Radicular pain caused by Schmorl's node: a case report

Kim, Saeyoung; Jang, Seungwon

doi:10.1016/j.bjane.2017.08.002

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…However, this is poorly documented in current literature and is more likely to be associated with LBP 46 as Schmorl's node locates in the disc-vertebral junction without affecting the spinal canal. Scatter researches 63 reported radicular pain in patients with Schmorl's nodes as the only radiological finding but they are of low level of evidence. Schmorl's node [DS16]is possibly a result of maldevelopment of the vertebrae which is similar to DSS 64 .…”

Section: Discussionmentioning

confidence: 99%

Clinical implications of lumbar developmental spinal stenosis on back pain, radicular leg pain, and disability

Lai

Cheung

Samartzis

et al. 2021

The Bone & Joint Journal

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Aims To study the associations of lumbar developmental spinal stenosis (DSS) with low back pain (LBP), radicular leg pain, and disability. Methods This was a cross-sectional study of 2,206 subjects along with L1-S1 axial and sagittal MRI. Clinical and radiological information regarding their demographics, workload, smoking habits, anteroposterior (AP) vertebral canal diameter, spondylolisthesis, and MRI changes were evaluated. Mann-Whitney U tests and chi-squared tests were conducted to search for differences between subjects with and without DSS. Associations of LBP and radicular pain reported within one month (30 days) and one year (365 days) of the MRI, with clinical and radiological information, were also investigated by utilizing univariate and multivariate logistic regressions. Results Subjects with DSS had higher prevalence of radicular leg pain, more pain-related disability, and lower quality of life (all p < 0.05). Subjects with DSS had 1.5 (95% confidence interval (CI) 1.0 to 2.1; p = 0.027) and 1.8 (95% CI 1.3 to 2.6; p = 0.001) times higher odds of having radicular leg pain in the past month and the past year, respectively. However, DSS was not associated with LBP. Although, subjects with a spondylolisthesis had 1.7 (95% CI 1.1 to 2.5; p = 0.011) and 2.0 (95% CI 1.2 to 3.2; p = 0.008) times greater odds to experience LBP in the past month and the past year, respectively. Conclusion This large-scale study identified DSS as a risk factor of acute and chronic radicular leg pain. DSS was seen in 6.9% of the study cohort and these patients had narrower spinal canals. Subjects with DSS had earlier onset of symptoms, more severe radicular leg pain, which lasted for longer and were more likely to have worse disability and poorer quality of life. In these patients there is an increased likelihood of nerve root compression due to a pre-existing narrowed canal, which is important when planning surgery as patients are likely to require multi-level decompression surgery. Cite this article: Bone Joint J 2021;103-B(1):131–140.

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Section: Discussionmentioning

confidence: 99%

Clinical implications of lumbar developmental spinal stenosis on back pain, radicular leg pain, and disability

Lai

Cheung

Samartzis

et al. 2021

The Bone & Joint Journal

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“…현재 증후성 쉬모를 결절의 치료법에 대한 논의가 지 속되고 있으며, 수술적 치료로 경피적 척추체 성형술 (percutaneous vertebroplasty) 6) , 척추감압술(vertebrae decompression) 7) 에 대한 증례가 보고되었고, 비수술적 치 료로 신경차단술(nerve block) 8,20) , 약물 요법(drug therapy) 9,21,22) , 물리치료(physical therapy)…”

Section: Table ⅰ Mri Findings Of Symptomatic Schmorl's Nodesunclassified

“…경피적 척추체 성형술은 미세 골절 부위 에 시멘트 삽입을 통해 척추체에 물리적인 장벽을 형성 하며, 척추감압술은 수핵에 가해지는 축성 압력을 분산 시켜 척추체로의 원심성 압력을 감소시켜 수핵의 척추 체로의 추가적 탈출을 방지한다. 두 번째는 통증 완화 로, 쉬모를 결절의 자연 경과에서 급성기의 증후성에서 만성기의 비증후성으로 발달되는 과정을 인내하게 하 는 것이며, 신경차단술8,20,21) , 항염증제제요법22,30) 과 물리요법 23) 이 이에 해당한다. 신경차단술은 척추체 주위에서 통각 수용을 담당하는 방척추 신경(sinuvertebral nerve) (TNF-α)를 억제하는 치료법으로 infliximab을 투여하는 치료법이 활용되고 있다.…”

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Two Case of Symptomatic Schmorl's Node: A Case Report and Literature Review

Kang

Choi

Park

et al. 2022

J Korean Med Rehabil

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쉬모를 결절(Schmorl's node)은 추간판 수핵(nucleus pulposus)이 인접한 척추체의 연골 종판(cartilaginous bony end plate)으로 탈출한 질환이다 1) . 쉬모를 결절의 병리를 고 려할 때 만성기(chronic stage)에서는 비증후성(asymptomatic)이며 2) 요추부 퇴행성 질환과 연관되어 쉬모를 결 절 자체의 임상적 중요성이 주목받지 못하고 있다 3) . 그러 나 급성기(acute stage)인 증후성 쉬모를 결절(symptomatic Schmorl's nodes)은 visual analog scale (VAS) score 10 에 인접한 극심한 통증을 유발하며 삶의 질을 크게 떨 어뜨릴 수 있다 4) . 증후성 쉬모를 결절은 자기공명영상 검사(magnetic resonance imaging, MRI

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Schmorl node induced multiple radiculopathy

Chen

Wei²,

Li³

et al. 2020

Medicine

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Rationale: We report a case of Schmorl node induced multiple radiculopathy. Patient concerns: A 70-year-old female patient complained of lower back pain in the left leg accompanied by numbness and weakness. Diagnosis: Radiographs showed obvious osteoporosis in the lumbar vertebrae. Computed tomography demonstrated a hole in the upper posterior half of the L2 vertebral body. Magnetic resonance imaging of the lumbar spine revealed a herniated disc involving a protrusion at the posterior wall of the L2 vertebral body, which was present in the left lateral and dorsal epidural spaces. There was significant lumbar stenosis at the L2 vertebral body secondary to dural sac compression due to the mass. Intervention: Left-sided hemilaminectomy was performed at L2 with screw fixation at L1–3. Intraoperatively, the severely ruptured disc compression in the dural sac and nerve root was removed. Outcomes: The patient's leg pain was immediately resolved, and her back pain was reduced. The patient recovered normal motor function at 20 days after surgery. Lessons: A Schmorl node can progress and break through the lumbar vertebral body, resulting in nerve compression. A large proximal herniated mass can cause distal multiple radiculopathy. Therefore, this special case of Schmorl node with multiple radiculopathy should be treated by removing the proximal herniated nucleus pulposus from the vertebral body.

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Radicular pain caused by Schmorl's node: a case report

Cited by 4 publications

References 5 publications

Clinical implications of lumbar developmental spinal stenosis on back pain, radicular leg pain, and disability

Clinical implications of lumbar developmental spinal stenosis on back pain, radicular leg pain, and disability

Two Case of Symptomatic Schmorl's Node: A Case Report and Literature Review

Schmorl node induced multiple radiculopathy

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