Lasers are something that you may have only seen in a sci-fi movie a few decades ago but now are considered in many industries essential pieces of technology. As the field of medicine evolves to meet the needs of patients so must the tools used. Today, laser surgery is readily discussed amongst providers and patients.
Spine surgeons continue to harness emerging technologies and make them their own. The advances are not only in technique but instrumentation. A laser is widely described as a surgical tool that can cut, coagulate, and vaporize tissues. Currently lasers are approved for and used in spine surgery. A laser is among the many tools that can be utilized during surgical procedures performed for a vertebral disc herniation.
What makes laser surgery better than any other minimally invasive technique? Well, we don't know that it is. Research has demonstrated that laser disc procedures are a safe treatment option.1 However, there is little scientific data available to support the idea that it is a superior surgical technique.
The gold standard of scientific research is a randomized controlled trial. There are few randomized trials that have been conducted to assess the value of laser disc surgery. One systematic review of this topic contained only two studies on laser discectomy. The review concluded that clinical outcomes following laser discectomy are at best fair and certainly worse than a microdiscectomy.2,3 Additional research and an increase in the number of publications demonstrating a true comparison of laser disc surgery to conventional and minimally invasive techniques is needed.3
Even though laser safety has been addressed and demonstrated through research, lasers are not exempt from all risk. Like all surgery, laser surgery, possesses its own potential risks to patients. While laser spine surgery is a viable option, it is not appropriate for everyone. Any decision to have surgery should be an informed decision. Make sure you discuss all alternative treatment options with your surgeon. Regardless of the type of procedure it is important to know the risks.
References
Choy, D., Ascher, P., Saddekni, S., Alkaitis, D., Liebler, W., Hughes, J., et al. (1992). Percutaneous Laser Disc Decompression; A New Therpeutic Modality. Spine , 17 (8), 949-956.
Gibson, J., & Waddell, G. (2007). Surgical Interventions for Lumbar Disc Prolapse; Updated Cochrane Review. Spine , 32 (16), 1735-1747.
Singh, V., Manchikanti, L., Benyamin, R., Helm, S., & Hirsch, J. (2009). Percutaneous Lumbar Laser Disc Decompression: A Systematic Review of Current Evidence. Pain Physician , 12, 573-588.
