Current evidence on the safety and efficacy of insertion of an annular disc implant at lumbar discectomy is limited in quantity and quality. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.
Clinicians wishing to undertake insertion of an annular disc implant at lumbar discectomy should take the following actions:
Inform the clinical governance leads in their NHS trusts.
Ensure that patients and their carers understand the uncertainty about the procedure's safety and efficacy and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.
NICE encourages further research on insertion of an annular disc implant at lumbar discectomy, particularly comparative trials. All studies should report details of patient selection and recurrence rates.
Clinicians should enter details about all patients undergoing insertion of an annular disc implant at lumbar discectomy onto the British Spine Registry and review clinical outcomes locally.