, Volume 60, Issue 10, pp 1035–1041 | Cite as

New grading system for the clinical evaluation of patients with spinal vascular lesions

  • Dae Chul SuhEmail author
  • Yunsun Song
  • Danbi Park
  • Minkyu Han
  • Young-Min Lim
  • Ji Eun Park
  • Sang Hun Lee
  • Sang Ryong Jeon
  • Kwang-Kuk Kim
Spinal Neuroradiology



Neurointerventional approaches have improved myelopathy in patients with spinal vascular lesions by providing effective management, particularly when surgical approaches are difficult. However, there have been challenges in describing and comparing recovery status during the post-treatment period.


We evaluated 43 patients with venous congestive myelopathy (VCM) using Aminoff–Logue Disability Scale for gait (AL-G) and micturition (AL-M) scores. These results were compared with our new PSMS grading system that evaluates four categories (grades 0–3): pain, sensory symptoms, motor deficit, and sphincter change. Simple linear regression was used to identify the association or trend among the scales. We also calculated an overall area under the receiver operating characteristic curve to compare the predictive ability of the PSMS system with that of the previous grading system (AL-G and AL-M).


Compared with other grading system, the PSMS system was more sensitively correlated with patient status and the results were easy to compare with previous clinical statuses during follow-up. The PSMS system also measured pain, which is commonly associated with spinal dural arteriovenous fistula and not precisely evaluated by other grading system.


The new PSMS grading system for patients with VCM correlated well with the previously used systems and included pain evaluation. This new grading system is an easy tool for the evaluation and comparison of outcomes before and after endovascular treatment.


Spinal vascular lesion Spinal vascular malformation Clinical evaluation Clinical outcome 


Compliance with ethical standards


This work was funded by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. 2018R1A2B6003143).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

For this type of retrospective study formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Dae Chul Suh
    • 1
    Email author
  • Yunsun Song
    • 1
  • Danbi Park
    • 1
  • Minkyu Han
    • 2
  • Young-Min Lim
    • 3
  • Ji Eun Park
    • 1
  • Sang Hun Lee
    • 1
  • Sang Ryong Jeon
    • 4
  • Kwang-Kuk Kim
    • 3
  1. 1.Department of Radiology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
  2. 2.Department of Clinical Epidemiology and Biostatistics, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
  3. 3.Department of Neurology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea
  4. 4.Department of Neurosurgery, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulRepublic of Korea

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