Nice | Percutaneous treatment of intervertebral discs for back pain

18th March 2016 by Louise Hudman

Nice | Percutaneous treatment of intervertebral discs for back pain

There are three new guidelines from NICE about using various percutaneous treatments for intervertebral disc problems.

Percutaneous coblation of the intervertebral disc for low back pain and sciatica.

  • NICE have advised that this procedure may be used to treat both low back pain and sciatica if conservative measures have failed and if open surgery is not suitable.
  • There is good evidence for its efficacy and no major safety concerns.
  • Treatment is done under sedation using local anaesthetic. Probes are inserted that allow radiofrequency to be applied to the nucleus of the disc, thus destroying it.

Percutaneous intradiscal radiofrequency treatment for low back pain.

  • NICE have advised that this procedure can be used, but only with special follow-up, as the evidence for its efficacy is limited in both quality and quantity.
  • In this situation, the aim is not to destroy the disc (as in coblation), but to enhance its structural integrity by altering its structure. Nociceptive fibres may also be destroyed.
  • Again, it can be used where conservative treatments have failed and where open surgery is not suitable.

Percutaneous electrothermal treatment of the intervertebral disc annulus for low back pain and sciatica.

  • NICE have advised that again this procedure should only be used with special follow-up as evidence on efficacy is inconsistent and of poor quality.
  • The procedure is carried out in a similar way, but electrothermal energy is applied to the annulus to try to stiffen it and to destroy nociceptive fibres within it.
  • They have not advised on when it is indicated.

Join

Join to view the rest of this content, as well as access all the benefits of joining NASGP.

Join

Login

Already a member? Login to view this content.

Login

"I must tell you that you have a brilliant team. I find it so convenient to ask for help and it's always tailored to my needs. Thanks a bunch :)"

Dr Aamina Khan

See the full list of features within our NASGP membership plans

Membership