Lack of Benefits, Combined with Potential Harm Leads to Evidence Against Laser Spine Surgery

ROSEMONT, Ill., Sept. 3, 2019 /PRNewswire/ -- With one internet search, a patient can find a host of information and marketing materials touting the purported benefits of laser surgery. Since 2011 "laser spine surgery" has become more popular among Google search terms than widely accepted spine techniques such as "minimally invasive spine surgery" or "artificial disk replacement."ⁱ

However, according to a new literature review published in the September issue of the Journal of the American Academy of Orthopaedic Surgeons, using lasers in spine surgery can add potential complications including thermal injuries such as burned nerves, tissue and cartilage due to the heat of the laser. As the risks outweigh the benefits, the current evidence suggests against the use of lasers in spine surgery.

"Many of my patients come to me with questions as they are intensely interested in laser spine surgery because of the aura of new technology, and the online information they consume speaks of high success rates, the absence of scars, and minimally invasive surgery," said lead researcher and orthopaedic surgeon Kris Radcliff, MD, with the Rothman Orthopaedic Institute. "We did this review because I wanted to provide my patients with educated answers about laser spine surgery. As we are not widely trained on lasers in orthopedic surgery training, we wrote this review article to provide other orthopaedic surgeons and spine surgeons with accurate background information to counsel patients."

Lasers or Light Amplification by Stimulated Emission of Radiation are commonly used in many medical procedures such as eye surgery, removing skin tags, kidney stones and brain tumors. While a host of studies demonstrate that lasers can be used in spinal procedures such as treating degenerative spine problems, removing disk tissue or the damaged portion of a herniated disk from the spine, Dr. Radcliff and his team did not find any evidence in the literature review stating that lasers are superior to traditional surgery. The evidence also documented the unique harm that could be caused by lasers.

"There are always risks linked to traditional spine surgery, which are typically associated with operating and controlling the surgical tools," said Dr. Radcliff. "However, by using a laser, you add another level of risk to the surgery including burns and thermal injury to nerves, discs, and bones. There is no information to justify that additional risk, since none of the literature we reviewed demonstrated advantages of using lasers in spine surgery over conventional methods."

Due to the public's perception of the benefits touted in laser spine surgery marketing materials, Dr. Radcliff sees this as a cautionary tale and hopes that medical boards, societies and organizations take an active role to ensure that medical providers disseminate fair and accurate descriptions of their procedures, as not to mislead the public.

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Disclosure
Dr. Radcliff or an immediate family member has received IP royalties from Globus Medical, Innovative Spine Devices, and Orthopedic Science; serves as a paid consultant to Globus Medical, Medtronic, and Orthopedic Science; serves as an unpaid consultant to Zimmer Biomet; has stock or stock options held in 4 Web Medical; has received research or institutional support from Orthofix, Pacira Pharmaceuticals, and Simplify Medical; has received nonincome support (such as equipment or services), commercially derived honoraria, or other non-research–related funding (such as paid travel) from CTL Medical, Lilly USA, NEXXT Spine, Paxen, Spinal Elements, Stryker, and Zimmer Biomet; and serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons, Cervical Spine Research Society, ISASS, North American Spine Society, and SMISS. Dr. Vaccaro or an immediate family member has received IP royalties from Aesculap, Atlas Spine, Globus Medical, Medtronic, SpineWave, and Stryker; serves as a paid consultant to Atlas Spine, DePuy, Gerson Lehrman Group, Guidepoint Global, Innovative Surgical Design, Medtronic, Nuvasive, Orthobullets, SpineWave, Stout Medical, and Stryker; and has stock or stock options held in Advanced Spinal Intellectual Properties, Avaz Surgical, Bonovo Orthopaedics, Computational Bio- dynamics, Cytonics, Dimension Orthotics LLC, Electrocore, Flagship Surgical, FlowPharma, Franklin Bioscience, Gamma Spine, Globus Medical, Innovative Surgical Design, Insight Therapeutics, Nuvasive, Paradigm Spine, Parvizl Surgical Innovations, Prime Surgeons, Progressive Spinal Technologies, Replication Medica, Spine Medica, Spinology, Stout Medical, and Vertiflex. Dr. Hilibrand or an immediate family member has received IP royalties from Amedica and Zimmer Biomet; has stock or stock options held in Lifespine and Paradigm spine; and serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons. Dr. Schroeder or an immediate family member serves as a paid consultant to Advance Medical, Stryker, and Zimmer Biomet; has received research or institutional support from Medtronic Sofamor Danek; and has received nonincome support (such as equipment or services), commercially derived honoraria, or other non-research–related funding (such as paid travel) from AOSpine and Medtronic.

ⁱAs detailed in Figure 1 of the article "Lasers in Spine Surgery," (Radcliff K, Vaccaro A, Hilibrand A, Schroeder G) Google trend data was analyzed from 2004 to 2017 of the search terms "minimally invasive spine surgery," "artificial disc replacement," and "laser spine surgery." The laser spine surgery searches were markedly higher on a monthly basis.

SOURCE American Academy of Orthopaedic Surgeons

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