You might want to read this May 4, 2011 article by
David Armstrong that appeared in
Bloomberg, if you are
considering laser spine surgery.
What is laser spine surgery?
Most often the term "laser spine surgery" refers to the use of a laser, or
concentrated beam of light, to perform a discectomy. Lasers can cut,
shrink or vaporize soft tissues. Lasers do not cut bone in a controlled
manner and thus are not effective on the bony structure of the spinal column.
Are there different types of lasers?
Yes, there are primarily 3 types of lasers used in surgical procedures.
The most common is called the YAG laser which uses a solid crystal to generate
the beam of light. Other types of lasers use various gases such as Carbon
Dioxide (CO2) or Argon to create the infrared light beam used in surgery.
How is the laser used in spinal surgery?
Laser spine surgery seems to have evolved has percutaneous techniques for
spine surgery have grown in popularity. The idea of minimally invasive
discectomies to remove part of the disc that may be pressing on a nerve has
become a popular approach. Being minimally invasive usually means that
there is minimal disruption of the muscle and tissue thru which access to the
spine is gained. There is also usually less blood loss and more rapid
recovery following the surgery. Using a laser to remove part of the disc
is just one method of performing a minimally invasive or percutaenous discectomy.
What do the "experts' think?
The September October 2009 issue "SpineLine - The Clinical and News Magazine
for Spine Care Professionals", published by the North American Spine Society
contained 2 reviews of Lasers in Spine Surgery. Jack Stern, MD, PhD, FACS,
of White Plains, New York, polled 24 neurosurgeons and orthopedic spine surgeons
in the New York City area and found that while two-thirds use minimally invasive
techniques, not a single one uses laser technology. Dr. Stern, in his
review, shared the fact that there are no published controlled studies reporting
percutaneous laser discectomy. He concluded that "Evidenced-based data
regarding application of laser technologies to the spine are limited.
There are no prospective studies comparing percutaneous discectomy with
conventional microlumbar discectomy or minimally invasive procedures making
analysis difficult. His final statement is that "to date, laser discectomy
may be more effective in attracting patients than in treating them."
Robert S. Biscup, DO, MS, FAOAO, of Fort Lauderdale, Florida, provided
commentary in the same issue of SpineLine, under the title of "Lasers in Spine
Surgery... and Other Controversial Topics." Dr. Biscup states early on in
his commentary that laser is just a tool and that it is not the laser that
determines clinical outcomes but the surgeon using it. He goes on to talk
about medical marketing via airline magazines, newspapers and the internet with
the explicit desire to attract patients to a practice. Dr. Biscup
concludes that "the laser is just another option for performing current,
sometimes longstanding, procedures. A great and powerful tool, the laser's
suitability depends on the experience and training of the surgeon."
Does insurance pay for laser spine surgery?
Blue Cross and Blue Shield of Texas and Aetna, among other major carriers,
consider laser spine surgery to be unproven technology and do not pay for this
procedure. Most carriers currently consider laser spine surgery to
be experimental and investigational.
Links to sites that may answer your questions about laser spine surgery
eHow - Pros and Cons of Laser Surgery
SpineHealth - Laser Disc Decompression for Spinal Stenosis: Does It Work
Mayo Clinic - Effectiveness of Laser Spine Surgery for Pain Relief Remains
Unproven
Do any of the surgeons at Central Texas Spine Institute perform laser spine
surgery?
No. Dr. Dryer performed several laser discectomies in the mid 1990's
and was not pleased with the results. None of our other surgeons have
experience with laser spine surgery.
