minimally invasive spine surgery, the surgeon uses a microscope or endoscope to visualize the part of the disc that is pressing on a nearby nerve root. The spine surgeon simply removes the disc tissue with a tiny cutting instrument.

With laser spine surgery, the surgeon at this juncture uses the heat of a laser to vaporize the disc tissue.

I believe in using the most advanced technology where it shows benefit to the patient. For example, we believe strongly in the benefit of the tiny incisions from minimally invasive spine surgery and how that helps patients back to activity with a less painful recovery. We also patients access to artificial disc technology for the cervical area that promises to retain the motion of the neck vertebrae as an alternative to spinal fusion which locks vertebrae together.

Use of restraint with any new technology is key to maximizing the benefit while lessening risk of new emerging technology. In conclusion, at this time, we do not use laser spine surgery with our patients.

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Need an Appointment?

Gus Varnavas, MD — at Community Hospital of Anaconda — specializes in the treatment of back and neck pain and strives to help people return to activity. Request an appointment with Dr. Varnavas in his office in Anaconda, MT.