Many people with chronic back pain are attracted to the idea of laser spine surgery because it conjures up an image of a quick and easy surgery that delivers a fast recovery.
But even though laser surgery in minimal instances can be very effective for some conditions, it is not for everyone and not a miracle cure, so just keep that in mind if you are considering back surgery.
The Co-Director of Cleveland Clinic’s Center for Spine Health, Michael Steinmetz, MD, offers his answers and insight to common questions about laser spine surgery.
How does laser surgery compare with other treatments?
Though it may seem like a new method, laser spine surgery has actually been around for decades. And actually, in this treatment, it’s not always the case that the surgeon will actually use a laser, says Dr. Steinmetz.
Traditionally in spinal surgery, the surgeon makes an incision through the skin to the muscle. The surgeon starts to dissect the muscles away from the spine to get to the tissue or other problem area. However, this can cause damage to the surrounding soft tissue which can cause pain, blood loss and a longer stay in the hospital to recover properly.
Another method is a minimally invasive procedure which is an alternative to traditional ‘open’ spine surgery. In this surgery, the doctor makes a smaller incision and uses a tool to burrow through to the problem area. And unlike open spine surgery, muscles aren’t pulled away so there’s minimal damage to the surrounding tissue and recovery time is often shorter.
This procedure has more recently been called laser surgery, typically. But this treatment is probably actually minimally invasive surgery, says Dr. Steinmetz. This is because your surgeon doesn’t always use a laser (as opposed to microsurgical instruments such as a scalpel for this method.
When should the surgeon use a laser?
Lasers are used, as Dr. Steinmetz and his colleagues do, but only for certain conditions. He says he would hardly ever use a laser for people with degenerative spine disease, for example. But he does use lasers in the following cases:
- Removing tumors from the spinal cord
- Removing soft tissue or bone around a nerve
- Shrinking disc material around a nerve
Only around 30 percent of surgeries for minimally invasive procedures in standard practice, and those may not always involve the use of a laser, he says.
What are the potential complications of laser spine surgery?
Inadequate procedure: One of the most common complications with laser surgery is having an inadequate operation, says Dr. Steinmetz, and that sometimes results in the need for additional surgery.
If you have a spinal deformity that causes leg pain, minimally invasive or laser surgery might minimize the pain briefly, but may not treat the root cause fully.
“You may have pain from the back instability,” he says. “If all one uses is a laser, the bigger problem is missed.”
Nerve damage: Though using a laser during surgery can often limit nerve damage, an inexperienced surgeon using a laser could actually increase the chances of tissue or nerve damage, says Dr. Steinmetz.
How do you know which treatment is right for you?
Choosing a physician who is very well-experienced in both traditional and minimally invasive procedures is what Dr. Steinmetz recommends. And always get a second opinion before getting back surgery, he says.
In order to make sure you’re getting the best approach for your condition, do your research and come up a list of questions to ask your surgeon. Some questions you should ask might be”
- What does the operation involve?
- Will a laser likely be used?
- Will there likely be fusion involved?
- Which procedure would be better, minimally invasive or traditional and why?
- What are my alternative options?
- What exactly will the surgery treat (back or leg pain or both)?
- How experienced is the physician? Have they been trained formally (i.e. fellowship) in spinal and/or minimally invasive surgery?
- Does the surgeon do both traditional “open” approaches and minimally invasive surgery? This is the most ideal situation.
Basically, the more complicated back problems usually require traditional surgery for the best results. Dr. Steinmetz always chooses the more appropriate procedure for each patient depending on their particular conditon.
“There is no magic bullet or miracle for spine disease,” he says.
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