This guidance replaces the previous guidance on Prosthetic intervertebral disc replacement in the cervical spine (Interventional Procedures Guidance no. 143, 2005).
1.1 Current evidence on the efficacy of prosthetic intervertebral disc replacement in the cervical spine shows that this procedure is as least as efficacious as fusion in the short term and may result in a reduced need for revision surgery in the long term. The evidence raises no particular safety issues that are not already known in relation to fusion procedures. Therefore this procedure may be used provided that normal arrangements are in place for clinical governance, consent and audit.
1.2 This procedure should only be carried out in specialist units where surgery of the cervical spine is undertaken regularly.
1.3 NICE encourages further research into prosthetic intervertebral disc replacement in the cervical spine. Research outcomes should include long-term data on preservation of mobility, occurrence of adjacent segment disease and the avoidance of revision surgery.