25 August 2025 : Clinical Research
Effect of Long-Term Smoking on Cervical Disc Degeneration: A Retrospective Study
Murat Kiraz
ABCDEFG 1*, Hakan Kina CEFG 2
DOI: 10.12659/MSM.949466
Med Sci Monit 2025; 31:e949466
Table 1 Modified Pfirrmann grading system [10,11].
| Grade | Signal from nucleus and inner fibers of annulus* | Distinction between inner and outer fibers of anulus at posterior aspect of disc | Height of disc |
|---|---|---|---|
| 1 | Uniformly hyperintense, equal to cerebrospinal fluid | Distinct | Normal |
| 2 | Hyperintense (>presacral fat and | Distinct | Normal | |
| 3 | Hyperintense though | Distinct | Normal | |
| 4 | Mildly hyperintense (slightly >outer fibers of anulus) | Indistinct | Normal |
| 5 | Hypointense (=outer fibers of anulus) | Indistinct | Normal |
| 6 | Hypointense | Indistinct | <30% reduction |
| 7 | Hypointense | Indistinct | 30–60% reduction |
| 8 | Hypointense | Indistinct | >60% reduction |
| * Grades 1, 2, and 3 are based on the signal intensity of the nucleus and inner fibers of anulus. For grade 4, the margins between the inner and other fibers of the anulus at the posterior margin of the disc are indistinct. For grade 5, the disc is uniformly hypointense, although there is no loss of disc space height. For grades, 6, 7, and 8, there is progressive loss of disc space height. These could be broadly classified as mild, moderate, to severe loss of disc space height. Very occasionally, although obvious disc collapse is present, hyperintense signal from the nucleus and inner fibers of the anulus is preserved. This is referred to by a double entry, eg 4/7, with the former reporting the disc signal and the latter the degree of collapse. | |||