The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on endoscopic laser foraminoplasty in December 2003. In accordance with the Interventional Procedures Programme Process Guide, guidance on procedures with special arrangements are reviewed 3 years after publication and the procedure is reassessed if important new evidence is available.

The guidance was considered for reassessment in October 2011 and it was concluded that NICE will not be updating this guidance at this stage. However, if you believe there is new evidence which should warrant a review of our guidance, please contact us via the email address below.


This procedure is mainly used to treat back pain caused by a prolapsed intervertebral disc. Approximately 2-5% of people suffer acute back pain per annum, while 0.5% of these have pain and neurologic conditions requiring surgery.

This endoscope-assisted laser technique is used to widen the lumbar exit route foramina in the spine. A laser is inserted to ablate portions of the intervertebral disc which have protruded.

Coding recommendations


SNOMED CT preferred term (concept ID)

Endoscopic laser foraminoplasty of lumbar spine (822281000000109)

V56.- Primary foraminoplasty of spine

V55.- Levels of spine

Y76.3 Endoscopic approach to other body cavity

Or if this is a revisional procedure:

V57.- Revisional foraminoplasty of spine

V55.- Levels of spine

Y76.3 Endoscopic approach to other body cavity

Note: Codes from categories V56.- or V57.- are selected depending on the site in the spine that is operated on, and fourth character detail is required.

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.

Diagnosis or health condition

SNOMED CT preferred term (concept ID)

Intervertebral disc prolapse (73589001)