What are Schmorl’s Nodes?
Schmorl’s nodes are the common small and round lesions that are known to occur in the spine. They develop due to slip out of the tissue in the intervertebral disc which pushes up and down in the adjacent vertebrae.
Schmorl’s nodes usually cause no symptoms and are found when performing imaging tests for other reasons.(1) It is known to occur in up to 76% of the general population.(2) However, some research also shows that fewer people develop Schmorl’s nodes.
Mostly the disc herniates sideways but in Schmorl’s node, it herniates upward and downward into the neighboring vertebrae, due to endplate issues. The vertebral endplate plays a role in preventing the disc from bulging.
Intervertebral disc act as a shock absorber. If the disc gets turned, the soft inner part bulges out. If this bulge comes in contact with the bone marrow inside the vertebra, it may lead to inflammation.
Schmorl’s node occurs most commonly on the upper lumbar spine.
Causes and Risk Factors of Schmorl’s Node
Weakening of the vertebral endplate leads to Schmorl’s node.(3) These nodes may also have links with other conditions such as:
- Metabolic diseases
- Degenerative spine diseases
- Spinal trauma of fracture
- Spine infection
- Scheuermann’s disease, in which the vertebrae grow unevenly in childhood
Symptoms of Schmorl’s Nodes
Mostly Schmorl’s nodes are asymptomatic, which means most people do not experience any symptoms. They are incidentally detected in the MRI scans that are done for the diagnosis of other conditions.
There may be an acute onset of lower back pain or worsening of chronic back pain after trauma.
Can Schmorl’s Nodes be Cancerous?
Schmorl’s nodes are not cancerous and are associated with benign and noncancerous diseases.
There is a possibility of Schmorl’s node to exist with cancer and be mistaken as cancer. In a 2015 case report, a person had thyroid carcinoma metastasis, in which thyroid cancer had spread to the spine.(4) The doctors thought the spinal growth to be Schmorl’s node. After a biopsy of the tumor, it was found that the lesion was a result of thyroid cancer metastasis.
How Schmorl’s Node Diagnosed?
Schmorl’s node is diagnosed with an imaging technique, such as MRI. They appear as small bony abnormalities in the endplate. If the imaging techniques reveal Schmorl’s node then other tests are done to determine the underlying cause.
Other tests are also done if the signs and symptoms reveal other spine conditions.
Treatment of Schmorl’s Nodes
As most Schmorl’s nodes do not show any symptoms, no treatment is required. If the Schmorl’s nodes are painful, pain-relieving medications are given. The symptoms if present resolve in 2-6 months. It may take 12 months for the swelling to gradually subside.
Surgery may be considered if the conservative approach brings no relief. Surgery involves the removal of the damaged disc or replacing the damaged disc with a bone graft. The surgeon may also attempt to restore the height between the vertebrae and promote fusion of the two bones.
Schmorl’s nodes are the formation of a soft disc in between the vertebra. Mostly the condition is symptomless, and if the symptoms persist, a doctor should be consulted for early intervention.
