Schmorl’s nodes

Abstract

Introduction First described in 1927, a Schmorl's node (SN) is the herniation of nucleus pulposus (NP) through the cartilaginous and bony end plate into the body of the adjacent vertebra. SNs are common findings on imaging, and although most SNs are asymptomatic, some have been shown to become painful lesions. In this manuscript, we review the literature regarding the epidemiology, clinical presentation, pathogenesis, imaging, and management of SNs. Materials and methods Using databases from the US National Library of Medicine and the National Institutes of Health, relevant articles were identified. Results While several theories regarding the pathogenesis of SNs have been proposed, an axial load model appears to have the greatest supporting evidence. Symptomatic SNs are thought to be due to the inflammatory response solicited by the herniation of NP into the wellvascularized vertebral body. Management options for symptomatic SNs vary, ranging from medical management to surgical fusion. Conclusion SNs are common lesions that are often asymptomatic. In certain cases, SNs can cause back pain. No consensus on pathogenesis exists. There is no established treatment modality for symptomatic SNs.

Historical Schmorls Node: Time to Differentiation and Renaming (A Mini- Review)

“…Some researchers proposed a positive association with increasing age, while others argue that age could not be a significant factor. Heredity may play an important role [1]. Hilton et al found an incidence of 75%, with a higher frequency in the thoracolumbar region than in the mid and lower lumbar spines [2].…”

“…Some researchers theorize that SNs are a result of pathologic processes that involve discovertebral complex [1]. Direct trauma to the vertebra has also been implicated as a risk factor in developing SNs.…”

“…These nodes have been identified with increased frequency in athletic adolescents. With regard to the prevalence of SNs, cadaver studies vary in their estimates, ranging from 38% to as high as 79% [1].…”

“…Physical therapy may be of some help in cases of Scheuermann's disease. In complicated SNs, percutaneous fluoroscopy-assisted vertebroplasty or segmental fusion is proposed to control severe pain due to SNs [1].…”

“…Schmorl's nodes" (SN) are destructive lesions at endplates which are believed to be due to the herniation of the nucleus pulposus through the cartilaginous endplate into the body of a vertebra [1]. Schmorl first described them in 1927.…”