Current evidence on the safety and efficacy of percutaneous endoscopic laser cervical discectomy is inadequate in quantity and quality. Therefore, this procedure should only be used with special arrangements for clinical governance, consent, and audit or research.
Clinicians wishing to undertake percutaneous endoscopic laser cervical discectomy should take the following actions.
Inform the clinical governance leads in their Trusts.
Ensure that patients and their carers understand the uncertainty about the procedure's safety and efficacy and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having percutaneous endoscopic laser cervical discectomy (see section 3.1).
Clinicians undertaking this procedure should have specific training in the use of lasers and in endoscopy of the spinal canal.
NICE may review the procedure on publication of further evidence.