The Spetzler classification of spinal cord vascular lesions was published in 2002 and seeks to classify lesions of the spinal vascular malformations based on "pathophysiology, neuroimaging features, intraoperative observations, and neuroanatomy". This was from a neurosurgical perspective, whereas many other classification systems focus primarily on angiographic features 1,2.
Usage
The Spetzler classification is widely used, particularly as the terminology used matches that in common clinical parlance. The publication, however, was met with criticism and generated lengthy and even entertaining public disagreements between authors via letters to the editor 3,4.
Classification
The classification broadly divides vascular lesions into 4 groups 1:
arteriovenous fistulas (AVF)
neoplastic vascular lesions
spinal aneurysms
These are then further subdivided. There is considerable overlap with other classification systems (e.g. Takai classification of spinal arteriovenous shunts ) and this is included in brackets 1,2.
-
arteriovenous fistulas (AVFs)
extradural
-
intradural
dorsal (type I)
ventral (type IV)
-
arteriovenous malformations (AVMs)
extradural–intradural (type III)
-
intradural
-
intramedullary
compact (type II)
diffuse
-
conus medullaris
-
neoplastic vascular lesions
spinal aneurysms