Document Detail

Modified classification of spinal cord vascular lesions.
MedLine Citation:
PMID:  12450276     Owner:  NLM     Status:  MEDLINE    
The literature on spinal vascular malformations contains a great deal of confusing terminology. Some of the nomenclature is inconsistent with the lesions described. Based on the experience of the senior author (R.F.S.) in the treatment of more than 130 spinal cord vascular lesions and based on a thorough review of the relevant literature, the authors propose a modified classification system for spinal cord vascular lesions. Lesions are divided into three primary or broad categories: neoplasms, aneurysms, and arteriovenous lesions. Neoplastic vascular lesions include hemangioblastomas and cavernous malformations, both of which occur sporadically and familially. The second category consists of spinal aneurysms, which are rare. The third category, spinal cord arteriovenous lesions, is divided into arteriovenous fistulas and arteriovenous malformations (AVMs). Arteriovenous fistulas are subdivided into those that are extradural and those that are intradural, with intradural lesions categorized as either dorsal or ventral. Arteriovenous malformations are subdivided into extradural-intradural and intradural malformations. Intradural lesions are further divided into intramedullary, intramedullary-extramedullary, and conus medullaris, a new category of AVM. This modified classification system for vascular lesions of the spinal cord, based on pathophysiology, neuroimaging features, intraoperative observations, and neuroanatomy, offers several advantages. First, it includes all surgical vascular lesions that affect the spinal cord. Second, it guides treatment by classifying lesions based on location and pathophysiology. Finally, it eliminates the confusion produced by the multitude of unrelated nomenclatural terms found in the literature.
Robert F Spetzler; Paul W Detwiler; Howard A Riina; Randall W Porter
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  96     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-11-26     Completed Date:  2002-12-13     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  145-56     Citation Subset:  AIM; IM    
Division of Neurological Surgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, Arizona 85013-4496, USA.
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MeSH Terms
Aneurysm / classification
Arteriovenous Fistula / classification
Arteriovenous Malformations / classification
Spinal Cord / blood supply*
Vascular Diseases / classification*
Vascular Neoplasms / classification
Comment In:
J Neurosurg. 2002 Mar;96(2 Suppl):143-4; discussion 144   [PMID:  12450275 ]
J Neurosurg. 2003 Jan;98(1 Suppl):117-9; author reply 119-20   [PMID:  12546408 ]

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