In the spine, nerve compression and subsequent pain can be caused by a herniated disc, bone spurs, thickened ligaments, and other degenerative or traumatic problems. When a nerve root that is part of the sciatic nerve becomes pinched, this can cause “sciatica,” leading to pain, tingling, numbness, and/or weakness in the lower back, buttock, and leg.

Laser spine surgery can be utilized to decompress the nerve and relieve nerve dysfunction. This surgery is much less invasive than other types of traditional back surgery.

How does the laser come into play during spine surgery?

A laser is a highly focused beam of light energy that can cut or shrink soft tissues such as herniated disc bulges, disc fragments, or thickened ligaments that may be compressing or pinching the nerve roots or nerve sac.

In traditional surgery, a scalpel or other instruments are used to cut tissue in or around the spine. During laser spine surgery, the initial incision in the skin is made with a surgical scalpel. Still, a surgical laser is also used to shrink or dissolve tissue affecting the nerves and causing problems.

What happens during laser spine surgery

Laser surgery is minimally invasive and is typically done with an endoscope or a microscope. Through an incision less than an inch long, a small probe containing a laser is passed into the into the spine. This is accomplished with the help of imaging technology. Then, the energy from the laser and other precision tools are used to carefully remove tissue that may be pressing on the nerves.

Patients are usually able to go home the same day, with minimal downtime.

Types of back surgery

Depending on your specific physical needs, there are different types of spine surgery. Laser spine surgery is not for every back pathology or problem. After consultation and careful examination, Dr. Stieber will recommend a traditional (or open approach), minimally-invasive spine surgery, robotic spine surgery, or laser spine surgery.

Traditional

During this surgery, a long incision would be made in the back, and the muscles and other tissue would be moved away to access and correct the affected area of the spine. The subsequent hospitalization and recovery period after this surgery is usually longer.

MISS (Minimally Invasive Spine Surgery)

During Minimally Invasive Spine Surgery, a unique tool is used, called a tubular retractor, to create a small channel from which to access the surgical site. Various specialized microsurgical tools are employed during the surgery to operate on the spine. MISS can lead to less pain and a faster recovery because it’s less invasive. You will be able to return to work in days to weeks.

Robotic Spine Surgery

During robotic spine surgery, the procedure technique begins with a small incision, then utilizes a cutting-edge robotic system. The robot’s computer system combines a CT scan of the patient’s anatomy with special x-rays taken in the operating room of the actual patient to tell the robot where the patient’s spine is located. Dr. Stieber can point to a precise location on the CT scan and the robot will aim for that site, processing what the navigation system sees in real time. Dr. Stieber will use the robotic guidance and navigation to place implants or do other spinal operations with precision. The procedure time and recovery time are shorter than the same procedure would be if done using the traditional method.

Laser

During laser back surgery, a laser is used to remove portions of tissue located around the spinal cord and nerves of the back. It is used for very specific conditions such as nerve compression around the spinal nerves or spinal cord. The recovery time can be as short as 7-10 days.

Preparation for surgery

During your consultation and subsequent preparation for surgery, you will be given detailed instructions about how to prepare. Be sure to tell Dr. Stieber about all prescriptions, over-the-counter medications, and supplements that you are taking.

Two weeks or more before surgery, we will ask that you stop smoking to promote optimal healing and a smooth recovery.
We will also ask you to stop taking any medications or herbal supplements that thin the blood, such as aspirin.
Please arrange for a friend or family member to drive you home on the day of your procedure.

Laser spine surgery benefits

Less invasive
Minimal downtime
Reduced blood loss
Reduced cost
Can be performed under local anesthesia
Can relieve some types of back pain caused by compression

Side Effects and Drawbacks (Uncommon)

Potential damage to the surrounding tissue (nerves, bone, membrane and cartilage)
Infection
Bleeding and blood clots

Recovery Time

For traditional spine surgery, recovery time may take longer, including some time in the hospital.

MISS is usually done as outpatient surgery, which allows you to go home the same day and return to work in days to weeks.

Laser back surgery is also done as an outpatient surgery, which allows you to go home the same day. You will usually be able to return to gentle, sedentary work in days.

During the first two weeks of recovery, avoid the following:

Bending, lifting anything over five pounds, or twisting
Strenuous physical activity, including exercising, housework, yardwork, and sexual activity
Driving or operating a vehicle of any kind
Drinking alcohol in the initial stage of recovery or while taking narcotic pain medication

Choosing the Right Surgeon

To perform laser spine surgery, a medical license is needed, but the doctor is not legally required to be a trained surgeon. Some anesthesiologists or other doctors without actual spine surgical training attempt to perform these procedures. This makes the importance of choosing the right surgeon, who is highly trained and expert, paramount.

A laser beam is an intense source of heat that, while focused, is still less precise than other surgical tools. This technology requires extreme expertise and control to avoid damaging the spinal cord and nerve roots.

Laser surgery can be inadequately understood and used by people who are not highly qualified for this type of precision procedure. In the hands of less practiced technicians, laser surgery can result in increased nerve damage when compared to traditional surgery techniques. When you’re looking for a doctor to perform this procedure, you will want a trained surgeon with experience and expertise who knows the technology and procedure extremely well.

Dr. Jonathan Stieber

Dr. Stieber is one of the best spine surgeons in NYC. Dr. Stieber is globally recognized as a leading orthopedic specialist. He is skilled in traditional and emerging technologies, and he has a specific interest in minimally invasive solutions for the treatment of spinal disorders, such as laser spine surgery.

He is an Associate Clinical Professor of Orthopedic Surgery at the NYU Grossman School of Medicine. His training and background make him a trusted choice for patients with back pain and problems.

Learn More About Dr. Stieber

Laser Spine Surgery in NYC