1.1 Current evidence suggests that there are no major safety concerns associated with automated percutaneous mechanical lumbar discectomy. There is limited evidence of efficacy based on uncontrolled case series of heterogeneous groups of patients, but evidence from small randomised controlled trials shows conflicting results. In view of the uncertainties about the efficacy of the procedure, it should not be used without special arrangements for consent and for audit or research.
1.2 Clinicians wishing to undertake automated percutaneous mechanical lumbar discectomy should take the following actions.
Inform the clinical governance leads in their Trusts.
Ensure that patients understand the uncertainty about the procedure's efficacy and provide them with clear written information. In addition, use of the Institute's information for the public is recommended.
Audit and review clinical outcomes of all patients having automated mechanical percutaneous lumbar discectomy. The Institute may review the procedure upon publication of further evidence.