Neurosurgical applications of laser technology

Although lasers have been used in clinical neurosurgery for over 40 years, technological advancements have expanded their use and improved technical application. Originally applied to brain tumors to confer destructive oncolysis, lasers have been used over the last few decades to incise, fenestrate, and repair tissues and now are being used for cerebrovascular bypass techniques. In this chapter, a brief history on the evolution of lasers in neurosurgery will be discussed, and technical and clinical aspects of current applications will presented. Such applications include: laser scalpel for spinal cord tumors and lipomas, fenestration of arachnoid cysts, cerebrovascular bypass with the ELANA device, laser-induced interstitial thermotherapy for brain tumors, laser tissue soldering for dural repair, and percutaneous laser disc decompression.