MRI classification system for lumbar disc degeneration

Disc degeneration can be graded on MRI T2 spin-echo weighted images using a grading system proposed by Pfirrmann 1. This classification is not used on routine spine reports, being more important for research purposes.

  • grade I: disc is homogeneous with bright hyperintense white signal intensity and normal disc height
  • grade II
    • disc is inhomogeneous, but keeping the hyperintense white signal
    • nucleus and annulus are clearly differentiated, and a gray horizontal band could be present
    • disc height is normal
  • grade III
    • disc is inhomogeneous with an intermittent gray signal intensity
    • distinction between nucleus and annulus is unclear
    • disc height is normal or slightly decreased
  • grade IV
    • disc is inhomogeneous with a hypointense dark gray signal intensity
    • there is no more distinction between the nucleus and annulus
    • disc height is slightly or moderately decreased
  • grade V
    • disc is inhomogeneous with a hypointense black signal intensity
    • there is no more difference between the nucleus and annulus
    • the disc space is collapsed

A modified classification was proposed in 2007 by Griffith et al. 2.

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Article Information

rID: 27904
Tag: spine
Synonyms or Alternate Spellings:
  • Pfirrmann disc classification
  • DDD classification

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