Lumbar Schmorl’s Nodes and Their Correlation with Spine Configuration and Degeneration

Abstract

The aim of this study was to reveal whether demographic aspect, vertebral morphometry, and spine degeneration are associated with lumbar Schmorl's nodes (SNs). A retrospective cross-sectional study was performed using data from the Department of Radiology (Carmel, Medical Center, Israel) for 180 individuals: age range between 40 and 99 years; 90 males and 90 females. All participants had undergone high-resolution CT scans for abdominal diagnostic purposes in the same supine position prior to our study, which enabled the processing of the scans in all planes and allowed a 3D reconstruction of the lower lumbar region. Eighty individuals (44.4%) had at least one SN along the lumbar spine, particularly at L3-4 level (30%). Vertebral body length (L1 to L3) and width (L1 and L4) were significantly greater in the SNs group compared to non-SNs group. On contrast, disc height (L3-4 and L4-5) was significantly lesser in SNs group than non-SNs group. SNs was significantly associated with smoking (X2= 4.436, P=0.02) and degenerative lumbar spinal stenosis (X2= 5.197, P=0.038). Moreover, the prevalence of SN was significantly greater in individuals with vacuum phenomenon and osteophytes formation (L1-2 to L4-5 levels). This study indicates that vacuum phenomenon on L3-4 (OR: 4.7, P=0.034), smoking habit (OR: 3.2, P=0.003), disc height loss of L4-5 (OR: 0.798, P=0.008), vertebral body length of L1 (OR: 1.37, P<0.001), and age (OR: 1.05, P=0.002) increase the probability of developing lumbar SNs.

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

“…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].…”

“…Other studies assessed the MRI images of different sample criteria, including healthy twin females [12] and healthy adults [24], a paper analysed discography in adults with back pain [16], and another assessed CT scans of lumber spine [25]; these manuscripts showed a significant relation between SNs and disc degeneration.…”

Vertebral column deformity with curved cross‐stitch vertebrae in Norwegian seawater‐farmed Atlantic salmon, Salmo salar L.

“…The presence of curved cross‐stitch vertebrae was significantly associated with the presence of gas on CT. Gas was not identified in any of the radiographically normal fish, which suggests a correlation between gas and the vertebral deformity. The presence of gas is frequently identified on CT studies of humans (Abbas, Hamoud, Peled, & Hershkovitz, ; Pfirrmann & Resnick, ; Samartzis et al, ) and dogs (Müller, Ludewig, Oechtering, Scholz, & Flegel, ; Weber, Berry, & Kramer, ) with intervertebral disc disease. The condition has been associated with pain in humans (Belfquih, El Mostarchid, Akhaddar, Gazzaz, & Boucetta, ; Gohil, Vilensky, & Weber, ).…”

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

“…However, specific types of SNs are associated with refractory low back pain, which is ineffective for conservative treatment. A few studies have reported that Schmorl's nodes(SNs) may related to degenerative disc diseases and osteoporotic vertebral compression fractures, and lead to low back pain [9][10][11][12][13]. Patients receiving spine MRI show low signal intensity on T1WI and high signal intensity on T2WI in the endplate around the SNs are at increased risk increased risk of appear low back pain.…”