Cervical degenerative spondylosis (grading)

Last revised by Daniel J Bell on 20 Nov 2023

Cervical degenerative disease is extremely common. Cervical spondylosis can be graded using a very old but reliable classification devised by Jonas Kellgren et al 1,2. It is based on findings on a lateral cervical spine radiograph although it can also be applied to MRI evaluation of spine.

The key parameters are osteophyte formation, intervertebral disc height narrowing and vertebral end-plate sclerosis.

  • grade 0 (normal)

    • no degenerative changes

  • grade 1 (minimal/early)

    • minimal anterior osteophyte formation

    • no reduction of intervertebral disc height

    • no vertebral endplate sclerosis

  • grade 2 (mild)

    • definite anterior osteophyte formation

    • subtle or no reduction in intervertebral disc height (<25%)

    • just recognisable sclerosis of the endplates

  • grade 3 (moderate)

    • definite anterior osteophyte formation

    • moderate narrowing of the disc space (25-75%)

    • definite sclerosis of the endplates and osteophyte sclerosis

  • grade 4 (gross)

    • large and multiple large osteophyte formation is seen

    • severe narrowing of the disc space (>75%)

    • sclerosis of the endplates with irregularities

See also

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