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The Truth About Laser Spine Surgery

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Laser spine surgery can be summed up in one word – hoax.
There is a perception by the general public that lasers are modern or even futuristic. Dating back to the 1960’s people were obsessed with lasers. Whether it be Auric Goldfinger using it as a hi-tech weapon to try and kill James Bond in 1964 or Val Kilmer designing a prototype for the military in 1985 – the American public has viewed lasers as the penultimate in science and technology. It would only seem natural that if one were to “apply” lasers to medicine, the public would find that application equally as futuristic, regardless of whether that use was real or just more movie special effects.
Dr. Theodore H. Mainan, the researcher who first constructed the optical laser in 1960, said it was “the solution in search of a problem.” Over the last 50 years, the world has come up with some pretty nifty uses for lasers: welding, measuring distances/surveying, guidance systems for rockets, and even cutting human tissue in the form of a laser scalpel – thus the birth of laser surgery. The only problem is, it’s still surgery and therein lays the deception.
Certain “institutions” have made a lot of commotion by totting the notion that their physicians use lasers to perform back and spine surgery, therefore it’s more futuristic, modern and overall precise. Then the television commercial shows a tiny Band-Aid over the area where the surgery was performed and voilà –the person is cured the miracles of modern medicine. There’s just one problem, the laser isn’t used to actually fix anything in the spine.
The spine is made of bone. Lasers cannot cut through bone. The laser is used for maybe 5% of the surgery to cut through some of the muscle to get to the spine but no for any of the important part of the surgery to fix the spine or the discs. Traditionally, this portion of the procedure is performed using a normal scalpel and/or electrocautery. This has no bearing or influence on the outcome of the surgery in any way. So basically, the surgeon will still have to use an ordinary scalpel to cut through the skin, no matter what, and then use whatever drills or cutting devices the FDA allows the surgeon to use to modify the spine – this does not include a laser.
In the case of laser spine surgery, after the surgeon has cut through the skin with an ordinary scalpel the continue to use the same, ordinary scalpel to get a little deeper, also using the electrocautery to cut and control bleeding, instead of continuing to cut this way (as is taught at every teaching institution in the world) he/she will switch to the laser for a few seconds to cut in order to call it “laser spine surgery” before switching back to conventional surgery methods. The important thing to keep in mind, the laser isn’t actually being used on your spine at all!
You are still being “cut”; the only difference is a laser is being used for some of it. It makes no difference what was used to make the incision; scar tissue is equally likely to form no matter what.
Laser spine surgery is not taught at any teaching institution any where in the United States. Not at Mass General Hospital (the flagship institution of Harvard), not the Mayo Clinic, not the Cleveland Clinic, Johns Hopkins, New York Presbyterian, nowhere. Ask yourself why. Why isn’t this “revolutionary” procedure being taught at any leading institution? Or any other institution for that matter? Why isn’t this procedure on the board examination for Orthopedic Spine Surgery or Neurosurgery? Why isn’t this procedure recognized by Medicare?
There’s no conspiracy. It’s because it isn’t a real procedure. It’s a fantastic marketing gimmick that takes advantage of people feelings that lasers are futuristic. And if lasers are futuristic, then laser spine surgery must be equally as futuristic. Well ladies and gentlemen…you’ve been had. There isn’t a single peer-reviewed article in any major medical journal on laser spine surgery, not a single shred of evidence to support it, no FDA-approved clinical trial, no randomized-controlled trials showing it is even superior to aspirin let alone other types of surgery.
Futuristic advances in medicine already exist (i.e. robotic surgery, nuclear medicine, gamma knife, etc.) and will continue to be invented all around us. We don’t need to latch on magic tricks and ploys to feel the impact of technology. Laser spine surgery is clever marketing technique which re-directs our feelings that lasers are modern and focuses those feelings on a product, the same way Apple did with the iPhone.
If you think you need spine surgery, leave it to the experts in the field to recommend the right treatment for you, not a group of marketers trying to figure out the best way to trick you out of the standard of care. Follow the evidence and data, not something cooked up in a cubicle by someone whose last course in school was marketing instead of gross anatomy.

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Dr. Corey Hunter is a nationally recognized interventional pain physician and the founder of Ainsworth Insitute. His publications have appeared in textbooks on treating pain and he is a regular contributor in leading pain management journals.

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