Spine surgery for common degenerative spinalconditions like herniated discs and spinal bonespurs is generally reserved as a last-resorttreatment, typically after several weeks or monthsof conservative treatments have failed to providesymptomatic relief. To best understand how the twomain options – open spine surgery and laser spinesurgery – can help relieve your neck or back pain,it’s helpful to first understand the anatomy thatmakes up the spine and how the two surgicalmethods contrast with each other.
Spinal AnatomyThe spine itself is made up of both individual and fused vertebrae, and serves to protect thespinal cord. Nerve roots exit the spinal cord to innervate other areas of the body through lateral,vertebral passageways called intervertebral foramina. Intervertebral discs are pads ofcartilaginous material that act as shock absorbers for the spine and lie between individualvertebrae, which are linked and articulate together at facet joints. All of these spinal componentsare further supported with a variety of muscles, ligaments, and tendons.Like other areas of the body, the spinal anatomy deteriorates over time, but since the spinalcomponents are situated in close proximity to neural structures, nerve compression can becomea factor as deterioration occurs. Nerve compression can be caused by a number of resultinganatomical abnormalities, such as bulging or herniated discs, bone spurs, calcified ligaments,displaced vertebrae, and others.While spine surgery of any kind is usually considered a last resort treatment method to alleviatesymptoms caused by the aforementioned conditions, the overarching goal for both open spinesurgery and laser spine surgery is typically to relieve the pressure placed on the spinal cord ornerve roots by anatomical abnormalities. The main difference between these two procedures isthe surgical approach each operation entails.
Open Spine SurgeryOpen spine surgery is a highly invasive operation and requires alarge incision in the throat, neck, abdomen, or back. Additionally,muscles and other soft tissues are detached or dissected.Oftentimes, a large portion of spinal anatomy, such as an entireintervertebral disc, must be removed to relieve nervedecompression. If spinal stability becomes an issue as a result,spinal fusion may also be required. Spinal fusion involves theinstallation of bone grafts and supportive hardware into two ormore vertebrae associated with the affected region of the spine. Ifyou choose to undergo open spine surgery, you may experience alengthy and difficult rehabilitation period, due largely to the softtissue dissection that is necessary to access the neck or back.
Laser Spine SurgeryUnlike open spine surgery, laser spine surgery is performed as a minimally invasive procedurewith an endoscope, or camera. Endoscopic spinal procedures require only a small incision in theneck or back; instead of cutting through layers of soft tissue, a series of progressively largertelescoping tubes are inserted through the incision to gently push tissue aside. An endoscope,tiny surgical tools, and a laser are funneled through the final tube to access the area of nervecompression. Then, only the portion of soft tissue or bone that is necessary to relieve nervecompression is excised or removed. This helps to ensure that the majority of the spinal anatomyremains largely intact. For certain candidates requiring additional spine support, a minimallyinvasive spine stabilization procedure, involving endoscopic placement of a supportive implantand screws, may be performed to help improve overall spinal stability.Because minimally invasive procedures in the neck or back don’t require large incisions, you mayenjoy a recovery that is faster and less painful that the recovery associated with open spinesurgery. Additionally, if you are a candidate for an endoscopic neck or back procedure, you won’trequire hospitalization as these procedures are performed on an outpatient basis.
Consult Your Physician Prior to consenting to any spine surgery, it’s important that you talk with your physician and obtain additional medical opinions. This can help confirm your initial diagnosis and possibly reveal any nonsurgical treatments that you may not have attempted. If you choose to undergo spine surgery, take time to review the benefits and risks associated with both laser spine surgery and open spine surgery. This will help you make an informed decision when it comes time to sign a consent form.