A new classification system for degenerative disc disease of the lumbar spine based on magnetic resonance imaging, provocative discography, plain radiographs and anatomic considerations

Thalgott, John S.; Albert, Todd J.; Vaccaro, Alexander R.; Aprill, Charles; Giuffre, James M.; Drake, John S.; Henke, Jonathan P.

doi:10.1016/j.spinee.2004.07.001

Cited by 54 publications

(24 citation statements)

References 9 publications

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“…15 Recently, authors such as Thalgott developed classifications to correlate not only the resonance changes but also the findings of X-ray images and discographies, enabling a better designation of indications for arthrodesis and arthroplasty. 20 …”

Section: Resultsmentioning

confidence: 99%

Classificação por ressonância magnética da degeneração do disco intervertebral

et al. 2009

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The authors suggest an analysis of the degeneration of intervertebral disks on human cadavers using magnetic resonance imaging. Nine lumbar spines were collected from fresh human cadavers and resonance images were captured. The images were analyzed and classified according to the degeneration grades, with the authors proposing a subdivision of type IV into IV-a and IV-b. Forty-four intervertebral disks were analyzed and authors found the following distribution: 4,5% type I; 40,9% type II; 32% Citation: Puertas EB, Yamashita H, Oliveira VM, Souza PS. Classification of intervertebral disc degeneration by magnetic resonance.

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Section: Resultsmentioning

confidence: 99%

Classificação por ressonância magnética da degeneração do disco intervertebral

et al. 2009

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“…12 The disc degeneration was classified as described by Pfirrmann et al, 8 since this presents excellent intra and interobserver reliability. Benneker et al 1 correlated the findings relating to magnetic resonance, simple radiography, biochemical abnormalities and morphological abnormalities from 39 intervertebral discs from cadavers.…”

Section: Discussionmentioning

confidence: 99%

“…1,6 Degeneration of the intervertebral discs has been studied and classified by many authors. [7][8][9][10][11][12][13] The classifications range from studies of purely histological nature on the discs 10 and on variations in their endplates, 7 to classifications of abnormalities of the nucleus pulposus in relation to the annulus fibrosus and the thickness of the discs seen on magnetic resonance images.…”

Section: Introductionmentioning

confidence: 99%

Correlations between radiographic, magnetic resonance and histological examinations on the degeneration of human lumbar intervertebral discs

et al. 2010

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Context and objeCtive: There is controversy regarding which imaging method is best for identifying early degenerative alterations in intervertebral discs. No correlations between such methods and histological finds are presented in the literature. The aim of this study was to correlate the thickness of intervertebral discs measured on simple radiographs with the degree of degeneration seen on magnetic resonance images and the histological findings relating to nerve ends inside the discs.design and setting: Cross-sectional correlation study on the lumbar spines of human cadavers, at Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.Methods: Ten lumbar spinal columns were extracted from human cadavers and subjected to magnetic resonance imaging and simple radiography. They were classified according to the degree of disc degeneration seen on magnetic resonance, and the thickness of the discs was measured on radiographs.The intervertebral discs were then extracted, embedded in paraffin and analyzed immunohistochemically with protein S100, and the nerve fibers were counted and classified.Results: No correlation was observed between the thickness of the intervertebral discs and the degree of degeneration seen on magnetic resonance images. Only the uppermost lumbar discs (L1/L2 and L2/L3) presented a correlation between their thickness and type I and IV nerve endings.ConClusion: Reduced disc thickness is unrelated to increased presence of nerve ends in intervertebral discs, or to the degree of disc degeneration. RESUMOContexto e objetivo: Há controvérsia sobre qual o melhor método de imagem para identificar alterações degenerativas precoces do disco intervertebral.Falta na literatura correlação desses métodos com os achados histológicos. O objetivo deste estudo foi relacionar a altura dos discos intervertebrais medidos em radiografias simples com o grau de degeneração nas imagens de ressonância magnética e os achados histológicos das terminações nervosas encontradas no interior do disco. Métodos: Dez colunas lombares foram retiradas de cadáveres humanos e submetidas a imagens de ressonância magnética e radiografias simples.Foram classificadas de acordo com o grau de degeneração dos discos pela ressonância e mensuradas as alturas dos discos nas radiografias. Os discos intervertebrais foram retirados, incluídos em parafina e foi realizado estudo imunoistoquímico com proteína S100; as fibras nervosas foram contadas e classificadas.Resultados: Não foi observada correlação entre a altura dos discos intervertebrais com o grau de degeneração nas imagens de ressonância magnética.Apenas os discos lombares altos (L1/L2 e L2/L3) apresentaram correlação entre a altura e as terminações nervosas dos tipos I e IV.ConClusão: A diminuição da altura dos discos não está relacionada ao aumento de terminações nervosas nos discos intervertebrais e nem com o grau de degeneração dos discos.

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“…The MR examinations were performed with a 1.0 T device (GE Signa Horizon, UK), and they included the T1 and T2 weighted sagittal and axial MRI of the cervical and lumbar spine. The grading of findings in the cervical spine [17] is presented in Table 1, and the grading of the lumbar spine findings [29] is presented in Table 2. The design of this study was approved by the Ethical Committee of the Central Finland Health Care District (Jyväskylä, Finland) before data collection.…”

Section: Methodsmentioning

confidence: 99%

MRI findings and physical performance as predictors of flight-induced musculoskeletal pain incidence among fighter pilots

Rintala

Sovelius²,

Rintala

et al. 2017

Biomedical Human Kinetics

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SummaryStudy aim: The aim of this study was to evaluate the possible association of pre-career magnetic resonance imaging (MRI) findings and physical performance level with possible musculoskeletal disorders during jet flight training. Material and methods:The study group consisted of 73 fighter pilots who had undergone pre-career cervical and lumbar spine MRI. Physical performance of a subgroup of the pilots (n = 67) was measured initially at the same time and followed up to the fast jet training phase (ranging from 3.8 to 7.0 years). Musculoskeletal pain history during pilot training was taken from the medical charts. MRI findings and physical performance were associated with perceived clinical complaints during the follow-up. Results: 82% of the cervical and 92% of the lumbar spines showed abnormalities at at least one disk level. MRI did not reveal significant cervical degeneration. Thirteen disk bulges in the lumbar spine were discovered, while 5 pilots had listhesis and/or osteophyte formation on the spine (lumbar vertebra 4/sacroiliac joint level, L4-SI). 41% of the studied pilots suffered spinal symptoms during the follow-up, but only 16% and 17% of the cervical and lumbar MRI findings, respectively, were associated with subsequent symptoms. Endurance and strength levels were not, but lower body motor skills were, strongly (relative risk, RR 0.46) associated with a decreased number of flight-induced medical appointments in the early flight career. Conclusions: Minor MRI findings have no predictable value in the very early flight career. Nevertheless, versatile, skills/ power-oriented exercises before the flight career seem to be occupationally beneficial in reducing musculoskeletal disorders.

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A new classification system for degenerative disc disease of the lumbar spine based on magnetic resonance imaging, provocative discography, plain radiographs and anatomic considerations

Cited by 54 publications

References 9 publications

Classificação por ressonância magnética da degeneração do disco intervertebral

Classificação por ressonância magnética da degeneração do disco intervertebral

Correlations between radiographic, magnetic resonance and histological examinations on the degeneration of human lumbar intervertebral discs

MRI findings and physical performance as predictors of flight-induced musculoskeletal pain incidence among fighter pilots

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