Classification of Ischemic Injuries to the Spinal Cord or Nerve Roots

Description

Interference with the vascular supply to the spinal cord can result in ischemia injury, which manifests as motor or sensory loss. This is a particular problem for patients have vascular surgery on the distal aorta or iliac arteries.

Blood supply to the spinal cord, nerve roots and plexus:

(1) anterior spinal artery

(2) posterior spinal artery

(3) radiculospinal artery

(4) radicular artery

Classification	Infarction Site	Vascular Association
I	complete infarction of the distal thoracolumbar cord
II	anterior two thirds of the spinal cord	anterior spinal artery syndrome
III	lumbosacral roots with or without patchy infarcts of cord
IV	lumbosacral plexus
V	segmental infarction of the spinal cord (one or 2 levels)
VI	posterior third of the cord	posterior spinal artery syndrome

Classif-ication	Motor	Sensory	Bowel and Bladder Function
I	bilateral flaccid paraplegia	bilateral sensory loss	bowel and bladder incontinence
II	bilateral flaccid paraplegia	loss of pain and temperature sensation; proprioception and vibratory sensation maintained
III	bilateral asymptomatic paraparesis		with or without bowel and bladder incontinence
IV	bilateral asymptomatic paraparesis; preservation paraspinal muscle innervation		with or without bowel and bladder incontinence
V	bilateral spastic paraplegia	bilateral sensory loss
VI		loss of proprioception and vibratory sensation

where:

• Paraparesis is partial paralysis.

• Paraplegia is paralysis of the legs and lower part of the body.

• Preservation of paraspinal muscle innervation is detected using EMG.

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Description

Specialty

ICD-10