Posted on February 7, 2012

…a question often asked by our patients.

Here’s the answer:

Spine surgery is typically done to relieve pain and other symptoms by decreasing pressure on a compressed nerve or by stabilizing the spine.  In the case of a herniated or ruptured disc, a discectomy may be done to remove the damaged portion of a disc in the spine; or a laminectomy may be done to remove bone spurs or other spinal growths. In cases where the spine is unstable, a spinal fusion can be performed to secure together two or more of the vertebral bones so that they “fuse” together.  These surgeries are now often performed using minimally invasive techniques that minimize damage to the surrounding tissue and allow for a faster recovery with much less blood loss. Laser spine surgery is often promoted as being minimally or even noninvasive and risk-free.  However, these laser spine procedures do require incisions and the laser itself can result in serious complications.

Laser spine surgery has never been studied in a controlled clinical trial to determine its effectiveness. Marketing pitches for spine surgery performed with a laser often make bold promises of pain relief for chronic neck and back pain and a quick return to normal life; sometimes in a matter of days. What is often not clear from marketing hype, is that laser spine surgery does actually involve surgery.  An incision is required to allow access to the spine.  A focused beam of light (laser) is then used only to remove the soft tissues over the spine.   Bone and ligament are then removed in order to free the nerve from compression using small instruments.  The laser in laser spine surgery actually plays a very minor role.

Lasers are certainly not new technology.  Lasers have been available for use in medicine since 1973.  However, they have not been widely adopted as a tool to be used in spinal surgery.  The fact is that most neurosurgeons do not use or recommend the use of lasers for spine surgery because there are no clear benefits and there are other well-established and documented studies proving the effectiveness of more modern and established spine surgery techniques.

The Importance of a Proper Diagnosis

It is important to have a proper diagnosis of your problem before deciding to undergo spine surgery.  Most cases of back and neck pain are muscular in origin and do not require or benefit from surgery. Unless severe pain or muscle weakness is making walking or performing daily activities extremely difficult, surgery is rarely the first line of treatment. Anti-inflammatory medication, physical therapy and exercise, lifestyle changes and other noninvasive treatment modalities such as therapeutic massage are often successful at resolving back and neck pain.

If conservative treatments fail to reduce back pain, then surgery may be necessary, depending on your diagnosis. For example, if you have a herniated disk with leg or arm pain as a major symptom that hasn’t been relieved with other treatments, discectomy may be appropriate. If surgery is recommended, get a clear explanation of your diagnosis and how the surgery will help relieve your symptoms.

Traditional spine surgery has been tested in numerous clinical trials.  The vast majority of patient who undergo discectomy for treatment of a herniated disc experienced relief from pain and other symptoms.  In elderly patients diagnosed with spinal stenosis, laminectomy is also a highly effectively procedure. Very few neurosurgeons regard laser spine surgery as a viable alternative to conventional spine surgery techniques. ONS neurosurgeons do not use or recommend laser spine surgery.

Mayo Clinic Opinion on Laser Spine Surgery