Abstract
The Schmorl node represents displacement of intervertebral disc tissue into the vertebral body. Both Schmorl nodes and degenerative disc disease are common in the human spine. We performed a retrospective study, for the period from January 2003 to February 2005, evaluating 23 patients affected by painful Schmorl nodes, who underwent in our department percutaneous transpedicular injection of polymethylmethacrylate (vertebroplasty) in order to solve their back pain not responsive to medical and physical management. Eighteen patients reported improvement of the back pain and no one reported a worsening of symptoms. Improvement was swift and persistent in reducing symptoms. Painful Schmorl nodes, refractory to medical or physical therapy, should be considered as a new indication within those vertebral lesions adequately treatable utilizing Vertebroplasty procedure.
Similar content being viewed by others
References
Lee P, Helewa A, Goldsmith CH, et al. (2001) Low back pain: prevalence and risk factors in an industrial setting. J Rheumatol 28(2):346–351
Roland MO, Morrell DC, Morris RW (1983) Can general practitioners predict the outcome of episodes of back pain? Br Med J (Clin Res Ed) 286(6364):523–525
Lee P (1994) The economic impact of musculoskeletal disorders. Qual Life Res 3(suppl 1):S85–S91
Kawakami M, Tamaki T, Hayashi N, et al. (1998) Possible mechanism of painful radiculopathy in lumbar disc herniation. Clin Orthop Relat Res 351:241–251
Long DM, Filtzer DL, BenDebba M, et al. (1988) Clinical features of the failed-back syndrome. J Neurosurg 69(1):61–71
Stilwell DL Jr (1956) The nerve supply of the vertebral column and its associated structures in the monkey. Anat Rec 125(2):139–169
Gangi A, Wong LLS, Guth S, et al. (2002) Percutaneous vertebroplasty: indications, technique, and results. Semin Intervent Radiol 19: 265–270
Riggs BL, Melton LJ 3rd (1995) The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 17(5 suppl):505S–511S
Gangi A, Kastler BA, Dietemann JL (1994) Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. Am J Neuroradiol 15(1):83–86
Jensen ME, Evans AJ, Mathis JM, et al. (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. Am J Neuroradiol 18(10):1897–1904
Takahashi K, Takata K (1994) A large painful Schmorl’s node: a case report. J Spinal Disord 7(1):77–81
Walters G, Coumas JM, Akins CM, et al. (1991) Magnetic resonance imaging of acute symptomatic Schmorl’s node formation. Pediatr Emerg Care 7(5):294–296
Galibert P, Deramond H, Rosat P, et al. (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 33:166–168
Masala S, Lunardi P, Fiori R, et al. (2004) Vertebroplasty and kyphoplasty in the treatment of malignant vertebral fractures. J Chemother 16(suppl 5):30–33
Stallmeyer MJ, Zoarski GH, Obuchowski AM (2003) Optimizing patient selection in percutaneous vertebroplasty. J Vasc Intervent Radiol 14:683–696
Hamanishi C, Kawabata T, Yosii T, et al. (1994) Schmorl’s nodes on magnetic resonance imaging. Their incidence and clinical relevance. Spine 19(4):450–453
Uetani M, Hashmi R, Hayashi K (2004) Malignant and benign compression fractures: differentiation and diagnostic pitfalls on MRI. Clin Radiol 59(2):124–131
Tan DY, Tsou IY, Chee TS (2002) Differentiation of malignant vertebral collapse from osteoporotic and other benign causes using magnetic resonance imaging. Ann Acad Med Singapore 31(1):8–14
Amar AP, Larsen DW, Esnaashari N, et al. (2001) Percutaneous transpedicular polymethylmethacrylate vertebroplasty for the treatment of spinal compression fractures. Neurosurgery 49:1105–1114
Masala S, Fiori R, Massari F, et al. (2004) Percutaneous kyphoplasty: indications and technique in the treatment of vertebral fractures from myeloma. Tumori 90(1):22–26
Jensen ME, Kallmes DE (2002) Percutaneous vertebroplasty in the treatment of malignant spine disease. Cancer J 8:194–206
Masala S, Roselli M, Massari F, et al. (2004) Radiofrequency heat ablation and vertebroplasty in the treatment of neoplastic vertebral body fractures. Anticancer Res 24(5B):3129–3133
McGraw JK, Strnad BT, Patzik SB, et al. (2000) Carbon dioxide and gadopentetate dimeglumine venography to guide percutaneous vertebroplasty. Cardiovasc Intervent Radiol 23(6):485–487
Masala S, Cesaroni A, Sergiacomi G, et al. (2004) Percutaneous kyphoplasty: new treatment for painful vertebral body fractures. In Vivo 18(2):149–153
Merskey H (1996) Pain specialists and pain terms. Pain 64(1):205
Fordyce WE (1995) What is pain? In: Fordyce WE (ed) Back Pain in the Workplace: Management of Disability in Nonspecific Conditions. IASP Press. Seattle, pp 11–17
Bogduk N (1988) Acute back pain: what is the lesion? Proceedings of a symposium on Acute Back Pain, 2nd European Congress on back pain. Montreux, pp 6–16
Frymoyer JW, Moskowitz RW (1991) Spinal degeneration. Pathogenesis and medical management. In: Frymoyer JW, ed. The Adult Spine: Principle and Practice. New York: Raven Press. pp 611–636
Takahashi K, Miyazaki T, Ohnari H, et al. (1995) Schmorl’s nodes and low-back pain. Analysis of magnetic resonance imaging findings in symptomatic and asymptomatic individuals. Eur Spine J 4(1):56–59
Hasegawa K, Ogose A, Morita T, et al. (2004) Painful Schmorl’s node treated by lumbar interbody fusion. Spinal Cord 42(2):124–128
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Masala, S., Pipitone, V., Tomassini, M. et al. Percutaneous Vertebroplasty in Painful Schmorl Nodes. Cardiovasc Intervent Radiol 29, 97–101 (2006). https://doi.org/10.1007/s00270-005-0153-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00270-005-0153-6