Laser Discectomy

Laser discectomy surgery for back and neck pain has become a popular trend in the medical industry and for a good reason. This approach is precise and more effective than other spine surgery techniques. At LAMIS Institute, we conduct laser discectomy surgery to achieve optimum spine health for our patients. We actively combine the latest sophisticated technologies to achieve the best possible outcome for our patients.

Where laser discectomy is not an option, we employ other minimally invasive approaches and ensure we give our patients the best. If you wish to undergo laser discectomy surgery in Los Angeles or any other minimally invasive surgical procedure to relieve pain, do not hesitate to call us for a consultation and case evaluation to determine your suitability.

What Is Laser Discectomy?

Laser discectomy, also called percutaneous laser discectomy, is a surgery to correct a disc herniation or bulging disc. The procedure is a less invasive surgery that entails the removal of the herniated disc in the spinal cord by burning it with laser light transmitted through a tiny incision made over the affected disc. Since it is minimally invasive, laser discectomy causes minimal pain, and patients recover quickly.

The backbone, or spine, comprises a chain of small bones known as vertebrae. These vertebrae create a hollow path or column via which the spine runs, and they protect the spine from injury and damage. The vertebrae lie on top of one another, with discs (intervertebral discs) between every bone to provide support and cushioning. Most nerves exiting the spine pass through the foramen (tiny holes found in the vertebrae).

In certain conditions, like injury, aging, or particular infections, the contents of the external walls of any of these discs may drain out, weakening the disc. This could result in the inner, softer section of the disc bulging out, a condition known as a bulging disc or herniated disc.

The bulging disc might exert pressure on the spinal cord and nerves to cause symptoms like tingling, weakness, or pain. In these cases, a laser discectomy can be conducted to extract the section of the disc pressing on the nerves by evaporating it with laser light, providing relief.

Laser Discectomy Background

Disc herniation is among the most common conditions impacting the spinal cord (cervical or lumbar spine). Recent technological advancements have been essential in enhancing disc herniation treatment. The development of state-of-the-art devices and machines and the application of biomedical engineering have resulted in improvements in managing this disabling spine condition.

In the past, surgeons performed an open procedure called a laminectomy to treat disc herniation. However, since laminectomy led to patients experiencing many problems, percutaneous techniques started appearing. Percutaneous means via the skin and through a tiny hole.

At first, chemonucleolysis was used, which entailed injecting a substance that could destroy tissue into the herniated disk. The procedure caused some problems because it could not precisely control the magnitude of disk destruction, and medical professionals abandoned it.

Then medical professionals introduced open disk surgery with a microscope approach. This procedure is similar to laminectomy, although it leaves a minor wound, resulting in less bone damage and instability. But open diskectomy can still expose patients to epidural fibrosis and infection risk.

After that, percutaneous discectomy surgery was introduced. This procedure involves removing the herniated disk via a small incision in the skin where fine equipment can pass without causing bone or muscle damage. This achieved the extraction of the affected disk tissue without the neighboring tissue being damaged and reduced intradiscal pressure, a crucial element contributing to disk herniation.

Percutaneous discectomy surgery does not lead to fibrosis, and it does not destabilize the spinal cord. Patients do not, therefore, have to use screws and rods. Hospitalization of patients is also unnecessary, as the procedure is outpatient and conducted under local anesthesia. Plus, it is more affordable than other techniques.

Now, treating disc herniation includes using a contact laser. For this technique, a surgeon inserts a cannula percutaneously. The cannula includes a TV micro-camera, laser fiber, irrigation hose, and a mechanism that enables the surgeon to mobilize the laser fiber tip per their requirements.

Once the cannula is inserted, the surgeon inspects the herniated disc via the video system to obtain a clear picture of the issue. Using the laser beam, the doctor destroys the damaged sections of the herniated intervertebral disk, reducing the disk pressure and achieving instant pain relief for the patient.

The irrigation system used in this approach guarantees that the laser light will not impact the region beyond what the surgeon requires since the liquid medium formed inside the intervertebral disk keeps the intradiscal temperature in the correct range. This approach is called laser discectomy.

Common Symptoms Laser Discectomy Can Relieve

While the most prevalent spine-related condition alleviated by laser discectomy is a bulging or herniated disc, there are also several other health conditions this less invasive procedure can relieve, including sciatica, pinched nerves, and degenerative disc disease.

The signs of these spinal cord conditions vary depending on the patient and how severe the condition is. Common symptoms patients experience include the following:

Leg or arm pain— apart from the localized pain you might experience at the area of the pressed nerve in the spine, you might also experience shooting or radiating pain in the extremities. If the cervical spine has been affected, you may feel pain in your shoulder and arm. If the pressed nerve is in the lumbar spine, you may feel radiating pain down your leg or buttocks. The pain might worsen with unexpected movements like coughing and sneezing.
Weakness— if the pressed nerve cannot send strong signals to the surrounding muscles, you could experience weakness in the foot and leg or hand and arm.
Tingling or numbness— you might feel numbness or tingling that spreads to the farthest extremities, like your foot or hand. The numbness or tingling is usually accompanied by pain in your leg or arm. Some patients might only experience tingling or numbness without the radiating pain.

Suitable Candidates for Laser Discectomy

Laser discectomy may be recommended for people with a herniated disc and related symptoms, like burning sensation, pain, weakness, or pain in the site of the pressed nerve.

Not everyone with a bulging or herniated disc requires the laser discectomy procedure. The procedure is conducted in patients experiencing chronic pain that has not responded to traditional treatment options like medications, physical therapy, weight management, analgesics, osteopathy, a targeted lumbar injection, and rest.

More importantly, the herniated disc’s configuration must be ideal for laser discectomy treatment since the surgery is unsuitable for all forms of disc herniation and disc injuries. Patients with a small and contained disc herniation causing severe pain or an annular tear may be more suitable for this surgery.

A contained disk herniation is a disk that has not detached from the parent disc. People with a central, large, sequestered, or extruded disk herniation may not be appropriate candidates for the laser discectomy procedure.

Where laser discectomy is not an option and traditional treatment options have failed, a doctor may recommend open surgery.

The Laser Discectomy Procedure

Laser discectomy is outpatient, meaning you can return home the very day you undergo the procedure. You will likely need to stay at the hospital for a few hours after the surgery. Ensure you have someone to drive you back home. The procedure involves the following steps:

The anesthesiologist will administer local anesthesia and light sedation to prevent you from feeling discomfort or pain during the surgery.
During the surgery, the surgeon will monitor your vitals, like heart rate and blood pressure.
The nurse will clean your skin using an antiseptic and apply drapes.
The surgeon will incision your back at the herniated disc level.
The surgeon will use fluoroscopy to locate the correct site.
Under X-ray guidance, the surgeon will advance a thin surgical needle via your back.
After the surgeon pushes the surgical needle up to the intended site, they insert a laser probe that emits laser energy that will burn the problem-causing disc to alleviate nerve and lower back pain.
The surgeon will remove the surgical needle.
The surgeon will place a small bandage over the incision to close it.

Laser Discectomy Success Rate

The laser discectomy procedure effectively relieves pain for most patients with disc herniation. The rate of success depends on several factors, like:

The degree of the spinal cord or nerve compression.
The severity of disc herniation.
The period for which a patient has suffered a disc herniation.
The existence of other medical conditions, like obesity, diabetes, and hypertension.

On average, the success rate for laser discectomy is about 80 percent. Some risks that come with this surgical procedure are:

Nerve injury.
Blood clots.
Excess bleeding.
Infection.
Discitis (intervertebral disc inflammation).

Recovering From the Laser Discectomy Surgery

Patients usually take a one- or two-day leave from work after a laser discectomy and can usually resume normal activities. After the surgery, you may feel a minor ache for some days, which you can manage with simple anti-inflammatories and analgesics. Averagely, patients who undergo laser discectomy start seeing improvement in their nerve or lower back pain 10 to 14 days after the procedure.

For your recovery plan, your doctor will provide instructions on how to use your back. You may have to limit bending or lifting. Your doctor may recommend wearing a back brace for a given period after the surgery. You might need physiotherapy after the procedure to assist in strengthening your back.

You might see some fluid coming out of your tiny incision. That is normal. Inform your doctor immediately if a lot of fluid drains from your incision site. Also, call your doctor if you experience so much pain at the incision site or have a fever.

At times, the surgery causes slightly more pain for some time. However, you could take pain medications to relieve the pain. Often, this disappears faster. Your pain should be less than it was before the procedure. Ensure you follow all the doctor's instructions and maintain your check-up appointments.

Risks and Complications of Laser Discectomy

Complications are rare, but they can include infection. The likelihood of developing an infection is low since the surgeons use sterile equipment in a theater setting with an IV antibiotic dose preoperatively. Other risks may include a reoccurrence of the disk herniation or no improvement. Additionally, there is a minimal risk of nerve injury with this procedure. The risks of laser discectomy are fewer than those of open surgery.

The surgery is conducted without muscle relaxants and under light sedation. As the surgeon navigates the surgical needle to the intended site of disc herniation through the back, it may touch the nerve. If this happens, since the patient will be sedated, the leg will move, alerting the doctor that they should adjust the needle before laser energy insertion. That means when the surgeon inserts the laser light via the needle, the insertion will be safe, and there will be no laser thermal nerve injury risk.

As the surgeon turns on the laser probe and begins treatment, they will also monitor the leg for twitching or movement if irritation or heat reaches the nerve. If this happens, the surgeon can stop the laser immediately to prevent nerve injury.

Consequently, the procedure is not conducted under general anesthesia as the leg would not react similarly to any contact or irritation, meaning the surgeon would only detect nerve injury after the patient wakes from surgery. The fact that the procedure is performed under light sedation helps the surgeon obtain continual feedback, thereby minimizing any nerve root injury risk.

Benefits of Laser Discectomy

Laser discectomy has many advantages compared to the traditional spine surgery approach. These include:

The procedure is minimally invasive compared to the conventional approach to spine surgery.
The procedure is outpatient, meaning you will not have to be hospitalized.
Laser discectomy can be performed under local anesthesia; thus, you can see what the surgeon is doing and provide feedback.
A shorter recovery period for this procedure, which, in turn, means reduced missed time from work.
There is no epidural fibrosis.
There is minimal to no bone and soft tissue injury with this procedure.
There is a minimal chance of creating instability as only a small tissue amount is removed.

Find a Los Angeles Back Surgeon Near Me

At LAMIS Institute, our neurointerventional surgeons are widely recognized for several successful laser discectomy procedures. Regaining control of your neurological or spinal condition is possible, and we offer a wide range of surgical procedures, including laser discectomy, to ensure that happens. If you seek treatment for your spinal condition in Los Angeles, call us at 310-734-6088 to schedule a consultation and checkup appointment.