An upward and downward protrusion (pushing into) of a spinal disc’s soft tissue into the bony tissue of the adjacent vertebrae. Schmorl’s nodes, which are common, especially with minor degeneration of the aging spine, are detectable via X-ray as spine abnormalities. Schmorl’s nodes are most common in the middle and lower spine. Schmorl’s nodes usually cause no symptoms, but they reflect that ‘wear and tear’ of the spine has occurred over time.
General Considerations
- -Common (1/3 of population); more common in men than women
- -Extrusion, invagination, protrusion of intervertebral disc material through a break in the subchondral end plate of a vertebral body
- -The disk material is displaced into the vertebral body
- -Most common in thoracolumbar spine
- -May occur spontaneously or in association with
- -Scheuermann’s disease (juvenile kyphosis)
- -Trauma
- -Hyperparathyroidism
- -Osteoporosis, other metabolic conditions
- -Infection
- -Neoplasm
linical Findings
-Are generally considered to be asymptomatic although cases are reported of acute pain
Imaging Findings
- -Lucent lesion, most often in middle or posterior portion of vertebral body
- -At margin with disc space
- -More commonly involves inferior endplate
- -Usually posterior of middle portion of endplate
- -Sclerotic margin
- -On MR-Schmorl’s node generally has same signal characteristics as adjacent disc-Best seen on sagittal images
- -Defect in endplate is often seen
Differential Diagnosis
-Limbus vertebra
Treatment
-Usually asymptomatic
-If symptomatic, conservative symptomatic treatment
Function
Exercises to combat Schmorl’s nodes must be supervised by your doctor, chiropractor or physical therapist. The exercises can stretch and relax tight muscles from the abnormal curvature of your spine, improve your posture and strengthen your abdominal muscles. Strong abdominal muscles help maintain correct posture.
Back Exercises
Sit on an exercise ball with your feet and knees together and breathe evenly with your diaphragm. Your stomach should inflate when you breathe in and deflate when you breathe out. Keep your knees bent and raise your right leg and left arm simultaneously. Lower both slowly and repeat with your left leg and right arm. Do not shift your hips or let the ball move as you perform the exercise. Repeat for the number of repetitions recommended by your therapist.
Maintain your position on the exercise ball and raise your heels from the floor. Breathe with your diaphragm and lift your arms out to your side. Perform a quarter turn to your left, return to your starting position, then turn to your right. Do the prescribed number of repetitions. Do not shift your hips or let the ball move.
Abdominal and Core Exercises
Lie flat on your back with your legs bent and feet flat on the floor. Keep your arms by your side. Tighten your abdominal and butt muscles, and gently lift your body as a single unit without tilting your pelvis. Lower your body and repeat for the number of repetitions recommended by your therapist.
Perform abdominal curls. Maintain your position on the floor and place your arms across your chest. Contract your abdominal muscles and gently lift your shoulders. Lower your shoulders and repeat for the prescribed number of repetitions. Exhale as you raise your shoulders.
Posture Balancing
Stand with your back against a wall with your feet 12 to 14 inches from the wall. Raise your arms sideways at 30 degrees with your palms facing outward. Try to touch the wall with your hips, lower back, middle back, shoulders and head while breathing with your diaphragm. Relax your neck muscles, and do not force your head back against the wall. Slide your arms up against the wall until you are unable to maintain bodily contact with the wall. Relax, step away from the wall, and repeat.
