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European Spine Journal

, Volume 27, Issue 1, pp 13–18 | Cite as

Painful Schmorl’s nodes treated by discography and discoblock

  • Junhui Liu
  • Lu Hao
  • Xuyang Zhang
  • Zhi Shan
  • Shengyun Li
  • Shunwu Fan
  • Fengdong ZhaoEmail author
Original Article

Abstract

Purpose

To determine the efficacy of discography and discoblock in the treatment of low back pain (LBP) associated with painful Schmorl’s nodes (SNs).

Methods

Between January 2010 and February 2015, 46 patients were studied who had LBP suspected to be secondary to SNs. There were 34 men and 12 women, and mean age was 54.2 years (range 42–68 years). All patients underwent provocation discography, and discoblock was given to positive patients (confirmed to have painful SNs). Visual analogue scores (VAS) and the Oswestry Disability Index (ODI) were evaluated at 4 h and 1, 3, 6, and 12 months post-operatively. MRI was also used to evaluate the SNs at 12 months.

Results

Discography was performed on a total of 60 discs without infection or other complications. Positive findings were found in 71.7% discs; 20.0% were negative, and 8.3% were indeterminate. Among the positive patients who underwent discoblock, 89.2% reported an improvement in their LBP, and none reported worsening symptoms. VAS and ODI scores decreased significantly after discoblock, and there were no significant differences between 4 h and 1, 3, 6, and 12 months post-operatively. In patients with painful SNs, the vertebral body bone marrow surrounding the SN was characterized by low T1 and high T2 signals on MRI. At 12 months, the node demonstrated either high T1 and T2 signals or low T1 and T2 signals. The SNs tended to remain stable in size over time.

Conclusions

Painful SNs refractory to medical or physical therapy should be an indication for treatment with discography and discoblock.

Keywords

Back pain Painful Schmorl’s node Discography Discoblock 

Notes

Compliance with ethical standards

Funding

National Natural Science Foundation of China (Project No. 31270997) and Zhejiang Medical and Health Science and Technology project (Project No. 2016136915).

Conflict of interest

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Junhui Liu
    • 1
  • Lu Hao
    • 1
  • Xuyang Zhang
    • 1
  • Zhi Shan
    • 1
  • Shengyun Li
    • 1
  • Shunwu Fan
    • 1
  • Fengdong Zhao
    • 1
    Email author
  1. 1.Department of Orthopaedics, Sir Run Run Shaw Hospital, School of MedicineZhejiang UniversityHangzhouPeople’s Republic of China

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