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Table 1 Pfirrmann grading system of lumbar disc degeneration

From: Modic changes of the lumbar spine—their association with the lumbar sagittal parameters: A retrospective imaging study

GradeStructureDistinction of nucleus and annulusSignal intensityDisc height
IHomogeneous, bright whiteClearHyperintense, isointense to CSFNormal
IIInhomogeneous with or without horizontal bandsClearHyperintense, isointense to CSFNormal
IIIInhomogeneous, grayUnclearIntermediate to CSFNormal to slightly decreased
IVInhomogeneous, gray to blackLostIntermediate to hypointense to CSFNormal to moderately decreased
VInhomogeneous blackLostHypointense to CSFCollapsed
  1. CSF cerebrospinal fluid