Lumbar Degenerative Disc Disease: Current and Future Concepts of Diagnosis and Management

Table 2

Pfirrmann grades as illustrated by Pfirrmann et al. [24].

Grade	Structure	Distinction (nucleus and annulus)	T2 MRI signal intensity	Disc space height
I	white, homogenous	clear	isointense to cerebrospinal fluid (hyperintense)	normal
II	inhomogeneous, with banding	clear	isointense to cerebrospinal fluid (hyperintense)	normal
III	gray, inhomogeneous	unclear	intermediate	normal to decreased
IV	gray to black, inhomogenous	no distinction	intermediate to hypointense	normal to decreased
V	black, inhomogenous	no distinction	hypointense	collapsed