Lumbar spine Schmorl's nodes; prevalence in adults with back pain, and their relation to vertebral endplate degeneration

Schmorl's nodes in a historic adult skeletal sample (19th to 20th centuries): An analysis of age, sex and occupation

OBJECTIVE

This study explores the interplay between age-at-death, sex and occupation and the presence, location and severity of Schmorl's nodes.

MATERIALS

Vertebral columns of 327 individuals, 180 (55.1%) males and 147 (44.9%) females, with age-at-death between 20 and 65 years old, with known occupation.

METHODS

Schmorl's nodes were recorded as present/absent and by location and severity.

RESULTS

In this sample, 58.7% (192/327) of individuals were affected by Schmorl's nodes, 75.6% (136/180) were males and 38.1% (56/147) were females, with statistically significant differences (p=0.000). Schmorl's nodes were most commonly found on the T7-L2 (77.1% of all Schmorl's nodes) vertebrae and at the center (73.4%) of the vertebral body surface. Age and occupational categories did not correlate with prevalence, quantity or severity.

CONCLUSIONS

Males appear more prone to develop Schmorl's nodes than females. In this study, the prevalence of Schmorl's nodes does not increase with age, nor with the type of occupation held by males.

SIGNIFICANCE

This study rejects the purported associations between prevalence of Schmorl's nodes and age and physical stress.

LIMITATIONS

It is unknown whether individuals had the same occupation throughout their lives or for how long they performed it. Additionally, it is impossible to access when the individual developed the Schmorl's node.

SUGGESTIONS FOR FURTHER RESEARCH

Evaluate the onset of Schmorl's nodes in individuals under 20 and explore possible links between vertebral morphology and the occurrence of Schmorl's nodes.

Evaluation of Cartilaginous Endplate Degeneration Based on Magnetic Resonance Imaging

In order to carry out the evaluation of cartilaginous endplate degeneration based on magnetic resonance imaging (MRI), this paper retrospectively analyzed the MRI data from 120 cases of patients who were diagnosed as lumbar intervertebral disc degeneration and underwent MRI examinations in the designated hospital of this study from June 2018 to June 2020. All cases underwent conventional sagittal and transverse T1WI and T2WI scans, and some cases were added with sagittal fat-suppression T2WI scans; then, the number of degenerative cartilaginous endplates and its ratio to degenerative lumbar intervertebral discs were counted and calculated, and the T1WI and T2WI signal characteristics of each degenerative cartilage endplate and its correlation with cartilaginous endplate degeneration were summarized, compared, and analyzed to evaluate the cartilaginous endplate degeneration by those magnetic resonance information. The study results show that there were 33 cases of cartilaginous endplate degeneration, accounting for 27.50% of all those 120 patients with lumbar intervertebral disc degeneration (54 degenerative endplates in total), including 9 cases with low T1WI and high T2WI signals, 5 cases with high T1WI and low T2WI signals, 12 cases with high and low mixed T1WI and high or mixed T2WI signals, and 4 cases with both low T1WI and T2WI signals. Therefore, MRI scanning can clearly present the abnormal signals of lumbar intervertebral disc and cartilaginous endplate degeneration, accurately identity their lesion locations, and type their degenerative characteristics, which may be best inspection method for the evaluation of cartilaginous endplate degeneration in the early diagnosis of intervertebral disc degeneration. The study results of this paper provide a reference for further researches on the evaluation of cartilaginous endplate degeneration based on magnetic resonance imaging.