Research Article
Lumbar Schmorl’s Nodes and Their Correlation with Spine
Configuration and Degeneration
Janan Abbas ,
1,2
Kamal Hamoud,
2,3,4
Natan Peled,
5
and Israel Hershkovitz
1
1
Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
2
Department of Physical Terapy, Zefat Academic College, Zefat 13206, Israel
3
Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat 1311502, Israel
4
Department of Orthopaedic Surgery, Te Baruch Padeh Poriya Medical Center, Tiberias 1520800, Israel
5
Department of Radiology, Carmel Medical Center, Haifa 3436212, Israel
Correspondence should be addressed to Janan Abbas; janan1705@gmail.com
Received 6 June 2018; Accepted 28 October 2018; Published 7 November 2018
Academic Editor: Bryan Cornwall
Copyright © 2018 Janan Abbas et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Te aim of this study was to reveal whether demographic aspect, vertebral morphometry, and spine degeneration are associated with
lumbar Schmorl’s nodes (SNs). A retrospective cross-sectional study was performed using data from the Department of Radiology
(Carmel, Medical Center, Israel) for 180 individuals: age range between 40 and 99 years; 90 males and 90 females. All participants
had undergone high-resolution CT scans for abdominal diagnostic purposes in the same supine position prior to our study, which
enabled the processing of the scans in all planes and allowed a 3D reconstruction of the lower lumbar region. Eighty individuals
(44.4%) had at least one SN along the lumbar spine, particularly at L3-4 level (30%). Vertebral body length (L1 to L3) and width
(L1 and L4) were signifcantly greater in the SNs group compared to non-SNs group. On contrast, disc height (L3-4 and L4-5)
was signifcantly lesser in SNs group than non-SNs group. SNs was signifcantly associated with smoking (X
2
= 4.436, P=0.02) and
degenerative lumbar spinal stenosis (X
2
= 5.197, P=0.038). Moreover, the prevalence of SN was signifcantly greater in individuals
with vacuum phenomenon and osteophytes formation (L1-2 to L4-5 levels). Tis study indicates that vacuum phenomenon on L3-4
(OR: 4.7, P=0.034), smoking habit (OR: 3.2, P=0.003), disc height loss of L4-5 (OR: 0.798, P=0.008), vertebral body length of L1
(OR: 1.37, P<0.001), and age (OR: 1.05, P=0.002) increase the probability of developing lumbar SNs.
1. Introduction
Schmorl’s nodes (SNs) have been described as herniation
of nucleus material through the endplate into the vertebral
body [1, 2]. Te nodes appear on computed tomography (CT)
scans as a round or sclerotic irregular area of bone density
with a sclerotic circumferential margin lying beneath the
cartilaginous endplate [3].
SNs can appear on any spine vertebra, mainly in the lower
thoracic and lumbar regions [1, 4]. SNs are considered a
multifactorial origin and can be associated with trauma to the
spine and several diseases such as osteoporosis and metabolic
disease [1, 4, 5]. Te reported frequency of SNs in the general
population varies from 2 to 76% [6–10] with considerable
preference for males [4, 6, 11].
Although the etiology of SNs remains elusive, both
congenital [6, 12, 13] and traumatic [13–15] factors have
been suggested. SNs were found to be associated with disc
degeneration [6, 16, 17] and back pain [5, 14, 18], while
their association with vascular disease (e.g., diabetic mellitus)
and occupational stress is less clear. Previous skeletal studies
[19, 20] have noted a correlation between SNs and vertebra
size and shape. To our knowledge, no study to date has
investigated the correlation between SNs and degenerative
changes on the posterior spine element (e.g., facet-joint
arthrosis).
Te aims of this study were (1) to reveal the association
between SNs and demographic factors (e.g., occupation stress
and diabetes mellitus), (2) to examine the relationships
between vertebral morphometry (e.g., vertebral body width
Hindawi
BioMed Research International
Volume 2018, Article ID 1574020, 9 pages
https://doi.org/10.1155/2018/1574020