The Pros and Cons of Laser Surgery for Back Injuries

Barry Korn, DO, DPM

Preventing back injuries can be a workplace safety challenge regardless of company size or industry. According to the National Institute of Neurological Disorders and Stroke, back pain is one of the most common reasons a person misses work and visits a doctor.1 And a recent study revealed that 25 percent of working U.S. adults deal with some level of back pain.2

Due to the physical nature of some blue-collar work, these employees tend to be at higher risk of back injury; however, this injury problem also affects white-collar workforces.3 Factors that can be associated with work-related back pain include4:

  • Amount of force or strain placed on the back (e.g., from lifting a heavy object)
  • Repetitiveness of motion (e.g., frequently bending)
  • Prolonged sitting or standing

Back pain can derive from symptoms associated with the spine. Because the spinal cord carries nerve signals throughout the body, back pain can be debilitating and limit one’s ability to perform a variety of normal work functions — from sitting at a desk in an office to lifting materials at a construction site.

As the medical field continues to evolve, it is crucial for workers’ compensation insurance carriers to stay abreast of emerging procedures to ensure the best care for employers and their injured employees.

An increasingly prevalent treatment option for back pain is laser surgery. But like many treatment options, laser surgery has its share of advantages and drawbacks. Applying more than 30 years’ clinical experience and expertise in the area of pain management, I’ve provided some notable pros and cons both workers’ compensation insurance carriers and employers should consider with this treatment option:

Pros of laser surgery for back pain

  • Minimally invasive procedure: Compared to traditional open surgery, laser spine surgery involves smaller incisions, which can reduce the risk of complications, minimize scarring, and lead to shorter recovery times.
  • Precision/accuracy: Laser technology allows surgeons to target specific areas with high precision, potentially reducing damage to surrounding tissues and nerves.
  • Quicker recovery: Due to its minimally invasive nature, laser surgery typically results in shorter hospital stays and faster recovery times compared to conventional surgeries.
  • Reduced pain/discomfort: Some patients report experiencing less postoperative pain and discomfort following laser spine surgery, potentially reducing the need for long-term pain management.

Cons of laser surgery for back pain

  • Limited applications: Laser surgery is not suitable for all back conditions and may not address certain complex spinal issues such as spinal instability or advanced degenerative diseases.
  • Skill/expertise: Performing laser surgery requires specialized training and expertise. It is crucial to ensure that surgeons performing these procedures have undergone proper training and possess the necessary qualifications.
  • Cost considerations: The expenses associated with laser spine surgery may vary, and it is essential to weigh the potential benefits against the costs for both the patient and the insurance carrier.

Determining medical necessity

Given the evolving nature of laser surgery for back pain, the determination of medical necessity is paramount. This reinforces the significance of utilization review services, which would help determine the medical necessity of this procedure or other surgical treatment options in a workers’ compensation case. Utilization review plays a pivotal role in objectively assessing the appropriateness and efficiency of medical treatments.

Subjectively speaking, here’s why utilization review provides the best means to evaluate the necessity of laser surgery:

  • Evidence-based decision-making: Utilization review relies on evidence-based guidelines and clinical research to weigh treatment options. By reviewing medical records and consulting with experts, utilization review professionals can make informed decisions based on the best available evidence.
  • Cost-effectiveness: Utilization review helps ensure that expensive procedures, such as laser surgery, are reserved for cases in which the potential benefits outweigh the risks and associated costs. This helps insurance carriers maintain sustainable coverage and allocate resources effectively.
  • Quality assurance: By implementing utilization review, insurance carriers can maintain a high standard of care, ensuring that patients receive appropriate treatments based on established medical guidelines and protocols.
  • Patient safety: Utilization review helps safeguard a patient’s well-being by preventing unnecessary or inappropriate procedures. It ensures that the recommended treatment aligns with the patient’s diagnosis, optimizing the chances of a successful outcome.

Overall, by embracing utilization review, insurance carriers can effectively navigate the evolving landscape of medical treatments, ensuring optimal care for their policyholders while maintaining sustainable coverage. The utilization review process can be an invaluable tool to evaluate medical necessity and make informed decisions that prioritize patient well-being and support the advancement of medical practices.

Medical ReviewStream

If treatment for a work-related injury is not found to be medically necessary, the workers’ compensation claim may be denied. Ideally, medical treatment recommendations are reviewed by licensed health care professionals with the trained medical knowledge to make a determination. Medical ReviewStream™ is a national peer review organization that assists utilization review services in making medical necessity decisions. Backed by Concentra®, this network of occupational health clinicians brings extensive workers’ compensation experience to help companies make informed decisions for better post-injury recovery and efficient claims management. Medical ReviewStream can also offer expertise to ensure a company meets regulatory requirements.


  1. Back Pain. National Institute of Neurological Disorders and Stroke.
  2. Luckhaupt, S. E., Dahlhamer, J. M., Gonzales, G. T., Lu, M., Groenewold, M. R., Sweeney, M. H., and Ward, B. J. (2019). Prevalence, recognition of work-relatedness, and effect on work of low back pain among U.S. workers. Annals of Internal Medicine, 171(4), 301.
  3. Żywień, U., Barczyk-Pawelec, K., and Sipko, T. (2022). Associated Risk Factors with Low Back Pain in White-Collar Workers—A Cross-Sectional Study. Journal of Clinical Medicine, 11(5), 1275.
  4. Back Pain. National Institute of Arthritis and Musculoskeletal and Skin Diseases.