The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Non-rigid stabilisation techniques for the treatment of low back pain.

It replaces the previous guidance on non-rigid stabilisation techniques for the treatment of low back pain (NICE interventional procedures guidance 183, June 2006).


Chronic low back pain is most often the result of normal wear and tear (degenerative change) which affects most people during their middle years, causing loss of height of the spinal discs and arthritis of the spinal joints. Non-rigid stabilisation (otherwise known as flexible or dynamic stabilisation) of the lumbar spine is intended to improve chronic low back pain by reducing painful movement without rigidly fusing the spine.

Coding recommendations

V40.1 Non-rigid stabilisation of spine

V55.- Levels of spine 

Y53.- Approach to organ under image control

Site code from Chapter Z

Note: Codes within category V55.-  are assigned in second place each time a spinal operation is coded: if the levels of spine are not specified, V55.9 Unspecified levels of spine is used.

Codes within category Y53.- are used as secondary codes to classify interventions that are percutaneous and require some form of image control: if the method of image control is unspecified, Y53.9 Unspecified approach to organ under image control is assigned.

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. 

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)