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Nurick (Ambulatory Function) Grade
Availability
Please visit this website for more information about the instrument: Nurick (Ambulatory Function) Grade
Classification
Supplemental – Highly Recommended: Chiari I Malformation (CM)
Short Description of Instrument
Purpose: Nurick's classification system is aimed at patients presenting with myelopathy on the basis of gait abnormalities. This grading scale also assess ambulatory functions, and includes a lower limb component.
Comments/Special Instructions
The Nurick Classification System was developed to assess the importance of ischaemia of the spinal cord caused by spondylosis (Nurick, 1972).
Scoring
Scoring: The scale works from 0–5, with higher scores indicating more severe injuries. The scores are as follows:
Grade 0: Signs or symptoms of root involvement but without evidence of spinal cord disease
Grade 1: Signs of spinal cord disease but no difficulty in walking
Grade 2: Slight difficulty in walking which did not prevent full-time employment
Grade 3: Difficulty in walking which prevented full-time employment or the ability to do all housework, but which was not so severe as to require someone else's help to walk
Grade 4: Able to walk only with someone else's help or with the aid of a frame
            Grade 5: Chair bound or bed ridden
Rationale/Justification
A very well established functional disability scale, widely used for decades, and well validated.
References
Nurick S. The pathogenesis of the spinal cord disorder associated with cervical spondylosis. Brain. 1972;95(1):87-100.
 
Guirado VM, Taricco MA, Nobre MR, Couto EB, Jr., Ribas ES, Meluzzi A, Brock RS, Dias MR, Rodrigues R, Teixeira MJ. Quality of life in adult intradural primary spinal tumors: 36-Item Short Form Health Survey correlation with McCormick and Aminoff-Logue scales. J Neurosurg Spine. 2013;19(6):721-735.
 
Revanappa KK, Rajshekhar V. Comparison of Nurick grading system and modified Japanese Orthopaedic Association scoring system in evaluation of patients with cervical spondylotic myelopathy. Eur Spine J. 2011;20(9):1545-1551.

 

Document last updated June 2019