The Effect of Bone Mineral Density on Development of Schmorl's Nodes in Young Patients

Overview

Journal Acta Orthop Traumatol Turc

Specialties Emergency Medicine
Orthopedics

Date 2020 Jun 17

PMID 32544064

Citations 6

Authors

Ozlem Gungor

Naciye Sinem Gezer

Umut Ozdamarlar

Ali Balci

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to detect the relationship between the development of Schmorl's nodes (SNs) and bone mineral density (BMD) in young patients.

Methods: Computerized tomography (CT) images of the thoracolumbar vertebral column were retrospectively examined by two experienced radiologists for SNs. The diagnostic criterion for SN was defined as a node size larger than one-third but not more than two-thirds of the relevant vertebral endplate. Considering the eligibility criteria, a total of 74 individuals (60 males and 14 females; mean age: 24.3 years; age range: 18-40 years) with SN at the thoracolumbar vertebrae were included in the patient group, and a total of 38 age- and gender-matched individuals (30 males and 8 females; mean age: 25 years) with no evidence of SN were included in the control group. All these individuals were younger than 40 years. In the patient group, SNs were assessed in terms of the distribution of the thoracolumbar vertebrae, the location of the upper and lower endplates, and the total number of lesions. In all individuals included in the study, BMD was measured from the axial CT sections by quantitative CT and then compared between the two groups.

Results: The distribution of age and gender was comparable between the two groups (p=0.438). A total of 208 SNs were identified in the patient group. Of these, 92 (44%) were located at the thoracic vertebrae and 116 (56%) at the lumbar vertebrae. The mean BMD was 131.6 g/cm3 in the patient group and 140.7 g/cm3 in the control group (p=0.03). There was no significant relationship between the total number of SNs per patient and the mean BMD (p=0.156).

Conclusion: Evidence from this study revealed that low BMD may be a predisposing factor for the development of SNs in patients younger than 40 years.

Level Of Evidence: Level III, Diagnostic Study.

Citing Articles

The Relationship Between Bone Mineral Density and Lumbar Disc Herniation in Postmenopausal Women.

Celen Z, Onay T Cureus. 2023; 15(8):e44156.

PMID: 37753050 PMC: 10519149. DOI: 10.7759/cureus.44156.

Schmorl's node of primarily developmental cause and Schmorl's node of primarily acquired cause: two related yet different entities.

Wang Y Quant Imaging Med Surg. 2023; 13(6):4044-4049.

PMID: 37284078 PMC: 10239993. DOI: 10.21037/qims-23-252.

The lumbar spinal endplate lesions grades and association with lumbar disc disorders, and lumbar bone mineral density in a middle-young general Chinese population.

Pei J, Yu A, Geng J, Liu Y, Wang L, Shi J BMC Musculoskelet Disord. 2023; 24(1):258.

PMID: 37013527 PMC: 10069090. DOI: 10.1186/s12891-023-06379-w.

Schmorl's nodes are associated with prevalent osteoporotic vertebral fracture and low bone mineral density: a population-based thoracic spine MRI study in older men and women.

Wang Y, Wang X, Leung J, Yu B, Griffith J, Kwok T Quant Imaging Med Surg. 2023; 13(3):1914-1926.

PMID: 36915321 PMC: 10006149. DOI: 10.21037/qims-22-1410.

The prevalence of Schmorl's nodes in osteoporotic vs normal patients: a Middle Eastern population study.

Othman M, Menon V Osteoporos Int. 2022; 33(7):1493-1499.

PMID: 35175396 DOI: 10.1007/s00198-022-06316-y.

References

Hilton R, Ball J, Benn R . Vertebral end-plate lesions (Schmorl's nodes) in the dorsolumbar spine. Ann Rheum Dis. 1976; 35(2):127-32. PMC: 1006522. DOI: 10.1136/ard.35.2.127. View

Walters G, Coumas J, Akins C, Ragland R . Magnetic resonance imaging of acute symptomatic Schmorl's node formation. Pediatr Emerg Care. 1991; 7(5):294-6. DOI: 10.1097/00006565-199110000-00009. View

Takahashi K, Miyazaki T, Ohnari H, Takino T, Tomita K . Schmorl's nodes and low-back pain. Analysis of magnetic resonance imaging findings in symptomatic and asymptomatic individuals. Eur Spine J. 1995; 4(1):56-9. DOI: 10.1007/BF00298420. View

Mok F, Samartzis D, Karppinen J, Luk K, Fong D, Cheung K . ISSLS prize winner: prevalence, determinants, and association of Schmorl nodes of the lumbar spine with disc degeneration: a population-based study of 2449 individuals. Spine (Phila Pa 1976). 2010; 35(21):1944-52. DOI: 10.1097/BRS.0b013e3181d534f3. View

Williams F, Manek N, Sambrook P, Spector T, MacGregor A . Schmorl's nodes: common, highly heritable, and related to lumbar disc disease. Arthritis Rheum. 2007; 57(5):855-60. DOI: 10.1002/art.22789. View

Fahey V, Opeskin K, Silberstein M, Anderson R, Briggs C . The pathogenesis of Schmorl's nodes in relation to acute trauma. An autopsy study. Spine (Phila Pa 1976). 1998; 23(21):2272-5. DOI: 10.1097/00007632-199811010-00004. View

Gezer N, Balci A, Kalemci O, Koremezli N, Basara Akin I, Ur K . Vertebral body bone mineral density in patients with lumbar spondylolysis: a quantitative CT study. Diagn Interv Radiol. 2017; 23(5):385-389. PMC: 5602365. DOI: 10.5152/dir.2017.16463. View

Seymour R, Williams L, Rees J, Lyons K, Lloyd D . Magnetic resonance imaging of acute intraosseous disc herniation. Clin Radiol. 1998; 53(5):363-8. DOI: 10.1016/s0009-9260(98)80010-x. View

Dar G, Peleg S, Masharawi Y, Steinberg N, May H, Hershkovitz I . Demographical aspects of Schmorl nodes: a skeletal study. Spine (Phila Pa 1976). 2009; 34(9):E312-5. DOI: 10.1097/BRS.0b013e3181995fc5. View

10.

Kyere K, Than K, Wang A, Rahman S, Valdivia-Valdivia J, La Marca F . Schmorl's nodes. Eur Spine J. 2012; 21(11):2115-21. PMC: 3481099. DOI: 10.1007/s00586-012-2325-9. View

11.

Vos T, Flaxman A, Naghavi M, Lozano R, Michaud C, Ezzati M . Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380(9859):2163-96. PMC: 6350784. DOI: 10.1016/S0140-6736(12)61729-2. View

12.

Mueller D, Kutscherenko A, Bartel H, Vlassenbroek A, Ourednicek P, Erckenbrecht J . Phantom-less QCT BMD system as screening tool for osteoporosis without additional radiation. Eur J Radiol. 2010; 79(3):375-81. DOI: 10.1016/j.ejrad.2010.02.008. View

13.

Moustarhfir M, Bresson B, Koch P, Perozziello A, Barreau G, Schouman-Claeys E . MR imaging of Schmorl's nodes: Imaging characteristics and epidemio-clinical relationships. Diagn Interv Imaging. 2016; 97(4):411-7. DOI: 10.1016/j.diii.2016.02.001. View

14.

Sward L, Hellstrom M, Jacobsson B, Nyman R, Peterson L . Disc degeneration and associated abnormalities of the spine in elite gymnasts. A magnetic resonance imaging study. Spine (Phila Pa 1976). 1991; 16(4):437-43. DOI: 10.1097/00007632-199104000-00009. View

15.

Resnick D, Niwayama G . Intravertebral disk herniations: cartilaginous (Schmorl's) nodes. Radiology. 1978; 126(1):57-65. DOI: 10.1148/126.1.57. View

16.

Bauer J, Henning T, Mueller D, Lu Y, Majumdar S, Link T . Volumetric quantitative CT of the spine and hip derived from contrast-enhanced MDCT: conversion factors. AJR Am J Roentgenol. 2007; 188(5):1294-301. DOI: 10.2214/AJR.06.1006. View

17.

Baum T, Muller D, Dobritz M, Rummeny E, Link T, Bauer J . BMD measurements of the spine derived from sagittal reformations of contrast-enhanced MDCT without dedicated software. Eur J Radiol. 2010; 80(2):e140-5. DOI: 10.1016/j.ejrad.2010.08.034. View