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What is the foraminal stenosis grading system?

Foraminal stenosis can range from very minor to incredibly severe. To indicate how severe a patient’s condition is, physicians often use a grading system that ranges from zero to three. Usually, a grade is assigned after a comprehensive review of a patient’s MRI results.

There are several important things to remember when discussing the severity of a person’s foraminal stenosis. First, some people have naturally narrow foramen. This is not always a problem. Secondly, narrowing can occur without causing any symptoms. Usually, foraminal narrowing becomes an issue only if one of the nerve roots in the spine becomes compressed or otherwise damaged. It’s entirely possible to have severe foraminal narrowing without any symptoms.

Grade zero stenosis

Grade zero stenosis indicates that there is no apparent narrowing of the foramen (the openings in the bones through which the nerve roots branch out to the rest of the body).

Grade one stenosis

Grade one stenosis indicates a small amount of spinal narrowing. If a nerve root is affected, less than 50 percent of the nerve root is in contact with the narrowed foramen.

Grade two stenosis

Grade two stenosis indicates moderate spinal narrowing. If a nerve root is affected, more than 50 percent of the nerve root is compressed.

Grade three stenosis

Grade three foraminal stenosis indicates severe spinal narrowing. If a nerve root is affected, the nerve root may have collapsed or sustained other forms of structural damage.

Treating foraminal stenosis

When creating a patient’s treatment plan, physicians will usually take into account the severity of the patient’s diagnosis, as well as the symptoms he or she is experiencing and how frequently those symptoms occur. The initial approach usually involves a combination of nonsurgical treatments, although some people with severe foraminal narrowing eventually require surgery.

At USA Spine Care, we perform minimally invasive outpatient surgery for foraminal stenosis, offering our patients a safer and effective alternative to open neck and back operations.^ We can help you find out if you’re a candidate for our muscle-sparing procedures by providing a no-cost MRI review.* To learn more, contact us today.

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