Use of lasers in minimally invasive spine surgery

Introduction: Currently, minimally invasive spine surgery (MISS) has become a new gold-standard spine technique because it may reduce morbidity and recovery times. Technical developments based on light amplification by stimulated emission of radiation (laser) have been applied extensively in the field of MISS. The objective of this review is to describe the surgical applications of laser technology in MISS and to discuss the pros and cons of laser spine surgery. Areas covered: We reviewed the medical literature to identify how lasers are being used in the current MISS techniques. We also described a variety of laser spine surgery according to the laser employed and surgical approach. There are three categories of laser surgery in MISS: (1) open microscopic laser surgery; (2) percutaneous endoscopic laser surgery; and (3) laser tissue modulation for spinal pain. Even though numerous laser procedures and related case series have demonstrated clinical efficacy in selected cases, there continues to be a paucity of randomized clinical trials. Expert commentary: Although there have been controversies on the effect of treatment, laser spine surgery shows promising results and has potentials for further investigations. Technical advancement and high-quality researches are needed to increase the practicality of laser spine surgery.