MR imaging of Schmorl's nodes: Imaging characteristics and epidemio-clinical relationships

Moustarhfir, M; Bresson, B.; Koch, Peter P.; Perozziello, Anne; Barreau, G; Schouman-Claeys, É.; Henry–Feugeas, Marie-Cécile; Ou, Phalla; Dallaudière, B.

doi:10.1016/j.diii.2016.02.001

Cited by 15 publications

(17 citation statements)

References 28 publications

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“…The prevalence of SN was significantly increased as age advanced, comparable with previous studies that suggested weakened aged cartilaginous endplates and reduced bone density in older age groups; both factors may play a role in pathogenesis of SNs [25][26][27]. The higher lumber levels were affected more, as L1-L2 was the most affected disc (23.6%) in the current study; this was consistent with most of the papers [8,24,27].…”

Section: Discussionsupporting

confidence: 91%

“…According to this paper, we prefer the theory of endplate osteonecrosis as a cause of SNs, rather than disc degeneration, as a study examined the surgical specimens of SNs proposed that the SNs are the end result of ischemic death of bone beneath the endplate and the herniation of the disc into the body of the vertebra is a secondary phenomenon. The hypothesis of microtrauma is also preferred as Burke et al found more SN in American soldiers [26]; these minor traumas cause herniation of nucleus pulposus through developmental weak points in the endplates [28]. Also, the developmental models revealed that SNs are already present during skeletal maturation prior the beginning of degeneration [2].…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

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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“…MRI also shows the shape of IVDs and vertebrae clearly and is commonly used for recording Schmorl's nodes. 19 The prevalence of some MRI findings (eg, Modic changes and spinal canal stenosis) was low, excluding any prominent differences between the groups. The inter-rater disagreement in IVD degeneration is endorsed by the fact that the Pfirrmann classification is primarily structured for and used in the assessment of lumbar IVDs, but it has been adapted also in assessment of cervical spine.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 88%

Degenerative cervical spine changes among early career fighter pilots: a 5-year follow-up

et al. 2021

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IntroductionDegenerative changes of the cervical spine often cause disability and flight duty limitations among Finnish Air Force (FINAF) fighter pilots. We aimed to study the effect of +Gz exposure on degenerative changes in the cervical spine by comparing cervical MRIs of FINAF fighter pilots and controls.MethodsAt baseline, the volunteer study population consisted of 56 20-year-old FINAF male fighter pilots (exposure group) and 56 21-year-old Army and Navy cadets (control group). Both groups underwent MRI of the cervical spine at the baseline and after 5 years. Degenerative changes evaluated using MRI included intervertebral disc (IVD) degeneration (Pfirrmann classification), disc herniations, uncovertebral arthrosis, Schmorl’s nodes, Modic changes, spinal canal stenosis, kyphosis and scoliosis.ResultsThe degree of IVD degeneration in the whole cervical spine increased significantly in both populations with no between-group differences. The prevalence of disc herniations also tended to increase in both populations with no difference in the incidence over the follow-up. However, pilots proved to have more disc herniations at the baseline and at the follow-up. There were virtually no between-group differences in other assessed degenerative changes.DiscussionWe found that IVD degeneration and the prevalence of disc herniations increased at a similar rate for fighter pilots and non-flying military students when all cervical levels were summed up. The lack of difference may be explained by the relatively low cumulative +Gz exposure during the first 5 years of a pilots’ career.

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“…Schmorl nodes correspond to herniation of nucleus material through the endplate of the vertebral bodies into the subchondral bone (28).…”

Section: Schmorl Nodesmentioning

confidence: 99%

Axial Spondyloarthritis: Mimics and Pitfalls of Imaging Assessment

2021

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Axial spondyloarthritis (axSpA) is a chronic inflammatory disorder that predominantly involves the axial skeleton. Imaging findings of axSpA can be divided into active changes, which include bone marrow edema, synovitis, enthesitis, capsulitis, and intra-articular effusion, and structural changes, which include erosions, sclerosis, bone fatty infiltration, fat deposition in an erosion cavity, and bone bridging or ankylosis. The ability to distinguish between imaging lesions suggestive of axSpA and artifacts or lesions suggestive of other disorders is critical for the accurate diagnosis of axSpA. Diagnosis may be challenging, particularly in early-stage disease and magnetic resonance imaging (MRI) plays a key role in the detection of subtle or inflammatory changes. MRI also allows the detection of structural changes in the subchondral bone marrow that are not visible on conventional radiography and is of prognostic and monitoring value. However, bone structural changes are more accurately depicted using computed tomography. Conventional radiography, on the other hand, has limitations, but it is easily accessible and may provide insight on gross changes as well as rule out other pathological features of the axial skeleton. This review outlines the imaging evaluation of axSpA with a focus on imaging mimics and potential pitfalls when assessing the axial skeleton.

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MR imaging of Schmorl's nodes: Imaging characteristics and epidemio-clinical relationships

Abstract: Our study suggests a potential role for ethnical and physical factors in the pathogenesis of SN. Furthers studies are mandatory to evaluate their clinical relevance, especially in patients such as Caucasian manual workers in whom SN have a high prevalence.

Cited by 15 publications

References 28 publications

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

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

Degenerative cervical spine changes among early career fighter pilots: a 5-year follow-up

Axial Spondyloarthritis: Mimics and Pitfalls of Imaging Assessment

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