Laser Spine Surgery

On March 1st, 2019, the Laser Spine Institute located in Florida and Arizona closed suddenly. Based out of Tampa, Florida, the center closed all of its doors with little warning to its employees or patients. Many patients paid out of pocket or spent large sums of money to travel to the Laser Spine Institute. The public attention towards laser spine surgery has been powered by internet marketing and since 2011, “Laser Spine Surgery” has led Google searches for spine-related terms.

The topic of Laser Spine Surgery is a controversial topic. I wrote a blog in 2015 addressing the increased questions I was receiving in regards to the center and their claims of smaller incisions and quicker recoveries.

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Simplistically, a laser is a tool to cut, burn or disintegrate tissue. In the spine, the laser is utilized via a handheld device or attached to the microscope. The claims made by these centers utilizing lasers include small incisions, less blood loss and less scarring; have simply not been proven.

A recent article in the Journal of the American Academy of Orthopedic Surgeons concluded that “NO clinical or preclinical data suggest a benefit and that there are some specific disadvantages to the use of lasers.”

Both the North American Spine Society and the Canadian Agency for Drugs and Technologies in Health recommend against laser spine surgery.

To date, there is limited high-quality research demonstrating the benefit of laser spine surgery.

Percutaneous discectomy techniques using a laser device have fallen out of favor secondary to limited evidence and safety issues. Potential safety concerns include heat injury to nerves, bone, cartilage and disc tissue. There is also a case report of a vascular injury to the vessels in front of the disc from a posterior procedure utilizing a laser.

Another procedure commonly utilizing a laser is percutaneous laser discectomy. In a study comparing Percutaneous Laser Discectomy vs traditional microdiscectomy, after 2 years of follow-up the traditional microdiscectomy group had quicker recovery and lower revision rate.

Sometimes, lasers can be used to assist a surgeon with traditional open activities such as facet joint medial branch rhizotomies, discectomies in interbody fusion and foramintomies; in nearly all of these instances no benefit is seen using the laser vs traditional techniques.

Laser Spine Surgery

For the patient undergoing the laser procedure, they had a 50% higher chance of requiring a second surgery.

Ultimately, the data in regards to lasers in spine surgery does not support the claims that this technique is better or safer than traditional spine surgery options.