This document replaces previous guidance on prosthetic intervertebral disc replacement (interventional procedure guidance 100).
1.1 Current evidence on the safety and efficacy of prosthetic intervertebral disc replacement in the lumbar spine is adequate to support the use of this procedure provided that normal arrangements are in place for clinical governance, consent and audit.
1.2 A multidisciplinary team with specialist expertise in the treatment of degenerative spine disease should be involved in patient selection for prosthetic intervertebral disc replacement in the lumbar spine. The procedure should only be carried out in patients for whom conservative treatment options have failed or are contraindicated.
1.3 The current evidence includes studies with a maximum follow-up of 13 years, but the majority of evidence is from studies with shorter durations of follow-up. NICE encourages clinicians to continue to collect and publish data on longer-term outcomes, which should include information about patient selection and the need for further surgery.