The pathogenesis of Schmorl’s nodes

Peng, Baogan; Wu, Wenqing; Hou, Steven X.; Shang, Wenting; Wang, X.; Yang, Young Ho

doi:10.1302/0301-620x.85b6.13555

Cited by 81 publications

(48 citation statements)

References 15 publications

(9 reference statements)

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“…Resultados recientes proponen que este debilitamiento estaría relacionado con cambios en los patrones vasculares entre el disco y el platillo vertebral (Haidar et al 2009) o con necrosis isquémicas óseas subcondrales producidas debajo del platillo vertebral (Peng et al 2003). Además, Zhang et al (2010) plantean como hipótesis un rol destacado de causas inmunológicas en el desarrollo de los NS.…”

Section: Palabras Clave: Nódulos De Schmorl Restos Humanos Arqueológunclassified

Nódulos de Schmorl en Restos Humanos Arqueológicos de Patagonia Austral

Suby

2014

Magallania

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RESUMENLos nódulos de Schmorl (NS) son herniaciones del núcleo pulposo de los discos intervertebrales dentro de los cuerpos vertebrales adyacentes. Las causas de su desarrollo son parcialmente comprendidas, asociadas a factores morfológicos, degenerativos, traumáticos y metabólicos, mientras el rol de su interpretación como indicador de actividad física es aún cuestionado. En este trabajo se estudia la prevalencia de NS en 22 esqueletos arqueológicos de Patagonia Austral, discutiendo sus posibles causas y relación con los estilos de vida propuestos para las poblaciones humanas de esa región. Se registró una prevalencia de 27,3% para el total de los esqueletos analizados. Además, se encontró una mayor prevalencia de NS en la región de Santa Cruz/Magallanes en relación a los esqueletos de Tierra del Fuego. Aunque no puede descartarse una tendencia biológica al desarrollo de estas lesiones, los resultados sugieren un mayor grado de estrés mecánico sobre la columna vertebral en los individuos de la región continental de Patagonia Austral. PALABRAS CLAVE: nódulos de Schmorl, restos humanos arqueológicos, Patagonia austral, paleopatología SCHMORL´S NODES IN ARCHAEOLOGICAL SKELETALREMAINS FROM SOUTHERN PATAGONIA ABTRACT Schmorl´s Nodes are herniations of the intervertebral disc nucleous pulposus into the adjacent vertebra. Their causes are partially understood and associated to morphological, degenerative, traumatic and metabolic factors, whereas their role as an indicator of physical activity is currently under debate. In this paper the prevalence of NS in 22 archaeological skeletons from Southern Patagonia is studied, discussing their possible causes and their relationship with the lifestyles of the human populations of this region. A prevalence of 27.3% was recorded. The skeletons from the Santa Cruz/Magallanes region showed higher prevalence of NS than skeletons from northern and southern Tierra del Fuego. Although biological susceptibility for this difference could not be

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Section: Palabras Clave: Nódulos De Schmorl Restos Humanos Arqueológunclassified

Nódulos de Schmorl en Restos Humanos Arqueológicos de Patagonia Austral

Suby

2014

Magallania

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“…This indicated the presence of inflammation and edema in the vertebral bone marrow which is less emphasized clinically so far [11]. These MRI findings were not present in asymptomatic individuals which suggested that Schmorl's nodes became asymptomatic when the inflammation subsided [9].…”

Section: Imaging Evaluationmentioning

confidence: 90%

“…The radiological manifestation of Schmorl's nodes is an endplate indentation with an indistinct sclerotic marginal line [9]. In the lateral projection, the vertebral bodies are rather rectangular in shape.…”

Section: Imaging Evaluationmentioning

confidence: 99%

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

Owlia¹

2013

J Spine

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Abstract"Schmorl's nodes" (SN) are lytic 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 vertebral endplates. Our observations disclose the fact that all Schmorl's nodes are not single entities and a subset of SNs seems to be a discrete clinical condition with similar (but not identical) imaging manifestations. They share many features of seronegative spondyloarthritis. We called them "Owlia's nodes".

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“…Schmorl's nodes have been widely assumed to be the herniation of the nucleus pulposus through the cartilaginous endplate into the body of a vertebra, ever since Schmorl first described them in 1927 [5,29]. The hypotheses of their origin and pathogenesis include developmental factors, degenerative conditions, pathological processes such as infection, neoplasia and trauma, and bone necrosis beneath the endplate [1,5,8,14,23,26,28,30,31]. The endplate degenerative changes, also known as Modic changes, were proposed independently by de Roos et al [7] and Modic et al [18,19] according to signal intensity changes of the endplate beneath the cartilage endplate and the adjacent marrow on MRI.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and surgical treatment of back pain originating from endplate

et al. 2009

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Twenty-one patients with back pain originating from the endplate injuries were selected to explore the methods of diagnosis and surgical treatment. All patients underwent examinations using radiography, CT, and MR imaging. Pain level of disc was determined through discography in each patient. The principal outcome judgments were pain and disability, and the efficacy of surgical treatment was assessed through the use of the visual analog scale (VAS) for pain and the Oswestry disability index (ODI) for functional recovery. All 21 patients with a diagnosis of back pain originating from endplate injuries according to discography were treated with anterior or posterior fusion surgery. The mean follow-up period was 3 years and 5 months (range, 2-6 years). Of the 21 patients, 20 (20/21) reported a disappearance or marked alleviation of low back pain and experienced a definite improvement in physical function. Statistically significant and clinically meaningful improvements in the VAS and ODI scores were obtained after treatment in the patients with chronic low back pain originating from the endplate injuries (P = 0.0001). The study suggests that discography and fusion surgery may be very effective methods for the diagnosis and treatment, respectively, of chronic back pain originating from the endplate injuries.

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The pathogenesis of Schmorl’s nodes

Cited by 81 publications

References 15 publications

Nódulos de Schmorl en Restos Humanos Arqueológicos de Patagonia Austral

Nódulos de Schmorl en Restos Humanos Arqueológicos de Patagonia Austral

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

Diagnosis and surgical treatment of back pain originating from endplate

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