Lumbar spinal canal stenosis grading systems by Lee and Schizas
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Visual grading of lumbar spinal canal stenosis based on axial T2-weighted MRI
- Grade 0: no stenosis: no obliteration of the anterior cerebrospinal fluid space
- Grade 1: mild stenosis: mild obliteration of the anterior cerebrospinal fluid space and all cauda equina clearly separated from each other
- Grade 2: moderate stenosis: moderate obliteration of the anterior cerebrospinal fluid space and some cauda equina aggregation
- Grade 3: severe stenosis: severe obliteration of the anterior cerebrospinal fluid space, marked compression of the dural sac, and the entire cauda equina appearing as one bundle
- Grade A: no or minor stenosis
- A1: rootlets lying dorsally and occupying less than half of the dural sac area.
- A2: rootlets lying dorsally with a horseshoe configuration
- A3: rootlets lying dorsally and occupying more than half of the dural sac area
- A4: rootlets lying centrally and occupying the majority of the dural sac area
- Grade B: moderate stenosis: rootlets occupying the entire dural sac, but rootlets can still be individualized
- Grade C: severe stenosis: no recognizable rootlets with complete effacement of cerebrospinal fluid space, but epidural fat is present posteriorly
- Grade D: extreme stenosis: no recognizable rootlets and no epidural fat posteriorly
Authors: Yeon-jee Ko, Eugene Lee, Joon Woo Lee, Chi Young Park, Jungheum Cho, Yusuhn Kang, Joong Mo Ahn.
Original file: https://doi.org/10.1371/journal.pone.0233633 (published in PLOS ONE)
Modifications: The original figures were divided, cropped, and captioned separately.
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- Ko Y, Lee E, Lee J et al. Clinical validity of two different grading systems for lumbar central canal stenosis: Schizas and Lee classification systems. PLoS ONE. 2020;15(5):e0233633. doi:10.1371/journal.pone.0233633