Medical societies unite to offer open access to universal spine terminology


From the radiologist to the spine specialist to the internal medicine physician, common spine conditions need universally-accepted definitions, say the authors of a new, open-access consensus document defining consistent and shared spine terminology.

The new document, “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,” is a revision of a 2001 document, originally published in Spine. The new version will be published in November 2014 print and online editions of The Spine Journal and online in Spine and the American Journal of Neuroradiology will provide a link to the document.

“While the past 13 years have brought a deeper evidence-based understanding of how to diagnose and treat spine disorders, that information can be ineffective until all spine and radiology professionals are speaking the same language,” said The Spine Journal editor in chief Eugene J Carragee of the Stanford University School of Medicine, Redwood City, CA. “By undertaking this arduous process and creating this universal language, these dedicated spine and radiology professionals will help millions of patients worldwide get appropriate and timely treatment.”

The revised document represents the recommendations of combined task forces of three major specialty societies: the North American Spine Society (NASS), American Society of Spine Radiology (ASSR) and the American Society of Neuroradiology (ASNR).

The authors of “Lumbar disc nomenclature version 2.0” are: David F Fardon, Department of Orthopaedics, Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, IL; Alan L Williams, Medical College of Wisconsin, Milwaukee, WI; Edward J Dohring, Midwestern University School of Medicine and the Spine Institute of Arizona; F Reed Murtagh, Moffitt Cancer Center and Research Institute, University of South Florida College of Medicine, Tampa, FL; Stephen L Gabriel Rothman, Keck School of Medicine of the University of Southern California, Los Angeles, CA; and Gordon K Sze, Department of Radiology, Yale University School of Medicine, New Haven, CT.

 “While the primary focus of this document is to promote clear and consistent communication between clinicians and radiologists, it also has important implications for patients, family members, employers, insurers, researchers and others,” said lead author David F Fardon of Rush University Medical Center in Chicago and former NASS president. “When patients and their families understand and have confidence in a universally-recognised diagnosis, including the medical terminology, they are able to actively participate in treatment decisions.”

Paper co-author Edward Dohring of the Spine Institute of Arizona and current member of the NASS board of directors says:  “For example, the term ‘annular fissure’ replaces the term ‘annular tear,’ reflecting the common, age-related presence of a linear opening in the outer part of the disc, without assuming that the abnormality is the result of an injury.”

To create this revised edition, the authors performed a PubMed search for all literature pertaining to the lumbar disc. The task force members individually and collectively reviewed the literature and revised and updated the original 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 paper was approved for publication by the three societies, as representative of the consensus recommendations of the societies.

The new document offers detailed discussions of the imaging diagnostic categories and subcategories and their implications for diagnosing lumbar disc disease. It also includes an extensive glossary for easy reference of various terms and definitions used in discussing lumbar disc disease, along with updated illustrations and references. Literature references that provided the basis for the task force recommendations are included. While “version 2.0” follows the categories of the original nomenclature paper, it includes many changes reflecting the most current thinking in research and clinical care.