Current evidence on percutaneous intradiscal radiofrequency treatment of the intervertebral disc nucleus for low back pain raises no major safety concerns. The evidence on its efficacy is limited 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 do percutaneous intradiscal radiofrequency treatment of the intervertebral disc nucleus for low back pain should:
Inform the clinical governance leads in their NHS trusts.
Ensure that patients understand the uncertainty about the procedure's efficacy and provide them with clear written information. In particular, patients should be informed about other treatment options, about the possibility that the procedure may not relieve their symptoms, and about the risk of a flare‑up of their pain after treatment. In addition, the use of NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having percutaneous intradiscal radiofrequency treatment of the intervertebral disc nucleus for low back pain (see further information).
NICE encourages further research into percutaneous intradiscal radiofrequency treatment of the intervertebral disc nucleus for low back pain. Further research should include details of patient selection, the duration of patients' symptoms, and a precise account of the technique used for treatment. Outcome measures should include pain relief and quality of life. Long‑term follow‑up data should include details of any subsequent procedures.