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Table 3 MRI-based grading system for cervical intervertebral disc degeneration.

From: The NEtherlands Cervical Kinematics (NECK) Trial. Cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; a double-blind randomised multicenter study

Grade Nucleus signal intensity Nucleus structure Distinction of nucleus and annulus Disc height
I Hyperintense Homogenous, white Clear Normal
II Hyperintense Inhomogenous with horizontal band, white Clear Normal
III Intermediate Inhomogenous, grey to black Unclear Normal to decreased
IV Hypointense Inhomogenous, grey to black Lost Normal to decreased
V Hypointense Inhomogenous, grey to black Lost Collapsed