What is Laser Spine Surgery?
Laser spine surgery is the latest, minimally invasive technique used to manage various types of spinal issues that occur in the neck, back, or related to nerve pain. Planned to alleviate these spinal issues in healthy tissues, the laser spine surgery method utilizes a focused laser to provide relief and manage specific structures within the spine. As care provided for spinal issues continues to develop, laser techniques have become a vital part of the larger category of minimally invasive spinal surgeries, offering carefully projected treatment options for patients who may not need considerable traditional open surgeries.
Laser Stands for Light amplification by stimulated emission of radiation. A laser produces a focused beam of light with high energy and accuracy. In spinal surgery, this energy is used in a calculated way to remove, reduce, or remodel soft tissues involved in nerve compression or inflammation. Lasers are mostly utilised on soft tissues like disc material, ligament fibres, and areas causing nerve discomfort.
The purpose is precise tissue modification while conserving nearby structures. Laser spinal surgery cannot be used in all cases; not all spinal diseases are suitable for treatment by laser-based techniques.
Laser spine surgery is a subtype of minimally invasive spine surgery. Minimally invasive spinal surgery depends on making smaller cuts, avoiding contact with nearby healthy tissues, and the use of advanced specialized instruments in combination, like endoscopes, tubular retractors, and other smaller instruments.
Conditions Treated Using Laser Spine Procedures
Laser spinal surgeries are used in treating conditions of cervical spine (neck) namely, herniated discs, nerve root compression, and canal narrowing that involves abnormal narrowing of the spinal canal, conditions that affect thoracic spine (mid-back) like disc or nerve related issues, and lumbar spine (lower-back) issues where laser assisted techniques are used especially sciatic and lower limb issues.
Laser techniques are used to treat diseases like herniated or bulging discs, where the laser vaporizes the displaced disc material that presses on nerves, reducing the pain and preserving the nearby healthy tissue.
In case of sciatica, which is often caused by disc herniation or spinal stenosis, laser spine surgery reduces the pressure causing sciatic nerve pain.
In treating spinal stenosis, laser surgery assists in decompressing nerves by cleaning soft tissue and excessive growth of ligament.
In degenerative disc diseases, laser spine surgery helps in reducing pain due to problematic discs, especially in cases where other modern techniques fail.
In case of pinched nerves (radiculopathy), laser surgery helps in decompression by removing herniated disc fragments or inflamed tissue.
Laser spine surgery treatment of facet joint disease involves laser facet ablation (rhizotomy) that targets and treats nerve endings in arthritic facet joints to block pain signals.
Laser spine surgery is used to treat annular tears by removing damaged tissue and sealing the tear and encouraging healing, and decreasing the inflammation.
Laser spine surgery is used for bone spurs and scar tissue by managing soft tissue components.
Laser spine surgery is also used in treating cervical disc issues, especially herniations in neck discs C3-C7. The technique also helps in increasing mobility. Lasers are also used to decrease the volume of tumors in certain cases and help decrease the abnormal pressure on the spinal cord.
Types of Laser Spine Surgery
Laser spine surgery is not a single method or procedure; it is a combination of various other techniques that are different on the basis of approach, instrumentation, and tissues that they treat. Key types of laser spine surgery include
- Percutaneous laser disc decompression (PLDD), where a laser is sent via a small needle to remove a small amount of disc material.
- Endoscopic laser discectomy uses a tiny camera along with a laser to treat disc issues through a small opening.
- Endoscopic laser foraminoplasty is where a laser widens the narrow tunnel where nerve exits the spine.
Endoscopic laser annuloplasty is where a laser treats irritation or small tears in the outer disc wall. - Endoscopic laser rhizolysis is used to target small, painful nerves around the spinal cord. Laser-associated microdiscectomy is a technique with added laser accuracy.
- Laser foraminotomy is where a laser is and clear soft tissues from the nerve exit passage.
- Laser facet rhizotomy is where a laser ablates tiny nerves around the joints of the facet.
- Laser soft tissue ablation shrinks or removes thickened soft tissue like ligaments.
- Laser nucleoplasty is where a laser removes or shrinks the laser disc material internally.
- Laser discoplasty is where a laser alters disc structure.
| Procedure Name | Laser Spine |
|---|---|
| Type of Surgery | Minimally invasive spinal surgery |
| Type of Anesthesia | Local anesthesia with sedation |
| Procedure Duration | Typically 30 mins to 1.5 hours |
| Recovery Duration | The patient can return to light activity in a few days, and full recovery is within 2 to 6 weeks, depending on specific procedures and patient factors. |
Laser Spine: Pre-Op & Post-Op Care
The procedure for laser spine surgery is divided into three different phases: pre-operative phase, intra-operative phase, and post-operative phase. These phases are designed to make sure of patient safety, accuracy of procedure, and optimal recovery. The pre-operative stage is examining the patient and making them ready for surgery, which is followed by the surgical procedure itself during the intraoperative stage, and finally the post-operative stage, where the patient returns to normal activities after surgery becomes an essential objective.
Before the Laser Spine Surgery
Initial examination begins with the surgeon examining the symptoms shown by the patient, namely back pain, radiating leg pain, numbness, or weakness, to get to know the specific nerves, groups of nerves that are affected by a disease, injury, or condition.
A neurological assessment is carried out to check reflexes, the strength of muscles, and sensory responses. This is followed by diagnosis by using imaging techniques like magnetic resonance imaging (MRI) to get to know disc herniation, nerve compression, or changes in soft tissue that are the reasons for the appearance of symptoms.
Additional imaging, such as computed tomography scans or X-rays, may be ordered to evaluate bone alignment or any deteriorating changes in the spine.
After completion of this, the decision is up to the surgeon to decide if the patient’s disease condition can be effectively treated by using laser techniques or if any other surgical technique is needed.
The patient is then provided a guidance by the surgeon about the expected results, shortcomings of the laser surgery, possible risks, and any other treatment options that are available.
Periodic blood evaluations, Electrocardiograms, and pre-anesthesia examinations are carried out to make sure that the patient is in perfect condition to undergo surgical treatment.
If the patient is already dealing with conditions like diabetes, hypertension, or heart disease, they are stabilized first, and medicines such as blood thinners are adjusted.
The patient is then advised not to eat anything for 6 to 8 hours before the laser spinal procedure to make sure that anesthesia can be safely given.
Instructions are given to the patient regarding bathing, shaving, and preparing the skin for surgery.
Final okay from the patient is taken, and then the surgeon informs the patient that surgery, being a day-care or an overnight stay, is mandatory.
Intra-Operating Procedure
The phase starts with giving the patient anesthesia. First, the patient is taken into the operating room and is asked to lie-down face down to give the surgeon all necessary approach angles to the spinal cord.
Local anesthesia is given, with sedation or light general anesthesia is given, and essential signs are routinely kept an eye upon.
The surgical site is then sterilised with an antiseptic solution, and sterile drape are applied to keep a pollution-free environment.
Fluoroscopy (live X-ray guidance) is kept in position to assist the surgeon in precisely targeting the affected level of the spinal cord.
A tiny cut measuring 5-8 mm long is made on the skin overlying the affected area of the spinal cord.
A narrow tubular retractor is then inserted through the cut to create a way to the disc or compressed nerve without cutting any major muscles.
The surgeon then advances a laser probe via this tubular channel while simultaneously keeping an eye on the area on the imaging monitors.
Controlled laser energy is utilised to lessen or vaporize the herniated disc material or soft tissue pressing against the nerve.
The surgeon then works slowly and accurately to pacify the nerve while protecting the nearby structures.
Fluoroscopy is utilised again to confirm that the nerve has been sufficiently decompressed and the pressure is reduced.
The instruments and the retractors are then removed, and the small cut is closed with the help of a single suture, adhesive glue, or a strip.
After completion of this procedure, the patient is then shifted to the recovery room for observation.
After the Laser spinal surgery
During the immediate recovery phase, the patient is kept under continuous observation as the effects of anesthesia start to decrease. Systematic monitoring of important parameters is conducted, level of pain and the neurological condition being the main focus.
Most patients are encouraged to sit up and walk a few hours after the surgery is finished to increase blood circulation in the body and decrease stiffness.
The pain after laser spine surgery is usually very little due to the small cuts, but still patient may still be provided with pain killers and anti-inflammatory medications. Antibiotics are prescribed in some cases, depending on the type of surgery.
The patient can begin light activities within 24-48 hours that include slight walking and continuous movements.
Heavy lifting, bending, or twisting, or any activity that causes stress, should not be done by the patient until 2-4 weeks after the surgery procedure to protect the healing tissues.
The area of operation must be kept clean and dry by the patient. The patient should only change the dressing upon advice from the doctor. The patient is then advised by the surgeon to keep an eye on any sort of redness, swelling, or fever.
The first follow-up occurs 7-10 days to examine the healing of the wound. If the patient feels necessary, additional visits may be scheduled based on the progress of recovery or for any re-evaluations.
Physical evaluation begins after the initial 2-3 weeks to strengthen the back, improve the posture, and prevent any recurrence of spinal issues. Exercises should focus on helping the patient to gain core stability, flexibility, and gradual strength.
After laser spine surgery, most patients return to office-based work within 3-7 days, depending on the comfort of the patient and the rate of recovery.
Heavy sport and physical activity after laser spine surgery can only be begun after 6-8 weeks under medical guidance.
Benefits of Laser Spine at Yashoda Hospitals
- Minimally invasive
- Decreased pain
- Quick recovery
- Less risk of complications
- Accuracy
- Minimal scarring
- Tissue preservation
- Preservation of spinal stability
- Effectiveness in treating some conditions.
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