European Myelopathy Score


Name and Synonyms

European myelopathy score (EMS)

Source Article

Herdmann J, Linzbach M, Krzan M et al (1994) The European myelopathy score. In: Baucher BL, Brock M, Klinger M (eds) Advances in neurosurgery. Springer, Berlin, pp 266–268.

Structure / Content

Criterion    (Points)

Upper motor neuron

      •  Unable to walk, wheelchair    (1)

Gait function

  •  Walking on a flat ground only with cane or aid    (2)
  •  Climbing stairs only with aid    (3)
  •  Gait clumsy, but no aid necessary    (4)
  •  Normal walking and climbing stairs    (5)

Upper motor neuron

  •  Retention, no control over bladder and/or bowel function    (1)

Bladder and bowel function

  •  Inadequate micturition and urinary frequency    (2)
  •  Normal bladder and bowel function    (3)

Lower motor neuron

  •  Handwriting and eating with knife and fork impossible    (1)

Hand function

  •  Handwriting and eating with knife and fork impaired   (2)
  •  Handwriting, tying shoe laces or a tie clumsy    (3)
  •  Normal handwriting    (4)

Posterior column

  •  Getting dressed only with aid    (1)

Proprioception and coordination

  •  Getting dressed clumsily and slowly    (2)
  •  Getting dressed normally    (3)

Paraesthesia/pain

  •  Invalidity due to pain    (1)
  •  Endurable paraesthesia and pain    (2)
  •  No paraesthesia and pain     (3)

Scoring Method

Total score    5–18.

Interpretation

The lower the score the more severe the deficits. Normal function: 17 + 18, grade 1: 13–16, grade 2: 9–12, grade 3: 5–8. Weight of the criterion in percentage of 18 points: upper extremity 27.8%, lower extremity 22.2%, coordination 16.7%, paraesthesia/pain 16.0%, bladder and bowel function 16.7%




References

Eur Spine J. 2007 December; 16(12): 2096–2103. 




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