APPENDIX: MRI IMAGING MEASURES MRI Finding Definition Endplate changes16 Type I Type II Type III Facet hypertrophy Mild Moderate Severe Annular fissure Disc height narrowing18 Disc dessication Mild Moderate Severe Disk bulging Spondylolisthesis Disc protrusion19 Central canal stenosis Mild Moderate Severe Disc extrusions19 Nerve root impingement Lateral recess stenosis Low T1 and high T2 (endplate edema) Threshold for incident change at any spinal level None vs. any endplate changes None vs. type I endplate change High T1 and low to intermediate T2 (fatty change) Low T1 and low T2 (sclerosis) Mild hypertrophy with minimal or no neural foramen encroachment Moderate hypertrophy with moderate neural foramen or canal encroachment Extensive hypertrophy with severe neural foramen or canal encroachment Focal hyperintensity of the annulus on T2weighted image17. Decrease in disc height compared with expected height of a hydrated disc at the same level Mild diffuse decrease in signal or focal moderate or severe decrease <1⁄3 of disc area on sagittal image. Moderate diffuse decrease in signal or focal moderate or severe decrease 1⁄3–2⁄3 of disc area on sagittal image. Severe diffuse decrease (no residual high T2 signal) >2⁄3 of disc area on sagittal image. Circumferential symmetric extension of the disc beyond the interspace Displacement of one vertebra atop another in the sagittal plane Focal or asymmetric extension of the disc beyond the interspace with the base against the disc of origin broader than any other dimension of the protrusion. Encroachment on central canal but abundant cerebrospinal fluid still present around roots Crowded roots with only small amount of residual cerebrospinal fluid No residual cerebrospinal fluid More extreme extension of the disk of origin narrower than the diameter of the extruding material itself or with no connection between the material and the disk Contact/displacement/compression of nerve root and or thecal sac20 Narrowing of the lateral recess graded subjectively as normal, mild, moderate, or severe None/mild vs. moderate/severe None vs. any fissure None vs. any narrowing None/mild vs. moderate/severe None vs. any bulging Any new or worsened spondylolisthesis None vs. any protrusion None/mild vs. moderate/severe None vs. any extrusion None vs. any impingement None vs. any 1. Jarvik JG, Hollingworth W, Heagerty PJ, Haynor DR, Boyko EJ, Deyo RA. Three-year incidence of low back pain in an initially asymptomatic cohort: clinical and imaging risk factors. 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