MR imaging of enhancing intraosseous disk herniation (Schmorl's nodes).

Stäbler, Axel; Bellan, Mattia; Weiss, M.; Gärtner, Ch.; Brossmann, Joachim; Reiser, M.

doi:10.2214/ajr.168.4.9124143

Cited by 118 publications

(63 citation statements)

References 22 publications

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“…It is therefore not surprising that the reported frequency of SNs in the literature varies (5-70%) [3,5,7,[10][11][12]. In our study, 116 individuals manifested one or more SNs along the spine (48.3%) (see also Dar et al [13]).…”

Section: Prevalence Of Sns In the Human Populationsupporting

confidence: 52%

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Schmorl’s nodes distribution in the human spine and its possible etiology

et al. 2009

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Although Schmorl's nodes (SNs) are a common phenomenon in the normal adult population, their prevalence is controversial and etiology still debatable. The objective was to establish the spatial distribution of SNs along the spine in order to reveal its pathophysiology. In this study, we examined 240 human skeleton spines (T4-L5) (from the Hamann-Todd Osteological Collection) for the presence and location of SNs. To determine the exact position of SNs, each vertebral body surface was divided into 13 zones and 3 areas (anterior, middle, posterior). Our results show that SNs appeared more frequently in the T7-L1 region. The total number of SNs found in our sample was 511: 193 (37.7%) were located on the superior surface and 318 (62.3%) on the inferior surface of the vertebral body. SNs were more commonly found in the middle part of the vertebral body (63.7%). No association was found between the SNs location along the spine and gender, ethnicity and age. This study suggests that the frequency distribution of SNs varies with vertebra location and surface. The results do not lend support to the traumatic or disease explanation of the phenomenon. SNs occurrences are probably associated with the vertebra development process during early life, the nucleus pulposus pressing the weakest part of the end plate in addition to the various strains on the vertebrae and the intervertebral disc along the spine during spinal movements (especially torsional movements).

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Section: Prevalence Of Sns In the Human Populationsupporting

confidence: 52%

“…Schmorl's nodes (SNs) have been previously studied and described as herniations of the intervertebral disc penetrating into the vertebral body [1][2][3][4][5]. SNs can appear on any spinal vertebra but tend to concentrate in the lower thoracic and lumbar regions.…”

Section: Introductionmentioning

confidence: 99%

Schmorl’s nodes distribution in the human spine and its possible etiology

et al. 2009

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“…Another source of disagreement arises from different views of the etiology of SN which of course affects the observations made. Traditionally, SNs have been perceived as histologically inert and idiopathic herniation of disk tissue through congenitally weak areas of the vertebral end-plate [12], while other investigators have emphasized a relationship of SNs to trauma, osteoporosis, Paget's disease, malignancy, infection, inflammation, hyperparathyroidism, Scheuermann's disease and the subsequent weakening of the vertebral architecture. If SN's are viewed in this light, they would represent dynamic lesions which vary over time in depth and size according to the severity of the underlying disease and the inherent healing potential of the affected individual in question.…”

Section: Discussionmentioning

confidence: 99%

“…If SN's are viewed in this light, they would represent dynamic lesions which vary over time in depth and size according to the severity of the underlying disease and the inherent healing potential of the affected individual in question. The hypothesis might explain some of the findings associated with consecutive MRI scans where some of the SNs are found to be vascularized, edematous and variable in regard to size and depth over time [9,11,12]. However, SNs are usually found at the thoracolumbar junction, they are usually not solitary lesions, they are usually found in otherwise intact vertebrae and they are usually not found to be associated to any overall degeneration of the spine.…”

Section: Discussionmentioning

confidence: 99%

The epidemiology of Schmorl’s nodes and their correlation to radiographic degeneration in 4,151 subjects

et al. 2013

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Purpose Schmorl's nodes (SNs) are commonly seen in vertebral imaging of the normal adult population referred for different reasons and are duly noted by the radiologist. However, little is known about their etiology: either SNs are perceived as largely inert developmental or congenital herniations of disc tissue into weak areas of the vertebral end-plates, or they are perceived as a common pathological pathway of different adverse and general factors such as malignancy, trauma, infection, osteoporosis, Paget's disease and so forth. A commonly accepted morphological definition of what precisely constitute SNs does not exist, and consequently prevalences vary wildly in the literature. In the present study of 4,151 standardized lateral radiographs of the lumbar spine in an adult, Caucasian population between 22 and 93 years (median age 63 years, M 1,533, W 2,618). Methods We investigated prevalence, distribution and epidemiologic relationships of SNs. Results SNs occur primarily in the upper part of the lumbar spine, and usually there are multiple lesions in the same individual. We could not establish any significant correlation between SNs and gender, age, BMI, height, weight or occupational exposure for heavy lifting. The overall prevalence was 3.8 %. We did not find any significant correlations between SNs and overall degeneration of the lumbar spine. Conclusion We found a prevalence of SNs in the lower end of the spectrum than hitherto reported.

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“…There was no difference in the prevalence rates of VESC in relation to sex in the 45 study samples that reported the Schmorl's nodes [60,94,135] Fracture [139,151] Spinal cord infarction [157] Other conditions [42, 121] prevalence in individuals or in the 22 study samples that reported the prevalence in relation to levels (data not shown).…”

Section: Sexmentioning

confidence: 99%

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

Jensen

Karppinen

Sorensen³

et al. 2008

Eur Spine J

391

297

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The prevalence of ''vertebral endplate signal changes'' (VESC) and its association with low back pain (LBP) varies greatly between studies. This wide range in reported prevalence rates and associations with LBP could be explained by differences in the definitions of VESC, LBP, or study sample. The objectives of this systematic critical review were to investigate the current literature in relation to the prevalence of VESC (including Modic changes) and the association with non-specific low back pain (LBP). The MEDLINE, EMBASE, and SveMED databases were searched for the period 1984 to November 2007. Included were the articles that reported the prevalence of VESC in non-LBP, general, working, and clinical populations. Included were also articles that investigated the association between VESC and LBP. Articles on specific LBP conditions were excluded. A checklist including items related to the research questions and overall quality of the articles was used for data collection and quality assessment. The reported prevalence rates were studied in relation to mean age, gender, study sample, year of publication, country of study, and quality score. To estimate the association between VESC and LBP, 2 9 2 tables were created to calculate the exact odds ratio (OR) with 95% confidence intervals. Eighty-two study samples from 77 original articles were identified and included in the analysis. The median of the reported prevalence rates for any type of VESC was 43% in patients with non-specific LBP and/or sciatica and 6% in non-clinical populations. The prevalence was positively associated with age and was negatively associated with the overall quality of the studies. A positive association between VESC and non-specific LBP was found in seven of ten studies from the general, working, and clinical populations with ORs from 2.0 to 19.9. This systematic review shows that VESC is a common MRI-finding in patients with non-specific LBP and is associated with pain. However, it should be noted that VESC may be present in individuals without LBP.

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MR imaging of enhancing intraosseous disk herniation (Schmorl's nodes).

Cited by 118 publications

References 22 publications

Schmorl’s nodes distribution in the human spine and its possible etiology

Schmorl’s nodes distribution in the human spine and its possible etiology

The epidemiology of Schmorl’s nodes and their correlation to radiographic degeneration in 4,151 subjects

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

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