The Classification of Nerve Injury Revisited: Sunderland 0‐VI

Abstract

Introduction:Seddon and Sunderland's original nerve injury classification systems have stood the test of time over the last 70 years and continue to be widely used today. However, since those original descriptions, knowledge of nerve pathophysiology and healing has advanced, electrodiagnostic results have become more refined, and surgical options have increased. Methods: We offer a revisited review of the nerve injury classification to incorporate new knowledge for the modern era of nerve surgery. Results: We offer the addition of grades 0 and VI to the existing classification of nerve injuries based on Sunderland's framework, and we present a simplified classification that is patient and physician oriented, reflecting prognosis, time to recovery, and degree of recovery. Discussion: By following this nerve injury framework, clinicians can better assess, prognosticate, and manage patients.