Ryu et al developed a grading system for evaluating a patient with epidural compression caused by a metastastic tumor. The authors are from Henry Ford Hospital in Detroit.
Parameters:
(1) radiographic grade
(2) neurological grade
Radiographic Findings
Grade
only vertebral bone involved
0
thecal sac impinged
I
thecal sac compressed
II
spinal cord impinged
III
cord displaced, with CSF visible between cord and tumor
IV
cord compressed, with no CSF visible between cord and tumor
V
Neurological Findings
Grade
none
a
focal, minor symptoms (pain, etc)
b
functional paresis (muscle power 4 or 5 out of 5), with involved muscle functional; the patient is ambulatory with a functional upper extremity
c
non-functional paresis (muscle power 0 to 3 out of 5), with involved muscle functional; the patient may be non-ambulatory or have a non-functional upper extremity
d
paralysis and/or incontinence
e
The patient status is a combination of the 2 grades (for example, Ve).
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