🦴 Spine Grading: Pfirrmann / Modic / Meyerding
Three core spine imaging grading systems in one tool: pick a system, then read out Pfirrmann (disc degeneration I–V), Modic (endplate changes I–III, auto-typed from T1/T2 signal) and Meyerding (lumbar spondylolisthesis I–V, auto-graded from percent slip). Instant, browser-side.
Pfirrmann: I normal; II–III early; IV–V advancing/end-stage. Grade I hinges on NP homogeneity; III→IV on loss of NP/annulus distinction.
When to use
Standardized grading for spine MRI/radiograph reports: disc degeneration, endplate marrow change type, and slip severity.
How it works
Pfirrmann I–V (homogeneity / NP-annulus distinction / T2 signal / height). Modic: I = T1 hypo, T2 hyper (edema); II = T1 hyper, T2 hyper or iso (fat); III = T1 hypo, T2 hypo (sclerosis). Meyerding: I 0–25%, II 25–50%, III 50–75%, IV 75–100%, V >100% (spondyloptosis).
Key points
- Pfirrmann: I normal; II–III early; IV–V advancing/end-stage. Grade I hinges on NP homogeneity; III→IV on loss of NP/annulus distinction.
- Modic I (T1 hypo, T2 hyper) correlates relatively more with active pain and instability.
- Modic II (T1 hyper, T2 hyper/iso) is the most common and relatively stable; III (T1 hypo, T2 hypo) is subchondral sclerosis.
- Meyerding: 25% per grade, >100% = spondyloptosis; I–II low-grade, III–V high-grade (50% divide).