Schmorl nodules are changes that appear in the spine. Schmorl's nodules are found in a relatively large number of people (most often in adults), yet they are detected rather incidentally, as there are usually no symptoms. What is the treatment of Schmorl nodules? Are special exercises and rehabilitation needed?

Schmorl nodulesare lesions that can appear in the spine. Their name comes from the name of a German pathologist - Christian Georg Schmorl who was the author of their first description, published in 1927. The essence of these changes is the convexity of the intervertebral disc (more precisely its nucleus pulposus) into the vertebral body.

Schmorl's nodules most often appear in the lumbar and thoracic spine. These changes can generally occur in patients of all ages, but they are most common in adults - the elderly. Schmorl's nodules are more often found in men than in women. The frequency of such changes in the vertebrae can generally be described as high. It turns out that in autopsy tests, Schmorl nodules are detected from 40 to about 80 percent. people.

Contents:

  1. Schmorl nodules: what is it and what are the causes?
  2. Schmorl nodules: symptoms
  3. Schmorl nodules: diagnostics
  4. Schmorl nodules: treatment and rehabilitation

Schmorl nodules: causes

The appearance of Schmorl's nodules within the spine occurs when the structures of the intervertebral disc are abnormally displaced through the boundary plate of the adjacent vertebrae. What are the causes of Schmorl nodules? It is not fully known. Researchers have put forward many different hypotheses. Some scientists believe that these structures develop as a result of injuries and various overloads of the spine. According to others, various developmental disorders of the spine structures can lead to the occurrence of Schmorl's nodules. According to other theories, the problem may be related to vitamin D deficiency.

The occurrence of Schmorl's nodules is also associated with various diseases, in the course of which the strength of the spine is weakened. In this case, Scheuermann's disease is mentioned as a possible cause of Schmorl nodules, but also other entities, such aslike, e.g.

  • osteoporosis
  • Paget's disease
  • hyperparathyroidism

Various autoimmune disorders are also considered a possible cause of Schmorl nodules. The role of genes in the etiology of the described changes is also indicated. It turns out that patients whose family members have already suffered from Schmorl's nodules are at increased risk of developing the disease.

Schmorl nodules: symptoms

Schmorl's nodules usually do not give any symptoms - they are usually detected accidentally. Some authors associate the presence of Schmorl's nodules with the patients' feeling of pain, although the studies conducted so far have not allowed to draw clear conclusions.

However, it may happen that the displaced intervertebral disc will significantly compress the deeper structures of the vertebra, and thus an inflammatory process may develop, and sometimes even necrosis. In such cases, patients may experience various types of symptoms, mainly in the form of pain.

Schmorl nodules: diagnostics

Schmorl's nodules can be detected during any imaging examination where it is possible to visualize the structures of the spine. Their presence can be determined on the basis of an X-ray of the spine, as well as computed tomography or magnetic resonance imaging of the spine. It is possible that Schmorl nodules will be diagnosed in any of these tests, although the latter - i.e. spine MRI - is most effective in the diagnosis of Schmorl nodules.

Schmorl's nodules are so characteristic that they are quite easy to recognize. However, this does not absolve doctors from carrying out differential diagnosis. Schmorl nodules should be differentiated primarily from the involvement of the vertebrae of the spine by neoplastic processes. The inflammatory process of bones and marrow should also be ruled out.

Schmorl nodules: treatment and rehabilitation

Asymptomatic Schmorl nodules do not require treatment. Therapy is used when patients develop symptoms such as pain. However, no clear treatment guidelines for patients with symptomatic Schmorl's nodules have been developed so far. For this reason, patients may be offered a wide variety of treatments. In the treatment of Schmorl's nodules, both vertebroplasty procedures and spine stabilizing treatments are sometimes used. Sometimes the therapy is based on conservative management and patients are recommended to use various medications (mainly non-steroidal anti-inflammatory drugs), as well as physiotherapy.

Exercisefor a he althy spine

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Sources: 1.Kwaku A. Kyere, Schmorl Nodes, Eur Spine J. 2012 Nov; 21 (11): 2115-2121, on-line access: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481099/2.Materials Radiopedia.org portal, on-line access: https://radiopaedia.org/articles/schmorl-nodes-1

About the authorBow. Tomasz NęckiA graduate of the medical faculty at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

Category:

Anatomy