Frequently Asked Questions

Medical

• Why is endoscopic surgery at Laser Spine Institute better for me than other surgical options?
  At Laser Spine Institute, we use advanced, minimally invasive spine procedures to treat neck and back conditions with a smaller incision, lower infection rate and a quicker recovery. Within this short time, everything from pre-operation to post-operation is thoughtfully planned out for you. Integrated services such as evaluation, diagnostic testing and pain management are conveniently located within the walls of each of our surgical centers or by trusted providers nearby*.

  * Some patients' individual medical conditions may require additional testing that Laser Spine Institute will facilitate through a third-party service provider.

• What are the risks of your laser-assisted spine procedures?
  Our surgery complications are generally very low compared to open back or neck surgery. Our procedures are endoscopic and require a small incision. Postoperative infection at the incision site is a complication that rarely occurs. The Laser Spine Institute infection rate is 0.10%, compared to average infection rates of 4.5% at hospitals for open neck and back surgery.*

  *All surgical procedures involve some level of risk.

• What type of anesthesia is used for these spine procedures?
  Nearly all of the surgeries at Laser Spine Institute are performed utilizing a combination of local anesthesia (numbing medicine) and intravenous sedation (pain medication, sedatives). Our board-certified anesthesiologists and certified registered nurse anesthetists work together to assure patient safety and comfort throughout surgery. Following surgery, patients are taken to the recovery area. Most patients remain there for 60 to 90 minutes prior to discharge from the facility.*

  * Each patient’s experience and time of rest may differ.

• I have spinal stenosis or foraminal stenosis. Can I be helped?
  Yes, our procedures are effective for these conditions. Laser Spine Institute can remove impingements to the spinal or foraminal canal and free the nerve, thereby relieving the pain and symptoms.
• How many spine procedures will I require to solve my neck or back pain?

  Neck and back pain is very individualized as to how many procedures will be needed. During the initial evaluation, it will be determined how many levels of damage are causing symptoms. In most cases, problems are found at multiple levels, but only one or two of them may be causing symptoms. Most patients just need one surgery but many have multiple procedures within that surgery. These procedures can be done concurrently by Laser Spine Institute surgeons so that you are in the operating room only once and your recuperation, time and costs are kept to a minimum*.

  *Individual spine conditions, treatment and recovery times may vary. Each patient’s experience with endoscopic spine surgery will differ.

• Can you help me if I have had failed open back surgery?
  Yes, we typically can. In fact, a large percentage of our patients have had failed open back surgery in the past or have new spine conditions. Laser Spine Institute's procedures can correct many spine conditions.
• What medications should I avoid prior to having your endoscopic spine procedures?
  There are many medications both prescription and over the counter which can increase your chance of bleeding. Because of these effects, there are requirements that certain medications be held prior to surgery. As an example you must be off of all aspirin or anti-inflammatory drugs (or any combinations drugs that contain these ingredients). Aspirin and aspirin products require a hold of ten days prior to coming for surgery. Anti-inflammatory medications require a hold of five days prior to coming for surgery. Some vitamins and herbal supplements also can cause bleeding and will need to be held for 10 days prior to coming for surgery. For some medications such as Coumadin, Plavix, and Pradaxa we will consult your physician regarding holds prior to surgery. If you are taking any other medications, please inform us at the time you are scheduling surgery so we can advise you on an individual basis, as there are other medications that could need to be held. Our nurses will give you detailed instructions prior to and after your surgery as to which medications can be taken or not. Patients should not discontinue any prescription or over the counter medication prescribed by a physician without consulting that physician first.
• How soon after surgery can I drive?
  Due to the IV sedation that we utilize, under typical circumstances, you're able to return to normal driving and other activities of daily living after 48 hours of your procedure.
• If I have cervical surgery, how long will I have to wear a neck collar?
  It is recommended that a cervical collar be worn for the first two weeks after surgery. Patients are instructed to wear the collar if they are sitting or walking for an extended period of time, such as working at a desk or driving in a car.
• How is the laminotomy procedure different from a laminectomy?
  To open up the spinal canal, we use an endoscopic approach for laminotomies, without the need for endotrachial intubation and ventilation, a form of general anesthesia. We do not perform laminectomies. A laminotomy is a surgical procedure that is used to relieve pressure off the spinal canal for the exiting nerve root and spinal cord, increasing the amount of space available for the neural tissue and thus releasing the nerve(s). The difference is that a laminotomy removes only part of the lamina and a laminectomy removes the entire lamina.

General

• What do I have to do to find out if I'm a candidate for Laser Spine Institute procedures?
  One of our Patient Coordinators will contact you at the time and manner in which you request, and answer your questions. Next, you will provide us a copy of your MRI or CT scan with the written report so that we can review your report and studies to preliminarily determine if you're an initial candidate for our surgery. A Patient Coordinator will then call you to discuss your condition and the next steps we recommend for you. The final determination will occur during your clinical evaluation with history and physical. There's no cost for your preliminary MRI or CT scan review or your discussion with our Patient Coordinator.
• If I'm coming from out of town, how long will I have to stay in your area?

  We perform outpatient surgery, so there is no overnight stay at our facility. If you are from out of town, a Laser Spine Institute Patient Coordinator can assist you in making arrangements for the length of your stay. There are numerous hotels that we partner with that offer you lower rates and are within the immediate area of Laser Spine Institute surgery centers. There are one to two preoperative days of evaluation, then surgery, followed by a day of rest and recovery, and a final postoperative appointment. If a second surgery is needed, the process would repeat after a determined number of days. Preoperative testing does not have to be repeated if more surgery is required within a 30-day period. In general, a patient is looking at staying in our area for five to seven days for a surgery*.

  *Individual spine conditions, treatment and recovery times may vary. Each patient’s experience with endoscopic spine surgery will differ.

• What are my limitations after endoscopic spine surgery, and how long will I be out of work?
  We recommend you limit lifting over 10 to 15 pounds for at least six weeks, and that you return to normal activities gradually to allow for maximum healing. Patients who have desk jobs can normally return to work within two weeks and patients with physically strenuous jobs should wait at least six weeks, depending on the job. Each patient's surgery and job differs; subsequently, the time in which one may return to normal daily activities depends on an individual's work environment and the type of surgery performed.
• What arrangements do I need to make with a caregiver in order to have surgery at Laser Spine Institute?

  You will need to have someone available for you 24 hours after your surgery that is at least 18 years of age, in good physical and mental health, and capable of providing care. They must either drive you home (if you are local) or stay with you at a local hotel (if you are from out of town). Your Patient Coordinator will assist you in making arrangements. You will need to bring all medications you are currently taking.

• Why aren't more surgeons around the country using these types of procedures?
  Due to the nature of these procedures and the steep learning curve, it takes a highly skilled and well-trained surgeon to utilize the laser and other advanced surgical instruments through such a small incision. At this time, the procedures performed by the surgical team at Laser Spine Institute are not widely taught in residency programs. A surgeon must be professionally trained by a certified physician in the specialty of minimally invasive endoscopic spine surgery in order to master the technique. We are fortunate to have eleven professionally trained surgeons operating at Laser Spine Institute that are enjoying positive results.*

  * Laser Spine Institute requires each surgeon to complete an extensive Laser Spine Institute training program.

• May I request a specific surgeon?
  Yes, patients can make a request on which surgeon they would like to perform their surgery at Laser Spine Institute, however we cannot guarantee that a specific surgeon will definitely perform all the procedures. Every patient is different due to their anatomy or history of physical symptoms. Therefore, every case is reviewed by each surgeon and delegated according to each surgeon's specialty and the availability in the schedule.

Insurance

• Is minimally invasive spine surgery covered by insurance?
  Your maximum financial responsibility will be determined by your individual health insurance coverage and can be discussed at any time with one of our Patient Coordinators. We're very happy to say that out-of-pocket expenses have dropped to 27 percent for patients over the past three years.
• Why isn't the Laser Spine Institute in contract with Medicare for the facility fee?
  Laser Spine Institute physicians are in contract with Medicare for the professional services that they provide. However, the Laser Spine Institute facility itself is not in contract with Medicare. Therefore, a facility fee is incurred by the Medicare patient as an upfront, out-of-pocket cost. Laser Spine Institute provides every patient with not only the most professional and qualified service from its surgeon and staff, but also with state-of-the-art amenities and equipment from its advanced facilities.