Lumbar Schmorl's Nodes and Their Correlation with Spine Configuration and Degeneration.

Janan Abbas,Natan Peled,Israel Hershkovitz,Kamal Hamoud

doi:10.1155/2018/1574020

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.

Highlights

Schmorl’s nodes (SNs) have been described as herniation of nucleus material through the endplate into the vertebral body [1, 2]
The nodes appear on computed tomography (CT) scans as a round or sclerotic irregular area of bone density with a sclerotic circumferential margin lying beneath the cartilaginous endplate [3]
SNs were associated with age; i.e., it was more common in the older age group (Figure 2) (X2= 19.382, P

Summary

Introduction

Schmorl’s nodes (SNs) have been described as herniation of nucleus material through the endplate into the vertebral body [1, 2]. SNs can appear on any spine vertebra, mainly in the lower thoracic and lumbar regions [1, 4]. SNs are considered a multifactorial origin and can be associated with trauma to the spine and several diseases such as osteoporosis and metabolic disease [1, 4, 5]. Previous skeletal studies [19, 20] have noted a correlation between SNs and vertebra size and shape. No study to date has investigated the correlation between SNs and degenerative changes on the posterior spine element (e.g., facet-joint arthrosis)

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Results

Conclusion