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- Table 1
Macnab Criteria (Macnab I. “negative disc exploration: an analysis of the cause of nerve root involvement in sixtyeight patients.” J Bone Joint Surg (Am) 1971 ;53:891-903).
Excellent: No pain; no restriction of activity.
Good: Occasional back or leg pain of sufficient severity to interfere with the patient’s ability to do his normal work or his capacity to enjoy himself in his leisure hours.
Fair: Improved functional capacity, but handicapped by intermittent pain of sufficient severity to curtail or modify work or leisure activities.
Poor: No improvement or insufficient improvement to enable increase in activities; further operative intervention required.
Indication N (%) Classical 515 (85%) Non-Classical 90 (15%) Leg pain with significant back pain 34 (6%) Far lateral/foraminal herniation 14 (2%) Recurrent disc herniation following surgery 3 (0.5%) dominant neurology with minimal leg pain 3 (0.5%) two level herniations 27 (4%) Cauda equina syndrome 1 (0.1%) Mean Age 47 years (range 17-88) Sex M 56% W 44% Duration of Symptoms 10 months (range 1 - 120) Radicular pain Right (51%); left (49%) Investigation Myelogram 42 patients; CT Scan 206 patients; MRI 357 patients L5-S1 296 L4-5 263 L3-4 16 L2-3 3 L4-5 & L5-S1 25 L3-4 & L4-5 2 Average Follow-up 62 months (range 12 - 123) Macnab (Excellent and Good) 76% Satisfaction 78% Surgical Intervention 14% Fusion/Stabilisation 4% (24 patients) Decompression 9% (54 patients) Chemonucleolysis 1% (6 patients) SF-36 scores generally correlated with age/sex of normal scores for the local population.
Infection 0 Neurological 0 Anaphylaxis 0 Recurrent herniation 0
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