Imaging Criteria for the Quantification of Disc Degeneration: A Systematic Review.

Abstract

Low back pain affects >54 million patients annually in the United States alone1. Many patients initially consult general practitioners or orthopaedic surgeons who do not specialize in spine care1. Therefore, knowledge of diagnostic methods for low back pain, including their limitations, may serve as an invaluable tool for all physicians. Imaging is routinely used for the diagnosis of low back pain, with radiographs reportedly being used for 12% (n = 16,567)2 to 31% (n = 17,148)3 of patients and magnetic resonance imaging (MRI) being used for 16% (n = 17,148)3 to 21% (n = 13,760)4 of patients. For the diagnosis of disorders associated with disc degeneration, a variety of grading systems involving both radiographs and MRI have been developed. Different grading systems have been proposed for research and clinical purposes. However, rather than quantifying disc degeneration, these measurements are often combined with subjective clinical symptoms for the purpose of making treatment decisions. The major limitation of spinal imaging is the poor correlation between …