NEUROLOGY EXPERT FORUM
schmorl's node

schmorl's node


  : What is a Schmorl's node, specifically with respect to the dorsal and lumbar spine.  Can this condition be caused by trauma?  What is the generally recommended treatment, if any?
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  Schmorl's nodes
  These are seen as erosive lesions on the surface of the vertebral body, are caused by herniation of the central part of the intervertebral disc, the nucleus pulposus, through the surrounding annulus fibrosus.
                                                  
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The above contribution by "J" is correct, but I'd like to add a few comments.
If you imagine an MRI of the lumbo-sacral spine, looking at it from the side so you see the vertebral bodies stacked on top of each other with discs in between. Got that image? Now imagine a little bleb, within the vertebral body, on the surface (can be lower or upper, doesn't matter) right next to the adjacent disc. That bleb might be a couple of millimeters in size.
That's different from other structural abnormalities. For example, in the typical "bulging disc," you would see the two vertebral bodies a bit closer together than they should be, the disc sandwiched between them a bit thinner than it should be, and off to the side you'd see disc material bulging out into the space where the spinal cord runs.
Schmorl's nodes do not bulge or herniate toward the cord or to the sides (neural foramen) where the nerve roots exit the spine.
Schmorl's nodes are seen in up to 75% of the normal population.
If you have degenerative spine disease (wear and tear), the MRI will show more than just Schmorl's nodes. If not, the presence of Schmorl's nodes just by themselves are not sufficient to warrant concern. In fact, many radiologists and neurologists see so many of these in otherwise normal scans that they might not even comment on them.
Treatment depends on what you have. If you have symptoms, the neurologist will take a careful history and do a systematic neurologic exam to demonstrate whether there is any damage to your nervous system. The MRI can help define this. But the presence of Schmorl's nodes does not influence the diagnosis or treatment decision.
I hope this helps. CCF MD mdf.





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