MRI Evaluation of Cervical Intervertebral Disc Degeneration According to Age and Sex Using the Modified Pfirrmann Grading System

Background: Cervical intervertebral disc degeneration (CIDD) is a common cause of neck pain and functional disability. Increasing sedentary lifestyles, prolonged screen use, and poor posture have contributed to its growing prevalence across all age groups. Magnetic resonance imaging (MRI) provides a reliable method for assessing the severity of disc degeneration. The objective is to evaluate cervical intervertebral disc degeneration according to age and sex using the Modified Pfirrmann grading system on MRI and to determine its association with clinical symptoms. Material and Methods: A hospital-based comparative cross-sectional observational study was conducted on 100 adults who underwent cervical spine MRI between January 2024 and January 2026. Cervical discs from C2–C3 to C6–C7 were graded using the Modified Pfirrmann classification. Participants were grouped by age (20–29, 30–39, 40–49, 50–59, and ≥60 years) and sex. Associations between degeneration grade, demographic variables, disc level, and clinical symptoms were analyzed using Chi-square, Fisher's exact, and ANOVA tests, with p<0.05 considered significant. Results: Increasing age showed a strong positive association with higher degeneration grades (r=0.72, p<0.001). The C5–C6 level was most frequently affected, followed by C4–C5. Grade III degeneration was the commonest finding. Radiating pain, bilateral symptoms, symptom duration exceeding six weeks, and restricted neck movements were significantly associated with advanced degeneration (p≤0.002). No significant association was observed between degeneration severity and sex (p=0.214). Conclusion: Cervical disc degeneration progresses with age and predominantly affects the lower cervical spine, particularly the C5–C6 level. MRI with the Modified Pfirrmann grading system offers a dependable method for evaluating degeneration severity and correlating imaging findings with clinical presentation, thereby supporting timely diagnosis and appropriate patient management.

Keywords: Cervical intervertebral disc degeneration, Magnetic resonance imaging, Modified Pfirrmann grading, Cervical spine, Neck pain, Age-related degeneration.