Figure 1. In minimally invasive surgery, a series of progressively larger tubes are used to create a small tunnel through the muscles to the bone and disc.
Figure 2. The herniated disc material compressing the nerve root is removed with grasping instruments.
Q&A: Laser Spine Surgery
Q: Why don't Mayfield Clinic spine surgeons perform or endorse laser spine surgery?
A:While lasers have been used in surgical procedures for more than 20 years,there is no scientifically proven benefit for spine disc removal by laser, as compared to more conventional spine surgery.
The approach used in laser spine surgery is the same as that used in conventional spine surgery. Both can be done with minimally invasive techniques (Figure 1), and both have similar recovery times. In addition, both involve a laminotomy or laminectomy to gain access to the disc. Once the disc is visualized with either a microscope or endoscope, it is removed. This is where the difference occurs: the laser vaporizes the disc with laser energy, and with conventional surgery it is surgically removed with surgical instruments (Figure 2).
According to the Cochrane Review, which is generally considered the definitive source for information summarizing complex medical scientific data, "Trials of automated percutaneous discectomy and laser discectomy suggest that clinical outcomes following treatment are at best fair and certainly worse than after microdiscectomy (conventional surgery)." Mayfield surgeons agree with this assessment and therefore do not endorse or recommend laser spine surgery for our patients.
Learn more about Minimally Invasive Spine Surgery
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MAYFIELD CLINIC POSITION STATEMENT
revised: March 4, 2009
The information in this Q&A is not intended to be a substitute for professional medical advice, nor is it intended to serve as medical diagnosis or treatment. The information is presented for the sole purpose of disseminating health information. It is not intended and must not be taken to be the provision or practice of medical, nursing, or professional health care advice or services in any jurisdiction. Always seek the advice of your physician or other qualified health provider if you have questions regarding a medical condition, and always seek the advice of your physician or provider before starting any new treatment. The information about drugs contained in this Q&A is general in nature and is intended for use as an educational aid. It does not cover all possible uses, actions, precautions, side effects, or interactions of these medicines. As such, the information is not intended to serve as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular drug.