This procedure will be funded if the following criteria can be met:
- The patient has had magnetic resonance imaging, showing disc herniation (protrusion, extrusion, or sequestered fragment) at a level and side corresponding to the clinical symptoms;
- The patient has a corresponding neurologic deficit (asymmetrical depressed reflex, decreased sensation in a dermatomal distribution, or weakness in a myotomal distribution, altered bowel or bladder function);
- The patient has radicular pain (below the knee for lower lumbar herniations, into the anterior thigh for upper lumbar herniations) consistent with the level of spinal involvement;
- There is evidence of nerve-root irritation with a positive nerve-root tension sign (straight leg raise – positive between 30° and 70° or positive femoral tension sign);
- Symptoms persist despite conservative management for at least 6 weeks e.g. physiotherapy, analgesics.
- The patient must be 18 years or older – Adult Service only
For patients not meeting the above criteria, an application should be made to the IFR Panel if the referrer considers there are clinically exceptional circumstances
Exemptions: Patients with severe symptoms requiring emergency admission and those patients with recent neurological deficit e.g. foot drop and equine cauda will be exempt from the threshold criteria.
||Agreed pre 1 April 2013.
|Next Review date