Nurick Grade for Cervical Myelopathy
Classifies severity of cervical myelopathy by gait impairment to complement JOA scoring and guide urgency of intervention
- Highest activation tier
- Available
- How it is scored
- Scored in code; a stated value is compared only from the structured summary or a supplied value
- Scoring type
- classification
- Care settings
- Inpatient, Outpatient
When it activates
Scribeable activates a calculator from the encounter. The Nurick Grade for Cervical Myelopathy can activate when the transcript or pasted chart context documents any of these:
- Cervical myelopathy grading
- Gait impairment from cervical cord compression
- Cervical myelopathy severity assessment
- Spinal cord dysfunction classification
- Cervical spine surgical candidacy
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: G99.2, M47.1.
Note-type scope: it activates on notes whose subject resolves to neurology, rehab. A note that resolves to another subject does not carry it even when the clinician's specialty matches; a note with no resolvable subject (a generic consultation) falls back to the specialty match.
Inputs the note needs
1 input. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and the code-scoring engine never inserts the score unprompted.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| Nurick grade (0-5) | exam |
Scoring
Grade 0: Root signs/symptoms only, no evidence of cord involvement. Grade 1: Signs of cord involvement, normal gait. Grade 2: Mild gait difficulty, able to be employed. Grade 3: Gait difficulty prevents employment, can ambulate without assistance. Grade 4: Able to ambulate only with assistance (cane, walker). Grade 5: Chair-bound or bedridden.
Interpretation
Grade 0: Root involvement only — conservative management typically appropriate, close monitoring. Grade 1: Early cord involvement — consider surgical consultation. Grade 2-3: Progressive myelopathy — surgery generally recommended before further deterioration. Grade 4-5: Advanced myelopathy — surgical decompression may stabilize but recovery limited; prognosis guarded. Higher pre-operative Nurick grade correlates with poorer surgical outcomes.
Evidence
Sources carried in Scribeable's citation registry for this calculator; guideline version: Nurick 1972.
- Nurick S. The pathogenesis of the spinal cord disorder associated with cervical spondylosisNurick (Myelopathy Grading) 1972 · 1972 · link last verified 2026-03-28
How Scribeable handles it in the note
Scribeable can list the Nurick Grade for Cervical Myelopathy as available to the note when the clinician's specialty matches and the encounter activates it. Its highest activation tier is available: you are never asked for its inputs, and the code-scoring engine never inserts it into the draft unprompted.
The registry entry carries the inputs, scoring criteria and interpretation above so a score you state is documented against the same reference.
Classified as a risk score: activated strictly, by a documented trigger, never by a permissive reading of the encounter.
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