Peripheral nerve injury grading simplified on MR neurography: As referenced to Seddon and Sunderland classifications

Indian J Radiol Imaging. 2014 Jul;24(3):217-24. doi: 10.4103/0971-3026.137025.

Abstract

The Seddon and Sunderland classifications have been used by physicians for peripheral nerve injury grading and treatment. While Seddon classification is simpler to follow and more relevant to electrophysiologists, the Sunderland grading is more often used by surgeons to decide when and how to intervene. With increasing availability of high-resolution and high soft-tissue contrast imaging provided by MR neurography, the surgical treatment can be guided following the above-described grading systems. The article discusses peripheral nerve anatomy, pathophysiology of nerve injury, traditional grading systems for classifying the severity of nerve injury, and the role of MR neurography in this domain, with respective clinical and surgical correlations, as one follows the anatomic paths of various nerve injury grading systems.

Keywords: Axonotmesis; MR neurography; Seddon; Sunderland; injury; neuroma-in-continuity; neurotmesis; peripheral nerve.