Schmorl's nodes: Common, highly heritable, and related to lumbar disc disease

Williams, Frances; Manek, Nisha J.; Sambrook, Philip N.; Spector, Timothy D.; Macgregor, Alexander

doi:10.1002/art.22789

Cited by 137 publications

(126 citation statements)

References 35 publications

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“…They concluded that the combination of increased range of rotational movement, anteriorly located instantaneous axis of rotation, and lowdisc thickness relative to vertebral body height in the thoracic spine makes this region more vulnerable to develop SNs. This predominance of SNs in the lower thoracic region has been verified by other studies [3,7].…”

Section: Axial Load (Trauma)supporting

confidence: 86%

“…Hence, disc degeneration leading to SN formation is a possibility. Williams et al [3] found that SNs were highly correlated to lumbar disc degeneration and back pain, although they were not themselves independent predictors of back pain. It is important to note, though, that the formation of a SN does not automatically imply the presence of pain.…”

Section: Disc Degenerationmentioning

confidence: 99%

“…A magnetic resonance imaging (MRI) study of 150 monozygotic and 366 dizygotic living twins found SNs in 30 % of subjects at any vertebral level, and multiple SNs in 14 % of participants [3]. A strong hereditary association was noted, with lumbar and thoracic SNs having heritability values of 80 and 72 %, respectively.…”

Section: Epidemiologymentioning

confidence: 99%

“…Although frequently incidental and asymptomatic, certain SNs have been purported to cause lower back pain and thereby considerably impact quality of life [3,9,17]. A number of strategies to alleviate the pain associated with symptomatic SNs have been reported in the literature.…”

Section: Management Of Symptomatic Lesionsmentioning

confidence: 99%

“…Unlike the better-known horizontal disc herniations into the spinal canal or neural foramina, SNs are herniation of nucleus pulposus (NP) through the cartilaginous and bony end plate into the body of an adjacent vertebra [2]. It has been reported that multiple SNs are highly associated with lumbar disc disease and lower back pain [3].…”

Section: Introductionmentioning

confidence: 99%

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Schmorl’s nodes

et al. 2012

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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.

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Section: Axial Load (Trauma)supporting

confidence: 86%

Section: Disc Degenerationmentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Section: Management Of Symptomatic Lesionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Schmorl’s nodes

et al. 2012

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Vertebral morphology influences the development of Schmorl's nodes in the lower thoracic vertebrae

Plomp

Roberts

Viðarsdóttir

2012

American J Phys Anthropol

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Schmorl's nodes are the result of herniations of the nucleus pulposus into the adjacent vertebral body and are commonly identified in both clinical and archaeological contexts. The current study aims to identify aspects of vertebral shape that correlate with Schmorl's nodes. Two-dimensional statistical shape analysis was performed on digital images of the lower thoracic spine (T10-T12) of adult skeletons from the late medieval skeletal assemblages from Fishergate House, York, St. Mary Graces and East Smithfield Black Death cemeteries, London, and postmedieval Chelsea Old Church, London. Schmorl's nodes were scored on the basis of their location, depth, and size. Results indicate that there is a correlation between the shape of the posterior margin of the vertebral body and pedicles and the presence of Schmorl's nodes in the lower thoracic spine. The size of the vertebral body in males was also found to correlate with the lesions. Vertebral shape differences associated with the macroscopic characteristics of Schmorl's nodes, indicating severity of the lesion, were also analyzed. The shape of the pedicles and the posterior margin of the vertebral body, along with a larger vertebral body size in males, have a strong association with both the presence and severity of Schmorl's nodes. This suggests that shape and/or size of these vertebral components are predisposing to, or resulting in, vertically directed disc herniation.

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Does the correlation between schmorl's nodes and vertebral morphology extend into the lumbar spine?

Plomp

Roberts

Viðarsdóttir

2015

American J Phys Anthropol

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This is the accepted version of the following article: Plomp, K., Roberts, C. and Strand Vidarsdottir, U. (2015), Does the correlation between schmorl's nodes and vertebral morphology extend into the lumbar spine?. American Journal of Physical Anthropology, 157(3): 526-534, which has been published in nal form at http://dx.doi.org/10.1002/ajpa.22730. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.Additional information: Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-pro t purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. Schmorl's nodes are depressions on vertebrae due to herniation of the nucleus pulposus of the intervertebral disc into the vertebral body. This study provides an extension of our previous study which analyzed the shape of the lower thoracic spine and found that vertebral morphology was associated with the presence of Schmorl's nodes. Ninety adult individuals from the late Medieval site of Fishergate House, York, and the Post-Medieval site of Coach Lane, North Shields, Tyne and Wear, England, were analysed using 2D geometric morphometrics to identify possible relationships between vertebral morphology and Schmorl's nodes at the thoraco-lumbar junction and in the lumbar spine. A significant correlation was found between vertebral shape and the presence of Schmorl's nodes in twelfth thoracic vertebrae and lumbar vertebrae 1-3. The findings corroborate previous findings and suggest that vertebral shape may be an important factor in spinal health and it is hypothesized that the pedicle shape of affected vertebrae may not provide adequate structural support for the vertebral bodies, resulting in vertical disc herniation.

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Schmorl's nodes: Common, highly heritable, and related to lumbar disc disease

Cited by 137 publications

References 35 publications

Schmorl’s nodes

Schmorl’s nodes

Vertebral morphology influences the development of Schmorl's nodes in the lower thoracic vertebrae

Does the correlation between schmorl's nodes and vertebral morphology extend into the lumbar spine?

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