The use of lasers in spine surgery has been of interest to the general public for several years now, especially those suffering from spinal problems. As thoughtful people, we always want to find the best, least invasive solution to our problems and many people envision laser surgery to be the least invasive method.
The most common method of use has been in the treatment of a damaged disc. This is done by inserting a large needle into a degenerating, bulging or protruding disc in the lumbar (lower) spine and then inserting a laser fiber in through the needle and vaporizing a portion of the center of the disc. There are other methods that achieve this as well, either with chemical dissolution using a substance called chymopapain, or by inserting the needle and heating the disc, called thermo-coagulation or by using a special device that essentially minces and suctions out a portion of the disc.
I personally believe none of these methods are capable of reliably removing a herniated or extruded disc fragment that would be compressing a nerve. All of these methods have had some initial success in reducing back pain but there is no evidence that they produce significant lasting effects and in my experience, more often than not, the pain recurs. There is a new technique that has recently been developed in which the vertebral bone in the lumbar spine is entered with a needle and a nerve in the bone, the vertebra-basilar nerve, is heated and this method seems to hold promise for relieving protracted low back pain for patients with specific indications.
The other use of the laser in spine surgery has been to remove a herniated/extruded disc compressing a nerve in the lumbar spine. In this method the spinal canal is entered using a small tube and microscope or with an endoscope (both are minimally invasive techniques that require only a very small incision) and expose the herniated/extruded disc that is compressing the nerve and then vaporizing it with a CO2 laser so that it no longer compresses the nerve. With this method the surgeon must be careful to only vaporize the disc and not the adjacent nerves.
There is no evidence that eliminating a disc fragment by vaporizing it with a laser is any more advantageous then removing the fragment by excising it with specially designed micro-instruments. Minimally-invasive procedures using these micro-instruments in the hands of experienced and board-certified surgeons has been clinically proven and is why we prefer these methods while treating patients in our practice.
Learn more about the minimally-invasive treatment options available from Dr. Kornel and Dr. Sharma and how they can reduce or eliminate your back, neck, or spine pain.
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