ArticleSpine surgery and related research2021
How Should We Grade Cervical Disk Degeneration? A Comparison of Two Popular Classification Systems.
Article in Spine surgery and related research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Approach to assess the effect of sagittal cervical alignment on three-dimensional movement of the cervical spine in spondylosis patients.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Radiological Alignment Trajectories and Late Functional Outcomes After Three-Level ACDF: A Single-Center Cohort Study.Journal of clinical medicine · 2026Article
- Effect of Long-Term Smoking on Cervical Disc Degeneration: A Retrospective Study.Medical science monitor : international medical journal of experimental and clinical research · 2025Article
- Correlation analysis between neck muscles and lifestyle habits in patients with cervical instability.BMC musculoskeletal disorders · 2025Article
- Preoperative three-dimensional simulation and clinical evaluation ofQuantitative imaging in medicine and surgery · 2025Article
- Increased cervical disc degeneration in ischemic stroke: a 10-year retrospective data review.Revista da Associacao Medica Brasileira (1992) · 2025Article
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5 authors.
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Abstract
introductionDespite 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.
methodsIn 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.
resultsThe 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).
conclusionsAlthough not designed for the evaluation of cervical disk degeneration, the Pfirrmann classification yielded equal inter- and higher intraobserver reliability. Both classification systems are viable options for the grading of cervical disk degeneration. While the Pfirrmann classification has the advantage of being better established, the Suzuki classification may be clinically superior due to a better representation of cervical disk degeneration and the consideration of disk bulging for the classification of cervical disk degeneration.
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