Chiro Note

The chiro explained to me that part of her diagnosis of my post Schermanns disease is the presence of things called Schmorl's nodes on my x-rays. I googled it and found out a few interesting little facts i thought I'd share in case anyone has any thoughts:

Schmorl's nodes are considered to be vertical disc herniations through the cartilaginous vertebral body endplates. They can sometimes be seen radiographically, however they are more often seen on MRI, even when not visible on plain film x-ray. They may or may not be symptomatic, and their etiological significance for back pain is controversial.

Schmorl's nodes were observed on MRI in 19% of 400 patients with back pain, and in only 9% of an asymptomatic control group. Plain film x-rays only revealed about 33% of the nodes identified on MRI. They also found a high incidence of nodes in the teenager group who had complaints of lower back pain and an increased level of participation in contact sports.

In younger patients, it seems to be more common because the annulus is strong and intact, and thus nuclear material herniates through the weaker endplate. As the annulus degenerates with time and age, transverse or posterolateral herniations are more common.

Patients with symptomatic Schmorl's nodes had pain on percussion, and manual compression of the vertebra (taking punches on guard?) was involved. Back pain was exacerbated by axial loading and extreme lumbar ROM (bending?).

Symptomatic Schmorl's nodes represent a fresh fracture of the vertebral endplate, which allows vertical disc herniation and nuclear migration(I don't get this - does that mean they disappear over time since they say it's a 'fresh fracture' rather than an old one?).

Yochum3 states that Schmorl's nodes may be caused by numerous factors: trauma; hyperparathyroidism; osteoporosis; Schuermann's disease; osteomalacia; infections; and neoplasm. (great could mean just about anything!)