Schmörl nodes (often spelled Schmorl nodes) refer to protrusions of the cartilage of the intervertebral disc through the vertebral body endplate and into the adjacent vertebra. The protrusions may contact the marrow of the vertebra, leading to inflammation.
They may or may not be symptomatic, and their etiological significance for back pain is controversial. Schmörl nodes are found in 40-75% of autopsies.
In the acute stage, Schmörl nodes can be difficult to diagnose or detect due to sclerosis around the margin of the herniation not having had time to develop.
Schmörl nodes are among the diagnostic criteria of Scheuermann disease 6.
A limbus vertebra is closely related to a Schmörl node as well.
It is believed that Schmörl nodes develop following back trauma, although this is incompletely understood. A more recent study suggests nucleus pulposus pressure on the weakest part of the end plate or vertebral development process during early life as possible explanation 7.
History and etymology
It is named after Christian Georg Schmörl (1861-1932), German pathologist who first described them in 1927.
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- 2. Peng B, Wu W, Hou S, Shang W, Wang X, Yang Y. 2003. The pathogenesis of Schmorl's nodes. J Bone Joint Surg Br. 85(6):879-82. PMID 12931811.
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- 4. Grivé E, Rovira A, Capellades J et-al. Radiologic findings in two cases of acute Schmörl's nodes. AJNR Am J Neuroradiol. 1999;20 (9): 1717-21. Pubmed citation
- 5. Die gesunde und kranke Wirbelsäule im Röntgenbild. By G. SCHMORL and H. JUNGHANNS, 2nd edition, xii. (Pp. 281, 299 figures; bound, D.M. 69.) Stuttgart: G.Thieme Verlag. 1951.
- 6. Resnick D, Niwayama G. Intravertebral disk herniations: cartilaginous (Schmorl's) nodes. Radiology. 1978;126 (1): 57-65. Pubmed citation
- 7. Dar G, Masharawi Y, Peleg S et-al. Schmorl's nodes distribution in the human spine and its possible etiology. Eur Spine J. 2010;19 (4): 670-5. doi:10.1007/s00586-009-1238-8 - Free text at pubmed - Pubmed citation
- 8. Abu-Ghanem S, Ohana N, Abu-Ghanem Y et-al. Acute schmorl node in dorsal spine: an unusual cause of a sudden onset of severe back pain in a young female. Asian Spine J. 2013;7 (2): 131-5. doi:10.4184/asj.2013.7.2.131 - Free text at pubmed - Pubmed citation
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