Small herniated discs in the low back and neck can be treated with this technique which uses a small laser in a fiberoptic videoscope for visualization. The entire operation is performed through a needle placed into the disc. The surgery is performed as an outpatient, often with the patient sedated for the procedure, without general anesthesia. Usually within 1-2 hours after surgery the patient returns to home. Because the entire procedure is performed through a needle, the risks are thought to be lower than the traditional open surgical techniques such as microdiscectomy. With LASE, there is no removal of bone or sensitive ligaments, and since the operation does not involve the epidural space with its many blood vessels, there is less chance of blood clots and scar tissue forming around the spine.
After sedation, a needle is carefully placed into the disc while remaining outside the spinal canal. A laser is used to remove disc tissue near the herniated site in order to decompress the disc. The procedure takes approximately one hour. Success rates are seen in about 2/3 to 3/4 of all patients who have this procedure. Return to work times are usually faster and there is usually less post operative pain than an open discectomy. Finally, if the procedure is not successful, an open discectomy is always possible since there is no creation of scar tissue in the epidural space or within the muscles overlying the entry site of an open discectomy.
Finally, by incorporating the Blackstone surgical system, herniated discs can be decompressed and annular tears modulated in the neck. The approach is from the front of the neck to avoid the spinal cord and other sensitive structures. LASE represents a clinical advancement using the laser technology that has been available and used for disc decompression for over 20 years.