A system for reporting the size and location of lesions in the spine

Abstract

Study design: A description of a method for standardizing the nomenclature used in reporting the size and location of lesions in the lumbar or thoracic spine is presented.

Objectives: To make the reporting of findings on computed tomography or magnetic resonance imaging scans simpler and more accurate.

Summary of background data: Over the past 10 years, three other systems have been proposed, and parts of each have been incorporated in this system.

Methods: This is a multicenter report. A group of 12 prominent physicians, including radiologists, neurosurgeons, orthopedic surgeons, and physiatrists, at 11 centers collaborated in the formulation of this system.

Results: In this system, areas in the axial plane, i.e., medial to lateral, are called "zones," and in the caudocranial direction, they are called "levels." The zones are the central canal zone, the subarticular zone, the foraminal zone, and the extraforaminal zone. In the caudocranial direction, the levels from above downward are the suprapedicle level, the pedicle level, the infrapedicle level, and the disc level. The size of a lesion can be rated by the descriptive words normal, mild, moderate, moderately severe, and severe, or by the numbers 1 to 5, with the number 1 indicating normal and the number 5 indicating severe.

Conclusions: The authors of the present study believe that all health care professionals who care for the spine will find this nomenclature valuable in communicating with each other, in writing medical reports, in presenting reports at meetings, or in writing scientific articles.