The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on percutaneous endoscopic laser thoracic discectomy in June 2004. It was considered for review as part of the Institute's work programme. Although it did not meet the criteria to be re-assessed, percutaneous endoscopic laser cervical discectomy and percutaneous endoscopic laser lumbar discectomy were identified for consideration.

The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on percutaneous endoscopic laser lumbar discectomy. 

Description

Symptomatic lumbar disc herniation is when one of the discs in the bottom of the back which act as cushions between the bones bursts and pushes against the spinal cord or nerve roots that run through the backbone, causing: pain in the neck or back, weakness and numbness in the arms or legs, or bladder problems.

The aim of a percutaneous endoscopic laser discectomy is to remove the part of the disc that is pushing against the spinal cord or nerve root. A small cut is made in the skin and special equipment including a laser is used to heat and destroy some of the disc and remove the part that is sticking out to relieve pressure on the spinal cord or nerve root.

Coding recommendations

V33.8 Other specified primary excision of lumbar intervertebral disc

V55.- Levels of spine

Y76.3 Endoscopic approach to other body cavity

Y08.3 Laser destruction of organ NOC

Note: Codes within category V55.-  are assigned in second place each time a spinal operation is coded: if the levels of spine are not specified, V55.9 Unspecified levels of spine is used.

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

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