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Table 1 Modified parameters collected for the histologic assessment of disc degeneration and scoring (Boos et al. 2002[31])

From: Histological analysis of surgical lumbar intervertebral disc tissue provides evidence for an association between disc degeneration and increased body mass index

Criteria Grading
cell density (chondrocyte proliferation):
multiple chondrocytes growing in small rounded groups or clusters sharply demarcated by a rim of territorial matrix
0 = no proliferation
1 = increased cell density
2 = connection of two chondrocytes
3 = small size clones (several chondrocytes grouped
together, 3-7 cells)
4 = moderate size clones (8-15 cells)
5 = huge clones (> 15 cells)
structural alterations (tears and clefts):
concentric tears following the collagen fiber bundle orientation in the annulus fibrosus or radiating defects extending from the nucleus pulposus to the outer annulus lamellae parallel or oblique to the end-plate (clefts)
0 = absent
1 = rarely present
2 = present in intermediate amounts between 1 and 3
3 = abundantly present
4 = scar/tissue defects
granular changes:
eosinophilic-staining amorphous granules within the fibrocartilage matrix
0 = absent
1 = rarely present
2 = present in intermediate amounts between 1 and 3
3 = abundantly present
mucous degeneration:
cystic, oval or irregular areas with intense deposition of acid mucopolysaccharides (i.e. sulfated glycosaminoglycans) staining dark blue with Alc-PAS
0 = absent
1 = rarely present
2 = present in intermediate amounts between 1 and 3,
3 = abundantly present
Histologic Degeneration Score (HDS) 0-15 points