Jonathan D. Lewin, MD Discusses Lasers in Spine Surgery

Jonathan D. Lewin, MD Discusses Lasers in Spine Surgery

The invention of laser over 50 years ago, in which focal light beams are targeted over a very narrow wavelength range, in a coherent fashion, has revolutionized medicine. Currently, its major uses are in ophthalmology, oncology, cosmetic surgery, as well as new advances in biomedical research and engineering. The ability of the laser with its short wavelength to directly ablate tissue makes it a powerful tool in multiple disciplines.

Particular to spine surgery, the use of the laser has potential for treatment of disc herniation in the cervical and lumbar spine. In addition, the combination of laser technology with endoscopic spinal equipment has the potential to minimize surgical incision to allow for a pinpoint and focused removal of disc bulge and/or herniation. The European and Asian community has been using laser in a percutaneous approach for over five to seven years, and its use in the United States is now gaining ground. However, it should be mentioned that with its new onset of use in North America, the data is equivocal in terms of its long-term efficacy, although there are multiple reports of its good short and medium-term efficacy. It stands to reason that a grossly herniated or extruded disc may be difficult via a laser technology, because of the short wavelength of the beam as well as its inability to turn a corner. However, for contained herniations in which the posterior longitudinal ligament is still intact, this may be an option. At The Center for Spinal Disorders we are attempting to individualize this application, as we do with all new and exciting technologies. Not everyone is an appropriate candidate, but there are those who can be helped with this revolutionary technology.

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