Lasers in Spine Surgery: Their Role in Endoscopic and Minimally Invasive Spine Surgery

December 27, 2023


Dr Christopher Yeung
BY Christopher A. Yeung, M.D.
Dr. Christopher Yeung is a board-certified, fellowship-trained orthopedic spine surgeon, with a special interest in minimally invasive spine surgery techniques with a philosophy of choosing the least invasive yet most effective method to treat spine problems.
Lasers in Spine Surgery: Their Role in Endoscopic and Minimally Invasive Spine Surgery

Back pain and spinal conditions afflict a significant portion of the population, with nearly 40% of adults in the United States grappling with chronic back pain and related issues. Amidst this landscape, the allure of laser spine surgery has emerged as a potential remedy. This innovative instrument leveraging laser technology has been marketed as a miracle cure for back pain. However, understanding its true nature and effectiveness is vital for informed decision-making.

In the quest for effective solutions to spinal conditions, medical advancements have introduced various surgical techniques that promise quicker recovery times and reduced trauma. One such technique that has garnered attention is laser spine surgery. However, as medical knowledge evolves, it becomes increasingly important to critically examine the claims of laser spine surgery while exploring alternative options that offer tangible benefits. This article aims to debunk the myths surrounding laser spine surgery and shed light on the advantages of minimally invasive and endoscopic spine surgery.

While the concept of laser spine surgery might seem enticing, it’s important to note that no standardized procedure is recognized by reputable medical institutions such as the American Academy of Orthopaedic Surgeons under the moniker “Laser Spine Surgery.” The term often refers to using lasers as part of broader surgical techniques, primarily in minimally invasive and endoscopic spine surgeries.

What Is a LASER and How Is It Utilized in Spine Surgery?

What Is a LASER and How Is It Utilized in Spine Surgery?

Lasers are often presented as a miraculous solution for various painful spinal conditions. In modern medicine, LASER (Light Amplification by Stimulating Emission of Radiation) has emerged as an instrument of precise ablation in various surgical procedures, including spine surgery. 

However, laser usage constitutes only a part of the comprehensive procedure and is not typically the decisive factor determining the overall success or failure of the treatment. In spine surgery, a laser is employed to target and reduce problematic tissues, like herniated discs, bone spurs, or other spinal irregularities causing nerve compression or irritation. The focused, intense light energy emitted by the laser can ablate or coagulate tissues, offering pain relief and enhancing functionality.

Lasers in Endoscopic Spine Surgery – Targeted & Precise

In minimally invasive spine procedures, such as endoscopic spine surgery, where the working area for tools is limited, lasers prove effective in treating tissues without obstructing the surgeon’s view. The Hol:YAG laser stands out as the most commonly utilized laser in spine surgery, delivered through small fiber optics and equipped with probes featuring side-firing and steerable straight-firing capabilities. This versatility enables the treatment of challenging, hard-to-reach areas within the surgical field. 

Lasers in Endoscopic Spine Surgery – Targeted & Precise

The precision of the treatment area allows lasers to be safely employed near sensitive structures like nerve roots. In spine surgery, lasers find significant utility in endoscopic lumbar discectomies, foraminal decompression (foraminoplasty), and facet nerve ablation. 

Potential Complications with Lasers in Spine Surgery

A recent article – “Lasers in Spine Surgery,” published in the Journal of the American Academy of Orthopaedic Surgeons, concluded that lasers add “distinct potential complications without any corresponding clinical benefits” It is important to note potential complications associated with lasers, including neurologic injury, vertebral osteonecrosis, and aseptic discitis. These complications can be mitigated by selectively targeting the laser beam to avoid direct focus on nerves or vertebral endplates and by avoiding prolonged, continuous firing that may lead to heat buildup in adjacent tissues.  

Realistic Expectations

However, patients need to have realistic expectations about lasers in spine surgery. The perceived advantages are sometimes exaggerated, leading to unrealistic expectations among patients seeking quick fixes.

It’s not a miraculous fix for all spine problems. The appropriateness of laser technology depends on the specific condition and the patient’s medical history. The laser, used in endoscopic spine surgery, can be very effective and precise instrument in the experienced hands of an endoscopic spine surgeon.  Traditional surgical techniques might be the best option in many cases. 

Navigating the Lasers in Spine Surgery Marketing Hype

Patients should approach the term “laser spine surgery” with caution. Not all procedures claiming to use lasers have equal benefits or outcomes. Choosing a reputable medical center with experienced surgeons who can assess whether laser technology is the best option for your spine issue is crucial. Remember whether an instrument is a solution or a surgical procedure.

The Rise of Minimally Invasive Spine Surgery

In contrast to the laser hype, minimally invasive spine surgery offers a proven track record and well-established benefits. This approach involves one or two small incisions and reduced muscle disruption compared to traditional open surgery. Specialized instruments and advanced imaging allow surgeons to access the affected area while minimizing trauma to surrounding tissues. This results in reduced postoperative pain, shorter hospital stays and faster recovery.

The Precision of Endoscopic Spine Surgery – Ultra-Minimally Invasive

Endoscopic spine surgery takes the concept of minimally invasive surgery to the next level by employing state-of-the-art technology. Through tiny ¼ inch incisions, surgeons insert a thin tube with a camera and light source, enabling visualization of the surgical site on a screen. This technique provides high-definition spine views, allowing surgeons to perform complex procedures with remarkable precision.

The Precision of Endoscopic Spine Surgery – Ultra-Minimally Invasive

Endoscopic spine surgery’s benefits include reduced blood loss, minimal scarring and the potential for outpatient procedures. Patients often experience less discomfort and can resume daily activities sooner than with minimally invasive and traditional open surgeries.

Debunking the Myths: Facts about Minimally Invasive and Endoscopic Spine Surgery

Here are some facts about minimally invasive and endoscopic spine surgery: 

  1. Innovative techniques backed by evidence: Unlike laser spine surgery, minimally invasive and endoscopic techniques have robust clinical evidence supporting their efficacy. Numerous studies have demonstrated their advantages in reducing postoperative pain, shortening hospital stays and improving patient outcomes.
  2. Tailored to individual needs: Minimally invasive and endoscopic approaches are not one-size-fits-all solutions. Surgeons carefully evaluate each patient’s condition and determine the most suitable technique. This personalized approach ensures better outcomes and patient satisfaction.
  3. Long-term efficacy: These techniques have demonstrated long-term effectiveness in treating various spinal conditions, debunking concerns about short-lived results or potential harm.

What Can Endoscopic and Minimally Invasive Spine Surgery Treat?

They can be used to treat numerous spinal issues that affect your neck and back. Some of the most common conditions laser back surgery can help with include:

  • Spinal stenosis: Spinal stenosis puts pressure on your nerves due to narrowing the spaces in your spine. Laser in surgery can be an effective treatment option since the instrument can remove tissue that’s putting pressure on your nerves, relieving painful symptoms and encouraging a more active lifestyle.
  • Tumors: Spinal tumors develop within the spine, either in the spinal canal or within the bones. Tumors have different classifications based on where they occur in the back and along the spinal cord. Your doctor may recommend utilizing a laser in spine surgery to reduce the tumor’s tissue and pressure on your spinal cord. 
  • Herniated discs: This condition occurs when the nucleus from the spinal disc pushes into the spinal canal through a rupture or tear. Herniated discs can be extremely painful, especially if you have more than one at a time. Endoscopic spine surgery can help remove and repair the soft tissue spilling into the spinal canal, helping alleviate the pressure causing pain. 
  • Pinched nerves: Pinched nerves can occur anywhere but are often present in the back due to excessive pressure on different nerves. Pinched nerve pain can be localized or radiate to other body parts. People with a pinched nerve may feel numbness, tingling or pain. Lasers in surgery can help remove the soft tissue putting pressure on the surrounding nerves to help reduce pain, numbness and tingling. 
  • Sciatica: Sciatica can be caused by different factors, such as bone spurs, spinal stenosis or herniated discs. Anything that puts pressure on the sciatic nerve can cause pain. Lasers in surgery can be an effective way to reduce stress on your sciatic nerve to help improve symptoms. 

Conclusion: A Balanced Approach to Spinal Surgery

As patients consider surgical interventions for spinal issues, it is crucial to approach the decision with a balanced perspective. The myths surrounding laser spine surgery must be debunked by critically examining evidence. Instead, patients can opt for minimally invasive or endoscopic spine surgery, benefiting from proven techniques including the use of a laser, that offer tangible advantages. By collaborating closely with qualified spine specialists, patients can make informed choices, prioritizing short-term relief and long-term well-being.

Trust Desert Institute for Spine Care for Your Ultra-Minimally Invasive Spine Surgical Needs

At Desert Institute for Spine Care (DISC), we understand how limiting a spinal injury or condition can be. That’s why our team of board-certified surgical specialists is here to help you find relief from your pain so you can start enjoying life again. We’ll help you find the least invasive treatment available that can help you find relief from your condition.

Our surgical specialists have been using lasers safely in our endoscopic procedures for 20 years. They can offer minimally invasive treatments to reduce recovery time while getting you back on your feet. Contact us today to speak to a specialist about our treatment options or schedule an appointment.

Trust Desert Institute for Spine Care for Your Ultra-Minimally Invasive Spine Surgical Needs
Previous ArticleExercises to Treat Facet Syndrome Next ArticleUnveiling the Best Surgical Option for Herniated Discs — Microdiscectomy vs. Endoscopic Discectomy