2. Spine surgery for common degenerative spinal
conditions like herniated discs and spinal bone
spurs is generally reserved as a last-resort
treatment, typically after several weeks or months
of conservative treatments have failed to provide
symptomatic relief. To best understand how the two
main options – open spine surgery and laser spine
surgery – can help relieve your neck or back pain,
it’s helpful to first understand the anatomy that
makes up the spine and how the two surgical
methods contrast with each other.
3. Spinal Anatomy
The spine itself is made up of both individual and fused vertebrae, and serves to protect the
spinal 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 of
cartilaginous material that act as shock absorbers for the spine and lie between individual
vertebrae, which are linked and articulate together at facet joints. All of these spinal components
are 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 spinal
components are situated in close proximity to neural structures, nerve compression can become
a factor as deterioration occurs. Nerve compression can be caused by a number of resulting
anatomical 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 alleviate
symptoms caused by the aforementioned conditions, the overarching goal for both open spine
surgery and laser spine surgery is typically to relieve the pressure placed on the spinal cord or
nerve roots by anatomical abnormalities. The main difference between these two procedures is
the surgical approach each operation entails.
4. Open Spine Surgery
Open spine surgery is a highly invasive operation and requires a
large 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 entire
intervertebral disc, must be removed to relieve nerve
decompression. If spinal stability becomes an issue as a result,
spinal fusion may also be required. Spinal fusion involves the
installation of bone grafts and supportive hardware into two or
more vertebrae associated with the affected region of the spine. If
you choose to undergo open spine surgery, you may experience a
lengthy and difficult rehabilitation period, due largely to the soft
tissue dissection that is necessary to access the neck or back.
5. Laser Spine Surgery
Unlike open spine surgery, laser spine surgery is performed as a minimally invasive procedure
with an endoscope, or camera. Endoscopic spinal procedures require only a small incision in the
neck or back; instead of cutting through layers of soft tissue, a series of progressively larger
telescoping 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 nerve
compression. Then, only the portion of soft tissue or bone that is necessary to relieve nerve
compression is excised or removed. This helps to ensure that the majority of the spinal anatomy
remains largely intact. For certain candidates requiring additional spine support, a minimally
invasive spine stabilization procedure, involving endoscopic placement of a supportive implant
and 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 may
enjoy a recovery that is faster and less painful that the recovery associated with open spine
surgery. Additionally, if you are a candidate for an endoscopic neck or back procedure, you won’t
require hospitalization as these procedures are performed on an outpatient basis.
6. 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.