Schmorl's nodes

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Schmorl's nodes are a type of spinal pathology characterized by the herniation of the intervertebral disc material into the vertebral body through the cartilaginous endplate. These nodes are often detected incidentally during imaging studies such as MRI or CT scan and are commonly associated with degenerative disc disease.

Pathophysiology

Schmorl's nodes occur when the nucleus pulposus of the intervertebral disc herniates through the vertebral endplate into the spongy bone of the vertebral body. This can be due to various factors including trauma, degenerative changes, or congenital weaknesses in the endplate. The herniation can lead to inflammation and pain, although many cases are asymptomatic.

Clinical Presentation

Many individuals with Schmorl's nodes are asymptomatic and the condition is often discovered incidentally. When symptoms do occur, they may include localized back pain, which can be exacerbated by physical activity. In some cases, Schmorl's nodes can be associated with other spinal conditions such as spondylosis or osteoporosis.

Diagnosis

Schmorl's nodes are typically diagnosed through imaging studies. X-rays may show the characteristic indentations in the vertebral bodies, but MRI and CT scan are more sensitive and can provide detailed images of the herniation and any associated inflammation or degenerative changes.

Treatment

Treatment for Schmorl's nodes is generally conservative. It may include physical therapy, pain management with NSAIDs or other analgesics, and lifestyle modifications to reduce stress on the spine. In rare cases where the nodes cause significant pain or neurological symptoms, surgical intervention may be considered.

Prognosis

The prognosis for individuals with Schmorl's nodes is generally good, especially if the condition is asymptomatic. For those with symptoms, conservative treatment is often effective in managing pain and improving function.

See Also

• Intervertebral disc
• Degenerative disc disease
• Spondylosis
• Osteoporosis