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Reliable Magnetic Resonance Imaging Based Grading System for Cervical Intervertebral Disc Degeneration.

Jacobs LJ, Chen AF, Kang JD, Lee JY - Asian Spine J (2016)

Bottom Line: The grading system included Grade 0 (normal height compared to C2-3, mid cleft still visible), grade 1 (dark disc, normal height), grade 2 (collapsed disc, few osteophytes), and grade 3 (collapsed disc, many osteophytes).Ninety-five percent and 85 percent of the clinicians judged the grading system to be clinically feasible and useful in daily practice, respectively.The grading system is easy to use, has excellent reliability, and can be used for precise and consistent clinician communication.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

ABSTRACT

Study design: Observational.

Purpose: To develop a simple and comprehensive grading system for cervical discs that precisely, consistently and meaningfully presents radiologic and morphologic data.

Overview of literature: The Thompson grading system is commonly used to classify the severity of degenerative lumbar discs on magnetic resonance imaging (MRI). Inherent differences in the morphological and physiological characteristics of cervical discs have hindered development of precise classification systems. Other grading systems have been developed for degenerating cervical discs, but their versatility and feasibility in the clinical setting is suboptimal.

Methods: MRIs of 46 human cervical discs were de-identified and displayed in PowerPoint format. Each slide depicted a single disc with a normal (grade 0) disc displayed in the top right corner for reference. The presentation was given to 25 physicians comprising attending spine surgeons, spine fellows, orthopaedic residents, and two attending musculoskeletal radiologists. The grading system included Grade 0 (normal height compared to C2-3, mid cleft still visible), grade 1 (dark disc, normal height), grade 2 (collapsed disc, few osteophytes), and grade 3 (collapsed disc, many osteophytes). The ease of use of the system was gauged in the participants and the interobserver reliability was calculated.

Results: The intraclass correlation coefficient for interobserver reliability was 0.87, and 0.94 for intraobserver reliability, indicating excellent reliability. Ninety-five percent and 85 percent of the clinicians judged the grading system to be clinically feasible and useful in daily practice, respectively.

Conclusions: The grading system is easy to use, has excellent reliability, and can be used for precise and consistent clinician communication.

No MeSH data available.


Related in: MedlinePlus

Grading System for cervical disc degeneration.
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Figure 1: Grading System for cervical disc degeneration.

Mentions: De-identified MRI data of 46 human cervical discs were and presented in PowerPoint format on a CD. T1 weighted MRI data were used. Each slide depicted a single disc with a normal (grade 0) C2–3 disc displayed in the top right corner for reference. CDs containing the PowerPoint presentations were given to 10 attending orthopaedic spine surgeons, three fellows, 10 residents, and two musculoskeletal radiology attending physicians. The grading system comprised grade 0 (normal height compared to C2–3, with or without a cleft in the nucleus pulposus), grade 1 (dark disc, with normal height), grade 2 (collapsed disc, little or no osteophytes), grade 3 (collapsed disc, many osteophytes) (Fig. 1). The presentation was given three times in 4 week intervals. A short survey regarding ease of use was conducted.


Reliable Magnetic Resonance Imaging Based Grading System for Cervical Intervertebral Disc Degeneration.

Jacobs LJ, Chen AF, Kang JD, Lee JY - Asian Spine J (2016)

Grading System for cervical disc degeneration.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4764544&req=5

Figure 1: Grading System for cervical disc degeneration.
Mentions: De-identified MRI data of 46 human cervical discs were and presented in PowerPoint format on a CD. T1 weighted MRI data were used. Each slide depicted a single disc with a normal (grade 0) C2–3 disc displayed in the top right corner for reference. CDs containing the PowerPoint presentations were given to 10 attending orthopaedic spine surgeons, three fellows, 10 residents, and two musculoskeletal radiology attending physicians. The grading system comprised grade 0 (normal height compared to C2–3, with or without a cleft in the nucleus pulposus), grade 1 (dark disc, with normal height), grade 2 (collapsed disc, little or no osteophytes), grade 3 (collapsed disc, many osteophytes) (Fig. 1). The presentation was given three times in 4 week intervals. A short survey regarding ease of use was conducted.

Bottom Line: The grading system included Grade 0 (normal height compared to C2-3, mid cleft still visible), grade 1 (dark disc, normal height), grade 2 (collapsed disc, few osteophytes), and grade 3 (collapsed disc, many osteophytes).Ninety-five percent and 85 percent of the clinicians judged the grading system to be clinically feasible and useful in daily practice, respectively.The grading system is easy to use, has excellent reliability, and can be used for precise and consistent clinician communication.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

ABSTRACT

Study design: Observational.

Purpose: To develop a simple and comprehensive grading system for cervical discs that precisely, consistently and meaningfully presents radiologic and morphologic data.

Overview of literature: The Thompson grading system is commonly used to classify the severity of degenerative lumbar discs on magnetic resonance imaging (MRI). Inherent differences in the morphological and physiological characteristics of cervical discs have hindered development of precise classification systems. Other grading systems have been developed for degenerating cervical discs, but their versatility and feasibility in the clinical setting is suboptimal.

Methods: MRIs of 46 human cervical discs were de-identified and displayed in PowerPoint format. Each slide depicted a single disc with a normal (grade 0) disc displayed in the top right corner for reference. The presentation was given to 25 physicians comprising attending spine surgeons, spine fellows, orthopaedic residents, and two attending musculoskeletal radiologists. The grading system included Grade 0 (normal height compared to C2-3, mid cleft still visible), grade 1 (dark disc, normal height), grade 2 (collapsed disc, few osteophytes), and grade 3 (collapsed disc, many osteophytes). The ease of use of the system was gauged in the participants and the interobserver reliability was calculated.

Results: The intraclass correlation coefficient for interobserver reliability was 0.87, and 0.94 for intraobserver reliability, indicating excellent reliability. Ninety-five percent and 85 percent of the clinicians judged the grading system to be clinically feasible and useful in daily practice, respectively.

Conclusions: The grading system is easy to use, has excellent reliability, and can be used for precise and consistent clinician communication.

No MeSH data available.


Related in: MedlinePlus