Laser Spine Surgery Facts and Myths
A laser is merely a tool (like a scalpel, burr, etc) in performing minimally invasive or open spine surgery.
A laser can:
1. Help make necessary cuts (rather than using the traditional scalpel)
2. Aid in removing and/or shrinking tumors and/or disc material around the spinal cord
There are many claims made by proponents of laser spine surgery. At the heart of these arguments is that the laser scalpel is better than other surgical options because it is more technically advanced and minimally invasive. In other words, laser surgery will theoretically cause decrease blood loss and scarring. Doctors who support laser spinal surgery maintain it is more efficient, effective and gentle than traditional methods.
In brief, laser spine surgery is very controversial, fraught with misconceptions, dangerous, and lacks quality medical evidence.
Is there any medical evidence for the use of Lasers in Spine Surgery?
Lasers have been suggested as cutting edge and precise.
It is only natural that introducing this into surgery could
be thought of by the public as something that could benefit and enhance
procedures. For a compelling majority of all spine surgeries,
however, the laser has no purpose or role. Lasers, when used safely,
may play a very small role in minimally invasive or open spine surgery.
There is NO scientific evidence in well-respected journals to suggest that lasers are critical and/or useful in the vast majority of spine surgery.
Can Lasers be harmful?
Absolutely. There are numerous limitations with lasers:
- A laser is a straight beam of light that is ill suited for removing lesions hiding around corners. The ability to navigate angles safely is an important feature for the traditional scalpel. Because nerves are often tucked into narrow anatomic structures, a straight beam of light like a laser can accidently injure a nerve causing permanent neurologic problems.
- Lasers obliterate tissue and cut but they do so with heat and sometimes gas production (due to the boiling of water molecules). This heat can be transmitted to adjacent anatomical structures and can damage nerves.
Can Lasers be helpful?
Lasers in certain areas of surgery have been helpful. For instance, a
laser can be a useful surgical tool in removing fatty tissue that is
pressing dangerously on the spinal cord. Again, it is used in only a
very small fraction of the entirety of the spine surgery.
There are very few conditions that even require the use of a laser.
Why are Lasers advertised as a treatment option for Spine Surgery?
If one person or group does laser surgery and markets it, it is a gimmick. The use of a laser in spine surgery is more of a marketing gimmick than surgical innovation.
When a number of surgeons adopt the technique and long term studies demonstrate safety and significant benefit, then laser spine surgery may be a legitimate option. This has never been proven in any well-respected medical journal.
If you are considering laser spinal surgery, ask yourself a few important questions:
- Does the practice or institute you are considering teach courses on the use of the laser at national spine meetings?
- Are they disseminating this information to the medical community to better society?
- Is this procedure they are proposing something that other respected surgeons around the country and world have adopted?
- If the answer to these questions is 'no,' that should raise a red flag.
Myths about Laser Spine Surgery
Myth 1: Laser Spine Surgery is Medically Recognized
Another truth is that laser spine surgery is not readily accepted in the medical community. At meetings of the North American Spine Society and the American Association of Neurological Surgeons, the topic of laser spine surgery is never on the agenda. Professionals are not talking about it because it is simply not recognized as a valid treatment.
Myth 2: Laser Spine Surgery is Affordable
Many advertisements for laser spine surgery do not mention that the procedures can be very costly. Because the technology is not clinically accepted and has not been proven, laser spine surgery is typically not covered by health insurance. As a result, procedures have been known to add up to $20,000 to $50,000 in out-of-pocket costs.
Myth 3: Laser Spine Surgery is Effective
Commercials for laser spine surgery often promise significant relief with less risk of complications and shorter recovery times. The truth is that it has not been proven what can actually be accomplished with a laser. Laser surgery is not the same as minimally invasive back surgery, which does produce results. And, pain does not show up on X-rays or MRIs. This means that even if pain goes away after laser spine surgery, it can be hard to prove whether the surgery cured the pain, or the pain just went away on its own (i.e. placebo).