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7800 E. Orchard Road, Suite 100
Greenwood Village, CO 80111
Phone: 303-697-7463

 
 

Laser Spine Surgery

Advancing Beyond Limited 2-D Laser Spine Surgery to True Three Dimensional (3-D) Spinal Microsurgery

An overview of by the surgeons at Denver Spine Surgeons

Patients will regularly ask us if they are candidates for laser spine surgery, with the impression that a procedure involving "laser surgery" uses the most up to date technology available. In reality, however, significant advances have been made that improve on the many limitations inherent in laser spine surgery. Minimally invasive spinal microsurgery utilizing an advanced, high technology operating microscope and retractors or tubes which limit soft tissue trauma during surgical exposure now represents the highest tech spinal surgery available.

Denver Spine Surgeons surgical and nonsurgical relief care for back pain Denver and neck pain Denver, Orthopedic Spine Surgery Ghiselli, Jatana, Wong, Denver Colorado

Laser Spine Surgery has many limitations. The anatomy and the surgical procedure are observed through an endoscope which provides only two dimensional visualization - there is no depth perception. The limited depth perception is not a major impediment when an endoscope is used in a joint such as the knee for an arthroscopy, nor the abdomen such as for laparoscopy. In the spine, however, it is not desirable to abut the scope against sensitive and easily damaged structures such as the nerves or spinal cord for lack of 3-D depth perception. The lack of depth perception also provides a challenge when targeting the laser used in laser spine surgery. Burning a hole in the dura, resulting in a difficult to repair spinal fluid leakage and severe spinal headaches can be the result. In addition, laser surgery works best against soft tissues but is a poor instrument for removing the bone spurs that are often a significant component in an older patient's nerve compression in spinal stenosis. The numerous drawbacks of laser spine surgery have been recognized in the medical community for many years. Recently, concerns have also been reported in the popular press. (http://www.bloomberg.com/news/2011-05-04/laser-spine-surgery-more-profitable-than-google-sees-surge-in-complaints.html).

In contrast, minimally invasive spinal microsurgery offers true three dimensional visualization with better illumination than the laser surgery endoscope. Micro-burrs and bone rongeurs allow direct trimming of bone spurs to relieve pressure on nerves. High tech operating microscopes also provide a variable field of focus to permit more detailed observation of pathology and any ongoing corrective surgical procedures than the fixed focus laser endoscope. The dual eyepieces on the operating microscope allow both the surgeon and the assistant a direct view of the surgical field. This allows any necessary retraction of nerves by the assistant to be done in a safe manner under direct visualization. The variable and deep field of focus of a high tech operating microscope has also allowed development of advanced surgical procedures such as the laminotomy and laminaplasty technique for decompressing nerves on both sides of the spine in lumbar spinal stenosis. In this procedure, only a unilateral surgical approach is necessary, so there is only limited trauma to the soft tissues on only one side of the spine while still allowing nerves on both the right and left sides of the spinal canal to be decompressed .

The surgeons at Denver Spine Surgeons have been at the forefront of developing the technology and techniques in advanced spinal microsurgery. Our deceased partner Dr. John McCulloch invented the minimally invasive soft tissue retractor and microsurgical instrument systems which bear his name. Dr. McCulloch also co-authored what is considered to be the definitive textbook on spinal microsurgery - Essentials of Spinal Microsurgery (Lippincott-Raven Publishers). Denver Spine Surgeons have been Course Directors and faculty for continuing medical education courses on minimally invasive spine surgery sponsored nationally by the North American Spine Society (NASS) and the American Academy of Orthopaedic Surgeons (AAOS). Additionally, our surgeons have authored chapters on minimally invasive spine surgery in major textbooks including Rothman and Simeone's Spine (Elsevier publishers), The Adult and Paediatric Spine (Lippincott, Williams and Wilkins publishers) and Spine Surgery-Tricks of the Trade (Thieme publishers).

Thus, given a choice between 2-D laser spinal surgery vs. 3-D minimally invasive microsurgery, the surgeons of Denver Spine feel that microsurgical techniques offer a clear high tech advantage over laser surgery. Microsurgery as well as minimally invasive techniques for other spine procedures such as fusion are a focal point of the surgical philosophy at Denver Spine.

To find out more, read the full article in Bloomberg news journal at: http://www.bloomberg.com/news/2011-05-04/laser-spine-surgery-more-profitable-than-google-sees-surge-in-complaints.html

 

 

 


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Dr. Sanjay Jatana, Sanjay Jatana MD, Sanjay Jatana, denver spine center, denver back pain, denver neck pain, denver spine surgery, denver spine surgeon, denver spine surgeons, fellowship trained spine surgeon denver, spine surgery denver, spine surgery coloradoSanjay Jatana, MD

Board Certified Orthopedic Surgeon
Fellowship-trained spine surgeon

As a fellowship trained spine surgeon, Dr. Jatana specializes in treatment of complex disorders of the cervical spine, degenerative lumbar spine and microsurgery. He also focuses on general spinal surgery with special training in the cervical spine and treating patients who require repeat or revision surgery.
Click here to learn more.

Dr. David Ghiselli, David Ghiselli MD, denver spine center, denver back pain, denver neck pain, denver spine surgery, denver spine surgeon, denver spine surgeons, fellowship trained spine surgeon denver, spine surgery denver, spine surgery colorado,Gary Ghiselli, colorado spine surgeonGary Ghiselli, MD

Board Certified Orthopedic Surgeon
Fellowship-trained spine surgeon

Dr. Ghiselli is a recognized expert in spine surgery. He has published multiple peer reviewed articles and book chapters throughout his career. His practice offers all options including non-operative care, stem cell and regenerative technologies as well as traditional and minimally invasive surgical techniques. Click here to learn more.

denver spine center, denver back pain, denver neck pain, denver spine surgery, denver spine surgeon, denver spine surgeons, fellowship trained spine surgeon denver, spine surgery denver, spine surgery colorado, dr david wong, david wong md, David WongDavid A. Wong, MD

Board Certified Orthopedic Surgeon
Fellowship-trained spine surgeon

Dr. David Wong is a fellowship-trained board-certified orthopedic spine surgeon with a specialty in lumbar microsurgery. He was the President of the North American Spine Society (NASS) from 2002-2003. Click here to learn more.