Grade 1: Normal disc; annulus free from ruptures and shiny white; shiny white gelatinous nucleus

Grade 2: Appearance is normal but the nucleus exhibits a more fibrous structure; clear boundary is present between and nucleus

Grade 3: Isolated fissures in the annulus; the nucleus is dry and occasionally discolored; boundary between the nucleus and annulus is no longer distinct

Grade 4: Severe changes; ruptures and sequestrae in both annulus and nucleus; marginal ostophytes often found


Provide an explanation for key principles and pertinent aspects of the classification


Insert figures illustrating the classification


Provide the citation for the landmark article and recent review articles describing the classification