RANDALL F. DRYER, M.D.
TOP RATED U.S. SPINE SURGEON
Laser Spine Surgery
If you are considering laser spine surgery, we recommend reading this article by David Armstrong from Bloomberg.
Q. What is laser spine surgery?
A. 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.
Q. Are there different types of lasers?
A. 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.
Q. How is the laser used in spinal surgery?
A. 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.
Q. What do the “experts’ think?
A. 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.”
Q. Does insurance pay for laser spine surgery?
A. 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
- SpineHealth – Laser Disc Decompression for Spinal Stenosis: Does It Work
- Mayo Clinic – Effectiveness of Laser Spine Surgery for Pain Relief Remains Unproven
Q. Does Dr. Dryer perform laser spine surgery?
A. Dr. Dryer performed several laser discectomies in the mid 1990’s and was not pleased with the results.