Laser Back Surgery
Laser back surgery is a type of back surgery. It’s different from other types of back surgery, such as traditional back surgery and minimally invasive spine surgery (MISS).
Continue reading to learn more about laser back surgery, its potential benefits and drawbacks, and possible alternative treatment options.
How is laser back surgery different?
There are a few different types of back surgery, including the traditional, or open approach, MISS, and laser back surgery. Below, we’ll explore what makes each technique different.
. Traditional
During traditional back surgery, the surgeon makes a long incision in the back. Then, they move muscles and other tissue away in order to access the affected area of the spine. This leads to a longer recovery time, and may cause tissue damage.
. MISS
MISS uses a smaller incision than traditional surgery. A special tool called a tubular retractor is used to create a small tunnel in order to access the surgical site. Various specialized tools can be placed into this tunnel during the surgery.
Because it’s less invasive, MISS can lead to less pain and a faster recovery.
. Laser
During laser back surgery, a thread-like fiber optic laser removes some or all of the central nucleus of the herniated intervertebral disc to relieve compression on the spinal cord and nearby spinal nerve roots. Unlike the other types of back surgery, it may only be appropriate for very specific conditions, such as when nerve compression is causing pain. Laser back surgery doesn’t work for every individual with low back pain.
Laser back surgery and MISS are often mistaken for one another, or are assumed to be the same. Further complicating this is that MISS may sometimes, but not always, use lasers.
Laser back surgery has been slow to gain broad acceptance by back surgeons, many of whom remain satisfied with their outcomes performing MISS. A 2021 analysis of 58 laser back surgery cases reported favorable outcomes in carefully selected back pain patients.
What to expect
When pressure is placed on a nerve, it can lead to pain and discomfort.
In the spine, things like a herniated disc or a bone spur can often cause compression. An example of one such condition is sciatica, where the sciatic nerve becomes pinched, leading to pain in the lower back and leg.
Lasers can be used to help decompress the nerve, with the aim of relieving pain. This is done under local anesthesia, which means that the skin and surrounding muscles of your back will be numbed to pain. You may also be sedated for the procedure.
One of the more well-studied methods of laser back surgery is called percutaneous laser disc decompression (PLDD). This procedure uses a laser to remove disc tissue that may be causing nerve compression and pain.
During PLDD, a small probe containing a laser is passed into the core of the affected disc. This is accomplished with the help of imaging technology. Then, the energy from the laser is used to carefully remove tissue that may be pressing on the nerve.
Benefits
The benefits of laser back surgery are that it’s less invasive than the traditional approach to back surgery. Additionally, it can be performed in an outpatient setting under local anesthesia. In many ways, it’s very similar to MISS.
There’s a limited amount of information regarding the overall effectiveness of laser back surgery in comparison to other methods.
One 2017 study compared PLDD to another surgical approach called microdiscectomy. Investigators found that both procedures had a similar outcome over a two-year recovery period.
However, it should be noted that when discussing PLDD, the researchers included additional follow-up surgery after PLDD as part of a normal outcome.
Drawbacks
Laser back surgery isn’t recommended for some conditions, such as degenerative spine diseases. Additionally, more complex or complicated conditions will often require a more traditional surgical approach.
One of the drawbacks to laser back surgery is that you could need an additional surgery for your condition. A 2015 study found that microdiscectomy had a lower number of reoperations required compared to PLDD.
Additionally, a 2017 meta-analysis of seven different surgeries for herniated discs in the lumbar region found that PLDD ranked among the worst based off of success rate, and it was in the middle for reoperation rate.
Side effects
Every procedure can have potential side effects or complications. This is also true for laser back surgery.
One of the main potential complications from laser back surgery is damage to the surrounding tissue. Because a laser is used for the procedure, heat damage can occur to surrounding nerves, bone, and cartilage.
Another possible complication is infection. This can occur during the placement of the probe if proper sanitization procedures aren’t followed. In some cases, you may be provided with prophylactic antibiotics to help prevent an infection.
Recovery time
Recovery time can vary by individual and the specific procedure performed. Some people may be able to return to normal activities relatively quickly, while others may require more time. How does laser back surgery compare to other types of back surgery?
Having a traditional back surgery requires a hospital stay after the procedure, and recovery may take many weeks. According to the Johns Hopkins Spine Service, people undergoing traditional spine surgery should expect to miss 8 to 12 weeks of work.
In contrast, MISS is often performed as an outpatient procedure, meaning that you can go home the same day. Generally speaking, people who’ve undergone MISS may return to work in around six weeks.
You may have read that laser back surgery has a faster recovery than other procedures. However, there’s actually been very little research into how the recovery time compares.
In fact, the 2015 study discussed above found that recovery from microdiscectomy was faster than for PLDD.
Alternative treatments
Not everyone that has back pain requires back surgery. In fact, if you’re experiencing back pain, your doctor will likely recommend that you try more conservative treatments first, unless you have a progressive neurologic loss or loss of bowel or bladder function.
There are a variety of things that you can try to help relieve pain due to conditions like sciatica. Examples include:
. Medications
Your doctor can prescribe several different types of drugs to help with pain. These can include things like
. nonsteroidal anti-inflammatory drugs (NSAIDs)
. muscle relaxants
. opioid pain relievers (for a very short period of time only)
. tricyclic antidepressants
. anti-seizure drugs
. Steroid injections
Getting an injection of corticosteroids near the affected area can help to relieve inflammation around the nerve. However, the injection’s effects typically go away after a few months, and you can only receive so many due to the risk of side effects.
. Physical therapy
Physical therapy can help with strength and flexibility and to prevent future problems. It can involve various exercises, stretches, and corrections to posture.
. At-home care
Using things like hot or cold packs can help to ease pain. Additionally, some over-the-counter NSAIDs like ibuprofen may also help.
. Alternative medicine
Some people use methods such as acupuncture and chiropractic services to help with back pain. If you decide to try these methods, you should be sure to visit a qualified professional.
The bottom line
Laser back surgery is a type of back surgery that uses a laser to remove tissue that may be pressing on or pinching a nerve. The procedure is less invasive than other back surgery methods, but it may require additional follow-up surgeries.
So far, little concrete information is available on if laser back surgery is more beneficial than other types of back surgery. Additionally, comparisons of cost effectiveness compared to other methods have yet to be made.
If you need to have back surgery, you should discuss all the possible options with your doctor. That way, you’ll be able to receive the treatment that’s best for you.
Source:
. https://www.healthline.com/health/back-pain/laser-back-surgery