How Should We Grade Cervical Disk Degeneration? A Comparison of Two Popular Classification Systems

作者：Lukas Urbanschitz, Susanne Bensler, Sascha Merat, Christopher G. Lenz, Karim Eid · 发表于：Spine Surgery and Related Research · 年份：2021 · DOI：10.22603/ssrr.2021-0048 · 被引用次数：9 · 研究领域：Cervical and Thoracic Myelopathy、Spine and Intervertebral Disc Pathology、Musculoskeletal pain and rehabilitation

INTRODUCTION: Despite being originally developed for the evaluation of lumbar disk degeneration, the Pfirrmann classification has emerged as the most popular classification system for cervical disk degeneration. However, with the Suzuki classification, a new classification system that is specifically tailored for the evaluation of cervical disk disease was introduced. In this study, we aim to evaluate differences in inter- and intraobserver reliability of both classifications in a head-to-head comparison. METHODS: In total, we have evaluated 120 cervical disks within 40 patients via magnetic resonance imaging according to the Pfirrmann and Suzuki classification. The degree of disk degeneration was evaluated by two independent musculoskeletal radiologists. After 6 months, the classification was reassessed to evaluate the intraobserver reliability. The inter- and intraobserver reliabilities were then calculated using Cohen's kappa. RESULTS: The inter- and intraobserver reliability provided a significant agreement between all ratings in Pfirrmann as well as the Suzuki classification (p>0.001). The interobserver reliability was determined to be fair in both the Suzuki classification (κ=0.290) and the Pfirrmann classification (κ=0.265). The intraobserver reliability was substantial in the Suzuki classification (κ=0.798), while it was almost perfect in the Pfirrmann classification (κ=0.858). CONCLUSIONS: Although not designed for the evaluation of cervical disk degeneration, the Pf...