Acute Schmorl Node in Dorsal Spine: An Unusual Cause of a Sudden Onset of Severe Back Pain in a Young Female

Abu‐Ghanem, Sara; Ohana, Nissim; Abu-Ghanem, Yasmin; Kittani, Mohamed; Shelef, Ilan

doi:10.4184/asj.2013.7.2.131

Cited by 31 publications

(37 citation statements)

References 25 publications

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“…Some studies suggested to insert the working cannulas directed towards the apex of the SNs to fill the polymethylmethacrylate (PMMA) around the profile of the SNs in an eggshell shape [18,21]. However, studies highlighting these procedures are limited to retrospective studies study [18][19][20][21][22][23][24]. Hence, In our study, we treated 65 patients with severe back pain by PVP that were suspected to be secondary to fresh endplate fractures (with high signal intensity on fat-suppression sequences in spinal MRI) around SNs.…”

Section: Clinical Evaluationmentioning

confidence: 99%

Percutaneous vertebroplasty (PVP) to treat specialized type of endplate fractures around the Schmorl's node: a prospective study of 65 patients

Zhang

Yin

Yang

et al. 2020

Preprint

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Background : The Schmorl's nodes (SNs) is defined as the herniation of the intervertebral disc into the vertebral body. Endplate fractures around the schmorl's node could result in severe back pain that is similar to vertebral compression fractures. The objective of this study was to prospectively analyze the surgical effectiveness and safety of percutaneous vertebroplasty (PVP) for endplate fractures around the SNs. Methods : Seventy-one consecutive patients with the fresh endplate fracture around SNs from October 2017 to February 2018 were enrolled in this study. The visual analog scale (VAS) and Oswestry disability index (ODI) scores of low back pain were evaluated in all patients preoperatively, postoperatively, and at 1 month, 6 months, and 1 year after primary single level PVP . Surgery related data including duration of the operation, injected cement volumes and surgical complications were recorded. Results : Sixty-five patients with fresh endplate fractures around the SNs were treated successfully via percutaneous vertebroplasty. Our study showed that the VAS scores and ODI scores of patients were obviously improved after operation. Cement leakage into the disc space occurred in 5 patients (7.7%), and adjacent segment refractures occurred in 2 patients (3.1%). No other surgical complications, including infections or nerve root injuries were encountered. Conclusions : Based on the results of this prospective study, PVP was an effective and safe procedure for endplate fractures around the SNs.

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Section: Clinical Evaluationmentioning

confidence: 99%

Percutaneous vertebroplasty (PVP) to treat specialized type of endplate fractures around the Schmorl's node: a prospective study of 65 patients

Zhang

Yin

Yang

et al. 2020

Preprint

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“…The Schmorl node may be well detected by plain radiography, computed tomography (CT), and bone scintigraphy; however, MRI is the modality of choice for the diagnosis of Schmorl nodes, as they are best seen on the sagittal MRI sequences [13]. The nodes usually exhibit the same signal characteristics as the adjacent disc, with a thin rim of sclerosis at the margins [14].…”

Section: Introductionmentioning

confidence: 99%

Lumbar spine Schmorl's nodes; prevalence in adults with back pain, and their relation to vertebral endplate degeneration

Sadiq

2019

Egypt J Radiol Nucl Med

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Background: In 1927, Schmorl described a focal herniation of disc material into the adjacent vertebral body through a defect in the endplate, named as Schmorl's node (SN). The aim of the study is to reveal the prevalence and distribution of Schmorl's nodes (SNs) in the lumbar spine and their relation to disc degeneration disease in Kirkuk city population. Results: A cross-sectional analytic study was done for 324 adults (206 females and 118 males) with lower back pain evaluated as physician requests by lumbosacral MRI at the Azadi Teaching Hospital, Kirkuk city, Iraq. The demographic criteria of the study sample were 20-71 years old, 56-120 kg weight, and 150-181 cm height. SNs were seen in 72 patients (22%). Males were affected significantly more than the females (28.8% vs. 18.8%, P = 0.03). SNs were most significantly affecting older age groups. L1-L2 was the most affected disc level (23.6%) and the least was L5-S1 (8.3%). There was neither a significant relationship between SN and different disc degeneration scores (P = 0.76) nor with disc herniation (P = 0.62, OR = 1.4), but there was a significant relation (P = 0.00001, OR = 7.9) with MC. Conclusion: SN is a frequent finding in adults' lumbar spine MRI, especially in males; it is related to vertebral endplate bony pathology rather than discal pathology.

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“…Schmorl nodes are focal indentations of the VEP containing herniated nucleus pulposus (8-11), with an unclear etiology. Congenital Schmorl nodes, arising from cartilage defects created after notochord regression, may be asymptomatic, while traumatic or degenerative Schmorl nodes from failure of the VEP, are more likely to be symptomatic (12). Peng et al suggested that Schmorl nodes may share an pathoetiology with osteonecrosis with fibrosis within the marrow cavities beneath the CEP and the disappearance of adipocytes and osteocytes (13).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the disco-vertebral junction using ultrashort time-to-echo magnetic resonance imaging: inter-reader agreement and association with vertebral endplate lesions

et al. 2016

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Objective To evaluate ultrashort time to echo (UTE) magnetic resonance (MR) morphology of the cartilaginous endplates (CEP) in cadaveric lumbar spines with bony vertebral endplate (VEP) lesions, to determine inter-reader agreement as well as associations between the CEP morphology and VEP lesions as well as other abnormalities. Materials and Methods MR imaging of cadaveric lumbar spines from 10 donors was performed at 3T using a UTE MR sequence. Two musculoskeletal radiologists identified the location of vertebral endplate lesions in consensus. The morphology of the CEP overlying the lesions and in the adjacent normal regions was assessed individually. A total of 55 vertebral lesions and 55 normal regions were assessed. The presence of osteophytosis, morphological changes of the anterior and posterior longitudinal ligament, and intervertebral disc signal and morphology was also assessed. Agreement between observers was determined using Cohen's kappa analysis, and association between CEP and vertebral endplate lesions was determined using chi square test. Results 55 vertebral endplate lesions were identified and the morphology of CEP evaluated by two readers was in substantial agreement with Cohen's kappa of 0.78. The presence of vertebral endplate abnormality was associated with the presence of osteophytes (39 out of 55 levels), altered morphology and signal of the anterior longitudinal ligament (23 out of 55 levels) and intervertebral discs (30 out of 55 levels). Conclusion UTE MRI enables evaluation of the CEP with substantial inter-reader agreement. Abnormal changes of the CEP may facilitate formation of lesions of vertebral endplate over time and are associated with degenerative changes of the lumbar spine.

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Acute Schmorl Node in Dorsal Spine: An Unusual Cause of a Sudden Onset of Severe Back Pain in a Young Female

Cited by 31 publications

References 25 publications

Percutaneous vertebroplasty (PVP) to treat specialized type of endplate fractures around the Schmorl's node: a prospective study of 65 patients

Percutaneous vertebroplasty (PVP) to treat specialized type of endplate fractures around the Schmorl's node: a prospective study of 65 patients

Lumbar spine Schmorl's nodes; prevalence in adults with back pain, and their relation to vertebral endplate degeneration

Evaluation of the disco-vertebral junction using ultrashort time-to-echo magnetic resonance imaging: inter-reader agreement and association with vertebral endplate lesions

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