The Schizas classification grades central lumbar spinal stenosis on axial T2-weighted MRI. It distinguishes grades A to D. Grade A is subdivided into A1 to A4.[^1]
Classification
Grade | Characteristics | Degree of stenosis |
A1 | The nerve roots are located dorsally and occupy less than half of the dural sac area. | There is no or mild stenosis. |
A2 | The nerve roots are located dorsally and contact the Dura in a horseshoe-shaped configuration. | There is no or mild stenosis. |
A3 | The nerve roots are located dorsally and occupy more than half of the dural sac area. | There is no or mild stenosis. |
A4 | The nerve roots are located centrally and occupy a large portion of the dural sac area. | There is no or mild stenosis. |
B | The nerve roots occupy the entire area of the dural sac. Cerebrospinal fluid can still be delineated between the nerve roots. | There is moderate stenosis. |
C | The individual nerve roots can no longer be delineated. The dural sac shows a homogeneous gray signal without discernible Cerebrospinal fluid. | There is severe stenosis. |
D | In addition to the lack of delineation of the nerve roots and the absent cerebrospinal fluid signal, no discernible epidural fat is seen posteriorly. | There is extreme stenosis. |
Figure
Clinical interpretation
The original study found no association between morphological grade and the Oswestry Disability Index. Grade alone therefore does not describe the extent of functional impairment.[^1]