In about 10% of patients with a herniated disc, surgery (discectomy) is indicated. However, the long-term results of discectomy are unsatisfactory. This report evaluates whether the implantation of an anular closure device (Barricaid®) results in better clinical long-term outcomes than the standard discectomy.

For the 2019 update, an RCT with a superiority design and an uncontrolled observational study with two years follow-up each were identified in addition to the observational study already included in the 2013 assessment. Both studies do not allow a reliable assessment of the efficacy and safety of the procedure due to their bias potential.