Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology.
BACKGROUND
The paper ''Nomenclature and classification of lumbar disc pathology, recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology,'' was published in 2001 in Spine (© Lippincott, Williams & Wilkins). It was authored by David Fardon, MD, and Pierre Milette, MD, and formally endorsed by the American Society of Spine Radiology (ASSR), American Society of Neuroradiology (ASNR), and North American Spine Society (NASS). Its purpose was to promote greater clarity and consistency of usage of spinal terminology, and it has served this purpose well for over a decade. Since 2001, there has been sufficient evolution in our understanding of the lumbar disc to suggest the need for revision and updating of the original document. The revised document is presented here, and it represents the consensus recommendations of contemporary combined task forces of the ASSR, ASNR, and NASS. This article reflects changes consistent with current concepts in radiologic and clinical care.


OBJECTIVE
To provide a resource that promotes a clear understanding of lumbar disc terminology amongst clinicians, radiologists, and researchers. All the concerned need standard terms for the normal and pathologic conditions of lumbar discs that can be used accurately and consistently and thus best serve patients with disc disorders.


METHODS
This article comprises a review of the literature.


METHODS
A PubMed search was performed for literature pertaining to the lumbar disc. The task force members individually and collectively reviewed the literature and revised the 2001 document. The revised document was then submitted for review to the governing boards of the ASSR, ASNR, and NASS. After further revision based on the feedback from the governing boards, the article was approved for publication by the governing boards of the three societies, as representative of the consensus recommendations of the societies.


RESULTS
The article provides a discussion of the recommended diagnostic categories pertaining to the lumbar disc: normal; congenital/developmental variation; degeneration; trauma; infection/inflammation; neoplasia; and/or morphologic variant of uncertain significance. The article provides a glossary of terms pertaining to the lumbar disc, a detailed discussion of these terms, and their recommended usage. Terms are described as preferred, nonpreferred, nonstandard, and colloquial. Updated illustrations pictorially portray certain key terms. Literature references that provided the basis for the task force recommendations are included.


CONCLUSIONS
We have revised and updated a document that, since 2001, has provided a widely acceptable nomenclature that helps maintain consistency and accuracy in the description of the anatomic and physiologic properties of the normal and abnormal lumbar disc and that serves as a system for classification and reporting built upon that nomenclature.
Department of Orthopaedics, Midwest Orthopaedics at Rush, Rush University Medical Center, Third Floor, 1611 W. Harrison, Chicago, IL 60612, USA.
David F
DF
Fardon
Medical College of Wisconsin, 9200 West Wisconsin Ave., Milwaukee, WI 53226, USA.
Alan L
AL
Williams
Midwestern University School of Medicine, 19389 N 59th Ave, Glendale, AZ 85308, USA; Spine Institute of Arizona, 9735 N. 90th Pl., Scottsdale, AZ 85258, USA. Electronic address: EdDohring@gmail.com.
Edward J
EJ
Dohring
Moffitt Cancer Center and Research Institute, University of South Florida College of Medicine, 3301 USF Alumni Dr., Tampa, FL 33612, USA.
F Reed
FR
Murtagh
Keck School of Medicine of the University of Southern California, 1975 Zonal Ave., Los Angeles, CA 90089, USA.
Stephen L
SL
Gabriel Rothman
Department of Radiology, Yale University School of Medicine, 20 York St., New Haven, CT 06510, USA.
Gordon K
GK
Sze
D032921:Consensus; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology*; D008159:Lumbar Vertebrae / Q000473:pathology*; D011871:Radiology; D013122:Spinal Diseases / Q000145:classification / Q000175:diagnosis* / Q000473:pathology; D009626:Terminology as Topic; D014481:United States
Annular fissure; Annular tear; Disc bulge (bulging disc); Disc degeneration; Disc extrusion; Disc herniation; Disc nomenclature; Disc protrusion; High intensity zone; Lumbar intervertebral disc