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BioMed Research International
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 (X 2 = 4.436, P=0.02) and degenerative lumbar spinal stenosis (X 2 = 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.
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European Spine Journal
Although Schmorl’s nodes (SNs) are a common phenomenon in the normal adult population, their prevalence is controversial and etiology still debatable. The objective was to establish the spatial distribution of SNs along the spine in order to reveal its pathophysiology. In this study, we examined 240 human skeleton spines (T4-L5) (from the Hamann–Todd Osteological Collection) for the presence and location of SNs. To determine the exact position of SNs, each vertebral body surface was divided into 13 zones and 3 areas (anterior, middle, posterior). Our results show that SNs appeared more frequently in the T7-L1 region. The total number of SNs found in our sample was 511: 193 (37.7%) were located on the superior surface and 318 (62.3%) on the inferior surface of the vertebral body. SNs were more commonly found in the middle part of the vertebral body (63.7%). No association was found between the SNs location along the spine and gender, ethnicity and age. This study suggests that the frequency distribution of SNs varies with vertebra location and surface. The results do not lend support to the traumatic or disease explanation of the phenomenon. SNs occurrences are probably associated with the vertebra development process during early life, the nucleus pulposus pressing the weakest part of the end plate in addition to the various strains on the vertebrae and the intervertebral disc along the spine during spinal movements (especially torsional movements).
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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 the twelfth thoracic vertebrae and the first to third lumbar vertebrae. The findings corroborate previous studies and suggest that vertebral shape may be an important factor in spinal health. 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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International Journal of Advanced Research
