Laser in the Removal of Extraaxial Tumors of the Brain and Spinal Cord

Abstract

Most neurosurgeons who have had the opportunity to use a laser or see laser removal of extraaxial tumors have been impressed, if not convinced, of the usefulness of the instrument in this application. One can speculate that had meningiomas rather that gliomas been chosen for the initial clinical applications of carbon dioxide laser in the early 60s, the subsequent history of laser in neurosurgery would have been drastically different. At present, it appears that the most widely accepted and uniformly appreciated use of laser in neurosurgery is in the removal of extraaxial tumors of the central nervous system. These neoplasms offer the surgeon the opportunity to capitalize on the inherent gentleness and precision of laser. These diseases histologically benign, but frequently malignant by location should be gratifying but frequently because of unsuspectedly poor results leave surgeon and patient frustrated and angry. On the other hand, several series have now demonstrated that the use of laser for this group of patients has been rewarding and appreciated. Statistically, patients do better immediately, are released from the hospital sooner, and enjoy a more neurologically normal life. When one considers that this group is expected to have a full hfe expectancy, the neurological status of the patient becomes all the more important both from a personal as well as a societal point of view.