Classification of Intervertebral Disc Disease

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Abstract

Intervertebral disc disease (IVDD) has been recognized in dogs since the 1800s, when the first descriptions of extruded disc material within the vertebral canal were published. In the intervening time our understanding of intervertebral disc pathology in dogs and cats has increased dramatically, with many variations of IVDD described. Whilst the volume of literature and collective understanding of IVDD has expanded, there has also been scope for confusion as the definition of intervertebral disc disease, with its myriad different manifestations, becomes more complicated. A large volume of literature has aimed to combine the use of histopathology, diagnostic imaging and clinical findings to better understand the various ways in which IVDD can be classified. Much of this research has focused on the classification of mechanisms of intervertebral disc degeneration, centering around the differences between, and overlaps in, IVDD in chondrodystrophic and non-chondrodystrophic dog breeds. However, with the increasing availability of advanced imaging modalities allowing more accurate antemortem diagnosis, the concept of IVDD has expanded to include other clinical presentations that may not fit into traditional models of classification of IVDD. This review aims to provide an up to date overview of both historical and current systems of IVDD classification, highlighting the important findings and controversies underpinning them.

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Most cited references 160

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Magnetic resonance classification of lumbar intervertebral disc degeneration.

C Pfirrmann, A Metzdorf, M. Zanetti … (2001)

A reliability study was conducted. To develop a classification system for lumbar disc degeneration based on routine magnetic resonance imaging, to investigate the applicability of a simple algorithm, and to assess the reliability of this classification system. A standardized nomenclature in the assessment of disc abnormalities is a prerequisite for a comparison of data from different investigations. The reliability of the assessment has a crucial influence on the validity of the data. Grading systems of disc degeneration based on state of the art magnetic resonance imaging and corresponding reproducibility studies currently are sparse. A grading system for lumbar disc degeneration was developed on the basis of the literature. An algorithm to assess the grading was developed and optimized by reviewing lumbar magnetic resonance examinations. The reliability of the algorithm in depicting intervertebral disc alterations was tested on the magnetic resonance images of 300 lumbar intervertebral discs in 60 patients (33 men and 27 women) with a mean age of 40 years (range, 10-83 years). All scans were analyzed independently by three observers. Intra- and interobserver reliabilities were assessed by calculating kappa statistics. There were 14 Grade I, 82 Grade II, 72 Grade III, 68 Grade IV, and 64 Grade V discs. The kappa coefficients for intra- and interobserver agreement were substantial to excellent: intraobserver (kappa range, 0.84-0.90) and interobserver (kappa range, 0.69-0.81). Complete agreement was obtained, on the average, in 83.8% of all the discs. A difference of one grade occurred in 15.9% and a difference of two or more grades in 1.3% of all the cases. Disc degeneration can be graded reliably on routine T2-weighted magnetic resonance images using the grading system and algorithm presented in this investigation.

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Preliminary evaluation of a scheme for grading the gross morphology of the human intervertebral disc.

J Thompson, R Pearce, M Schechter … (1990)

A five-category grading scheme for assessing the gross morphology of midsagittal sections of the human lumbar intervetebral disc was developed. The ability of three observers to categorize a series of 68 discs with a wide spectrum of morphologies established the comprehensiveness of the classification. Three independent observers tested the reproducibility of the procedure by assignment of grades blindly to duplicate images of 68 discs taken from 15 spines. The intraobserver agreement ranged from 87 to 91%. The interobserver agreement was 61, 64, and 88% for the three pairs, the two low values being attributable to the bias of one observer. The agreement between the assigned and average grades was 85, 92, 68, 90, and 76% for Grades I through V, respectively. Except for Grade III, the disagreements were attributable mainly to the bias of one observer. Both the increase in the grade with age and the finding that all the discs within 14 of 15 spines had a narrow range of grades demonstrated the biologic credibility of the scheme.

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Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology.

David F Fardon, Alan Williams, Edward Dohring … (2014)

The paper ''Nomenclature and classification of lumbar disc pathology, recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology,'' was published in 2001 in Spine (© Lippincott, Williams & Wilkins). It was authored by David Fardon, MD, and Pierre Milette, MD, and formally endorsed by the American Society of Spine Radiology (ASSR), American Society of Neuroradiology (ASNR), and North American Spine Society (NASS). Its purpose was to promote greater clarity and consistency of usage of spinal terminology, and it has served this purpose well for over a decade. Since 2001, there has been sufficient evolution in our understanding of the lumbar disc to suggest the need for revision and updating of the original document. The revised document is presented here, and it represents the consensus recommendations of contemporary combined task forces of the ASSR, ASNR, and NASS. This article reflects changes consistent with current concepts in radiologic and clinical care.

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Author and article information

Contributors

Joe Fenn: URI : http://loop.frontiersin.org/people/840926/overview

Natasha J. Olby: URI : http://loop.frontiersin.org/people/808262/overview

Journal

Journal ID (nlm-ta): Front Vet Sci

Journal ID (iso-abbrev): Front Vet Sci

Journal ID (publisher-id): Front. Vet. Sci.

Title: Frontiers in Veterinary Science

Publisher: Frontiers Media S.A.

ISSN (Electronic): 2297-1769

Publication date (Electronic): 06 October 2020

Publication date Collection: 2020

Volume: 7

Electronic Location Identifier: 579025

Affiliations

Author Affiliations: DACVIM-Neurology, Associate Professor, Neurology and Neurosurgery, Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus OH, United States; DACVIM Neurology, Professor of Neurology/Neurosurgery; Distinguished Chair of Gerontology, Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, United States; DACVIM-Neurology, Professor; Chair, and Head, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States; DAVCIM (Neurology), Assistant Professor of Neurology, Department of Veterinary Clinical Sciences, Purdue University College of Veterinary Medicine, West Lafayette, IN, Unites States; Professor Neurology & Neurosurgery; Professor in Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX, United States; ACVIM—Neurology, Professor and Service Head, Neurology and Neurosurgery, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, Unites States; Department of Clinical Sciences, Colorado State University, Fort Collins, CO, United States; Department of Clinical Science and Services, Royal Veterinary College, Hatfield, United Kingdom; The Royal Veterinary College, University of London, Hatfield, United Kingdom & CVS referrals, Bristol Veterinary Specialists at Highcroft, Bristol, United Kingdom; Institute of Veterinary Pathology, Faculty of Veterinary Medicine, Leipzig University, Leipzig, Germany; Division of Clinical Neurology, Department for Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland; Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany/Europe; Neurology and Neurosurgery, Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO, United States; Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany/Europe

[1] ¹Department of Clinical Science and Services, Royal Veterinary College , London, United Kingdom

[2] ²Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University , Raleigh, NC, United States

Author notes

Edited by: John Henry Rossmeisl, Virginia Tech, United States

Reviewed by: Sheila Carrera-Justiz, University of Florida, United States; Thomas Robert Harcourt-Brown, University of Bristol, United Kingdom

*Correspondence: Joe Fenn jfenn@ 123456rvc.ac.uk

This article was submitted to Veterinary Neurology and Neurosurgery, a section of the journal Frontiers in Veterinary Science

Article

DOI: 10.3389/fvets.2020.579025

PMC ID: 7572860

PubMed ID: 33134360

SO-VID: 42975c3e-2f52-4aad-bab7-45eeb9e5f9b4

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This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 01 July 2020

Date accepted : 24 August 2020

Page count

Figures: 1, Tables: 2, Equations: 0, References: 163, Pages: 17, Words: 15179

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Classification of Intervertebral Disc Disease

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Magnetic resonance classification of lumbar intervertebral disc degeneration.

Preliminary evaluation of a scheme for grading the gross morphology of the human intervertebral disc.

Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology.

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