The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on prosthetic intervertebral disc replacement in the lumbar spine.
Artificial intervertebral discs have been developed to act as a functional prosthetic replacement unit for intervertebral units in much the same way as prostheses have been developed for a variety of joints such as the hip or knee. The design of most prosthetic discs is similar, with two metallic endplates separated by a more pliable inner core designed to emulate the biomechanical properties of the nucleus pulposus. The implantation of the prosthetic discs involves a small incision below the umbilicus. The diseased disc is partially or fully excised (depending on the prosthesis used). The vertebral endplates and surrounding spinal ligaments are preserved and help maintain implant stability. Single discs can be replaced, or alternatively, several levels can be replaced during the same surgery.
The standard intervention for patients with these indications would be discectomy and spinal fusion.