Laser and Back Surgery

Laser and Back Surgery

Laser and Back Surgery

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What the deal with laser and back surgery? This is a common question we are asked by patients.

Our answer to this question is “not much” . The laser is a tool that has been used in surgery for over 35 years. Many associate the use of the laser as ultimate fix all as its use has been widely marketed in other specialties including eye surgery, dermatology, and even dentistry. For some procedures the use of the laser has been an invaluable tool to remove soft tissue with precision. In spinal surgery, the use of the laser is controversial as no clear benefit when compared to traditional surgery has been shown. This is especially the case when considering surgery to remove spinal stenosis (bone). Remember that there is no surgery that is completely risk free and noninvasive. Surgery should always be the last treatment option, regardless of the approach used.

As for the specific use of laser and back surgery,  there is definitely a marketing aspect to its use.  The goals of spine surgery remain the same for almost every situation.  If the nerve is compressed,  the goal is to eliminate the cause of compression. That goal can be achieved with many techniques.  Traditional techniques include removing the disk material by direct visualization.  By utilizing small knives, and curets, the compressing material is mechanically removed off the nerve.  The compressing materials can be soft and gelatinous, like the soft nucleus of the disk,  or firm like crab meat with the annulus.  In the situation of spinal stenosis,  actual bone spurs must be removes.  Sometimes,  it requires use of micro-chisels and high speed burs.    In my experience, there is no substitute for direct visualization, for safety and effectiveness.  The laser sounds like an attractive alternative,  but it is not as precise as the other techniques for spine surgery.  Lasers are widely used in eye surgery, and for ablation of softer tissues. Lasers work well in uniform tissues, that have a predictable reaction to the laser energy.   But in the spine,  the variability of structures causing compression on the nerves make laser use too unpredictable.  To decompress the spine,  often the surgeon will need to remove bone, then ligament, then fat, then disk material or additional bone.  As the laser has different impacts on each of the materials,  there is potential that use of the laser will cause  unintentional damage to the nerves.  If you are considering Laser spine surgery,  please discuss the technique with your surgeon, and consider getting a second opinion.

Citations

  • Zhao XL, Fu ZJ, Xu YG, Zhao XJ, Song WG, Zheng H. Treatment of lumbar intervertebral disc herniation using C-arm fluoroscopy guided target percutaneous laser disc decompression. Photomed Laser Surg. 2012 Feb;30(2):92-5. PubMed PMID: 22150064

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Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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