Schmorl's nodes: current pathophysiological, diagnostic, and therapeutic paradigms

Neurosurg Rev. 2014 Jan;37(1):39-46. doi: 10.1007/s10143-013-0488-4. Epub 2013 Aug 18.

Abstract

Schmorl's nodes were first described by the pathologist Christian Schmorl in 1927 as a herniation of the nucleus pulposus through the cartilaginous and bony endplate into the vertebral body. Although such lesions present most commonly as incidental findings in asymptomatic patients (or in patients with back or radicular pain due to other etiology), there have been several reports emphasizing the deleterious effects of the inflammatory response and endplate changes elicited by the herniation of for such reasons, Schmorl's nodes have been occasionally implicated in the etiology of chronic axial pain as well as in pathological osteoporotic fractures. In this article, a thorough literature review about the most relevant historical studies on Schmorl's nodes previously published is performed. Furthermore, the authors provide an overview about the recent advances in basic science research on the pathophysiology of such lesions, as well as on current diagnostic and therapeutic paradigms.

Publication types

  • Review

MeSH terms

  • Animals
  • Disease Models, Animal
  • Humans
  • Intervertebral Disc Degeneration / complications
  • Intervertebral Disc Degeneration / diagnosis
  • Intervertebral Disc Degeneration / pathology*
  • Intervertebral Disc Degeneration / surgery*
  • Intervertebral Disc Displacement / complications
  • Intervertebral Disc Displacement / diagnosis
  • Intervertebral Disc Displacement / pathology*
  • Intervertebral Disc Displacement / surgery*
  • Low Back Pain / etiology
  • Lumbar Vertebrae / pathology
  • Osteoporotic Fractures / etiology
  • Regional Blood Flow / physiology
  • Spinal Fusion
  • Spine / blood supply
  • Spine / pathology
  • Vertebroplasty

Supplementary concepts

  • Intervertebral disc disease