Schmorl's nodes

Schmorl's nodes are protrusions of the nucleus pulposus of the intervertebral disc through the vertebral body endplate and into the adjacent vertebra.

[1] These are protrusions of disc material into the surface of the vertebral body, which may contact the marrow of the vertebra and lead to inflammation.

Schmorl's nodes often cause no symptoms, but may simply reflect that "wear and tear" of the spine has occurred over time; they may also reflect that bone strength was at one time somewhat compromised, perhaps due to a vitamin D deficiency although this has yet to be confirmed with studies, or if heavy lifting is done at a young age before the vertebral bodies are completely ossified such as in young farm workers.

During this time the forces normally distributed by the nucleus pulposus (the incompressible gelatinous center of the intervertebral disc) are concentrated in a certain area causing endplates to deform in a concave manner.

In a study in Spine by Hamanishi, et al., Schmorl's nodes were observed on MRI in 19% of 400 patients with back pain, and in only 9% of an asymptomatic control group.

CT scan in the sagittal plane of two Schmorl's nodes. The small Schmorl's node at the inferior endplate of the L3 vertebral body (arrow) has typical features, being broad-based at the endplate, with well-defined contours and thin marginal sclerosis. A large and less typical Schmorl's node (arrowhead) is observed at the superior endplate of L4. [ 3 ]