The National Institute for Health and Care Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Percutaneous endoscopic laser lumbar discectomy in May 2009. NICE is currently updating this guidance. The new guidance will be published shortly. Until then the NHS should continue to follow the recommendations outlined in the current version of the guidance LINK to current guidance. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure review and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
 
Status In progress
Process IP
Description Lumbar disc herniation occurs when the nucleus pulposus of an intervertebral disc protrudes through a weakening or tear in the surrounding annulus fibrosus. Symptoms include pain in the back or leg, and numbness or weakness in the leg. Serious neurological sequelae including painful foot drop, bladder dysfunction, or cauda equina syndrome, may sometimes occur. Conservative treatments include analgesics, non-steroidal anti-inflammatory medication and manual therapy. Epidural corticosteroid injections can also be used to reduce nerve pain in the short term. Lumbar discectomy is considered if there is severe nerve compression or persistent symptoms that are unresponsive to conservative treatment. Surgical techniques include open discectomy or minimally invasive alternatives using percutaneous endoscopic approaches. The choice of operative technique may be guided by several factors, including the presenting symptoms and signs and the location and size of the disc involved.

Timeline

Key events during the development of the guidance:

Date Update
14 December 2016 Expected publication
22 April 2016 - 20 May 2016 Interventional procedure consultation

For further information on how we develop guidance, please see our page about NICE interventional procedures guidance