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Schmorl’s nodes distribution in the human spine and its possible etiology

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Abstract

Although Schmorl’s nodes (SNs) are a common phenomenon in the normal adult population, their prevalence is controversial and etiology still debatable. The objective was to establish the spatial distribution of SNs along the spine in order to reveal its pathophysiology. In this study, we examined 240 human skeleton spines (T4-L5) (from the Hamann–Todd Osteological Collection) for the presence and location of SNs. To determine the exact position of SNs, each vertebral body surface was divided into 13 zones and 3 areas (anterior, middle, posterior). Our results show that SNs appeared more frequently in the T7-L1 region. The total number of SNs found in our sample was 511: 193 (37.7%) were located on the superior surface and 318 (62.3%) on the inferior surface of the vertebral body. SNs were more commonly found in the middle part of the vertebral body (63.7%). No association was found between the SNs location along the spine and gender, ethnicity and age. This study suggests that the frequency distribution of SNs varies with vertebra location and surface. The results do not lend support to the traumatic or disease explanation of the phenomenon. SNs occurrences are probably associated with the vertebra development process during early life, the nucleus pulposus pressing the weakest part of the end plate in addition to the various strains on the vertebrae and the intervertebral disc along the spine during spinal movements (especially torsional movements).

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Acknowledgments

The author thanks Prof. Bruce Latimer, Mr. Lyman Jellema from the Cleveland Museum of Natural History, Cleveland, Ohio, for their support and assistance in using the invaluable Hamann-Todd osteological collection; to Mrs. Phyllis Curchack Kornspan for her editorial services; The Dan David Foundation, The Tassia and Dr. Joseph Meychan Chair of History and Philosophy of Medicine, and the Israel Science Foundation for their financial support.

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Authors and Affiliations

  1. Department of Physical Therapy, Faculty of Social Welfare and Health Studies, Haifa University, Mount Carmel, 31905, Haifa, Israel

    Gali Dar

  2. Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, 69978, Tel Aviv, Israel

    Gali Dar, Youssef Masharawi, Smadar Peleg, Nili Steinberg, Hila May, Bahaa Medlej & Israel Hershkovitz

  3. Spinal Research Laboratory, Department of Physical Therapy, School of Health, Tel-Aviv University, 69978, Tel Aviv, Israel

    Youssef Masharawi

  4. Zinman College of Physical Education and Sports Sciences, Wingate Institute, Netanya, Israel

    Nili Steinberg

  5. Department of Radiology, Carmel Medical Center, 34362, Haifa, Israel

    Natan Peled

  6. Cleveland Museum of Natural History, Cleveland, OH, USA

    Israel Hershkovitz

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  1. Gali Dar
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  2. Youssef Masharawi
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  3. Smadar Peleg
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  4. Nili Steinberg
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  5. Hila May
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  6. Bahaa Medlej
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  7. Natan Peled
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  8. Israel Hershkovitz
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Correspondence to Gali Dar.

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Dar, G., Masharawi, Y., Peleg, S. et al. Schmorl’s nodes distribution in the human spine and its possible etiology. Eur Spine J 19, 670–675 (2010). https://doi.org/10.1007/s00586-009-1238-8

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  • DOI: https://doi.org/10.1007/s00586-009-1238-8

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