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Table 1 Classification of MRI findings

From: Degenerative findings in lumbar spine MRI: an inter-rater reliability study involving three raters

Diagnostic findingsScale/categoriesDefinitions
Spondylolisthesis, (Meyerding [27])OrdinalDefined as slippage of the vertebral body in relation to the one below in: Anterior, posterior or lateral direction.
 0Normal
 Grade I1Displacement of vertebral body ≤ ¼ of vertebral body below.
 Grade II2Displacement of vertebral body ≤ ½ of vertebral body below.
 Grade III3Displacement of vertebral body ≤ ¾ of vertebral body below.
 Grade IV4Displacement of vertebral body ≤ 4/4 of vertebral body below.
Disc degeneration, (Pfirrmann [22])OrdinalFor this study grade I and II is considered normal.
 Grade I:0Nucleus pulposus is homogenous and has high, bright white, signal intensity. Clear distinction of nucleus and annulus. Normal heights of the intervertebral disk
 Grade II:0Like grade I, but the nucleus pulposus is inhomogeneous, with or without clear horizontal bands.
 Grade III:1Nucleus pulposus being inhomogeneous and gray, unclear distinction of the nucleus and annulus, intermediate signal intensity and normal to slightly decreased intervertebral disc height.
 Grade IV:2Inhomogeneous, gray to black nucleus pulposus and no distinction between the nucleus and the annulus. The signal intensity is intermediate to hypointense and normal to moderately decreased disc height.
 Grade V:3Nucleus pulposus is inhomogeneous and black, with hypointense signal intensity and collapsed disk space.
Nerve root compromise, (Lee [24])Ordinal 
 Normal0No contact to nerve roots
 Contact1Perineural fat obliteration from two opposing sides. No morphologic change (no signs of compression/deformation) of the nerve root.
 Contact and deviation2Perineural fat obliteration surrounding the nerve root from four sides. No morphologic change (no compression/deformation) of nerve root.
 Compression3Visible nerve root collapse or morphologic change
Spinal stenosis, (Lee [24])Ordinal 
 Central
  No stenosis:0Up to 3 mm disc bulge is normal.
  Relative stenosis:1Reduced space < 50%, but still visible fluid signal around the nerve roots.
  Absolute stenosis:250% reduction or more of the dural sac area and no visible signal (dark/black) from cerebrospinal fluid around the nerve roots or medulla spinalis.
 Lateral
  No stenosis:0Normal levels of perineural fat.
  Relative stenosis:1Reduced space, perineural fat obliteration from at least two opposing sides but still visible perineural fat/CSF signal in the recess.
  Absolute stenosis:2Reduction of the recess to a point where perineural fat signal/CSF signal no longer is visible.
 Foraminal
  No stenosis:0Normal upside-down pear shape contour of the foramina with an apical nerve root location.
  Relative stenosis:1Reduced space, but still visible perineural fat signal in the foramen.
  Absolute stenosis:2Reduction of the foramen to the point where perineural fat signal is no longer visible.
Facet degeneration,
 (Ross/Moore [30]; Pathria [31])Ordinal 
  No degeneration:0Normal
  Mild degeneration:1Mild joint space narrowing and joint irregularity.
  Moderate degeneration:2Moderate joint space narrowing/irregularity, subchondral sclerosis/osteophyte formation.
  Severe degeneration:3Little, if any, joint space, severe subchondral sclerosis/ osteophyte formation. Possible subluxation and/or subchondral cyst formation.
 Scoliosis (Cobb [29])BinominalDefined as any spinal curvature with a Cobb’s angle greater than 10 degrees.
  sinistro convex0/1Apex of the curvature to the left.
  dextro convex0/1Apex of the curvature to the right.
  rotational0/1Pedicles and spinous process oriented to the left or right.
 Annular Fissure, (April [23])Binominal
0/1
High T2 signal (HIZ) in the otherwise low signal annulus. Diameter > 1.5 mm. Annulus material visible all around the fissure.
 Disc contour, (Fardon [32])Nominal 
  Normal or bulge0< 3 mm and > 25% of the disc periphery (90 degrees). Negative for herniation.
  Protrusion:1< 25% (90 degrees) of disc periphery, distance between disco-vertebral corners is greater than distance of disc material past the base, measured in same plane.
  Extrusion:2Dimension of disc material in any one direction is greater than distance between disco-vertebral corners. Migration cephalad or caudad indicates extrusion.
  Sequestration:3Disc material has lost continuity with the parent disc.
  Combination of types4Combined protrusion and extrusion