The effect of bone mineral density on development of Schmorl’s nodes in young patients

Objective: The aim of this study was to detect the relationship between the development of Schmorl’s nodes (SNs) and bonemineral density (BMD) in young patients.Methods: Computerized tomography (CT) images of the thoracolumbar vertebral column were retrospectively examinedby two experienced radiologists for SNs. The diagnostic criterion for SN was defined as a node size larger than one-third butnot more than two-thirds of the relevant vertebral endplate. Considering the eligibility criteria, a total of 74 individuals (60males and 14 females; mean age: 24.3 years; age range: 18-40 years) with SN at the thoracolumbar vertebrae were includedin the patient group, and a total of 38 age- and gender-matched individuals (30 males and 8 females; mean age: 25 years)with no evidence of SN were included in the control group. All these individuals were younger than 40 years. In the patientgroup, SNs were assessed in terms of the distribution of the thoracolumbar vertebrae, the location of the upper and lowerendplates, and the total number of lesions. In all individuals included in the study, BMD was measured from the axial CTsections by quantitative CT and then compared between the two groups.Results: The distribution of age and gender was comparable between the two groups (p=0.438). A total of 208 SNs wereidentified in the patient group. Of these, 92 (44%) were located at the thoracic vertebrae and 116 (56%) at the lumbar vertebrae.The mean BMD was 131.6 g/cm3 in the patient group and 140.7 g/cm3 in the control group (p=0.03). There was nosignificant relationship between the total number of SNs per patient and the mean BMD (p=0.156).Conclusion: Evidence from this study revealed that low BMD may be a predisposing factor for the development of SNs inpatients younger than 40 years.

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1. Kyere KA, Than KD, Wang AC, et al. Schmorl’s nodes. Eur Spine J 2012; 21: 2115-21. [Crossref]

2. Hilton RC, Ball J, Benn RT. Vertebral end-plate lesions (Schmorl’s nodes) in the dorsolumbar spine. Ann Rheum Dis 1976; 35: 127-32. [Crossref]

3. Resnick D, Niwayama G. Intravertebral disc herniations: cartilaginous (Schmorl’s) nodes. Radiology 1978; 126: 57-65. [Crossref]

4. BenIliyahu DJ. Schmorl’s nodes, back pain, and mri - clinically significant or insignificant? Dynamic Chiropractic 1996; 14: https://www.dynamicchiropractic.com/mpacms/dc/article. php?id=39515.

5. Schmorl G, Junghanns H. The human spine in health and disease, 2nd ed. New York: Grune and Stratton; 1971.

6. Walters G, Coumas JM, Akins CM, Ragland RL. Magnetic resonance imaging of acute symptomatic Schmorl’s node formation. Pediatr Emerg Care 1991; 7: 294-6. [Crossref]

7. Takahashi K, Miyazaki T, Ohnari H, Takino T, Tomita K. Schmorl’s nodes and low-back pain. Analysis of magnetic resonance imaging findings in symptomatic and asymptomatic individuals. Eur Spine J 1995; 4: 56-9. [Crossref]

8. Seymour R, Williams LA, Rees JI, Lyons K, Lloyd DC. Magnetic resonance imaging of acute intraosseous disc herniation. Clin Radiol 1998; 53: 363-8. [Crossref]

9. Kayan M, Bora A, Üstün ED, Benzin Ş, Kayan F, Gülşen İ. Rutin abdominal ÇDBT incelemelerinde disk ve disk dışı patolojilerin değerlendirilmesi. S.D.Ü. Tıp Fak. Derg 2013; 20: 131-8.

10. Gezer NS, Balcı A, Kalemci O, Köremezli N, Başara Akın I, Ur K. Vertebral body bone mineral density in patients with lumbar spondylolysis: A quantitative CT study. Diagn Interv Radiol. 2017; 23: 385-9. [Crossref]

11. Başaloğlu C. Abdominal anatomi dual enerji X-ray absorbsiyometri ile kemik mineral yoğunluğu ölçümünü etkiler mi? Dokuz Eylül Üniv. Tıp Fak., İzmir; 2014.

12. Bauer JS, Henning TD, Müeller D, Lu Y, Majumdar S, Link TM. Volumetric quantitative CT of the spine and hip derived from contrast-enhanced MDCT: Conversion factors. AJR Am J Roentgenol 2007; 188: 1294-301. [Crossref]

13. Baum T, Müller D, Dobritz M, Rummeny EJ, Link TM, Bauer JS. BMD measurements of the spine derived from sagittal reformations of contrast-enhanced MDCT without dedicated software. Eur J Radiol 2011; 80: 140-5. [Crossref]

14. Mueller DK, Kutscherenko A, Bartel H, Vlassenbroek A, Ourednicek P, Erckenbrecht J. Phantom-less QCT BMD system as screening tool for osteoporosis without additional radiation. Eur J Radiol 2011; 79: 375-81. [Crossref]

15. Schmorl G. Uber Knorpelknotchen an den Wirbelbandscheiben. Fortschr Rontgenstr 1928; 38: 265-79.

16. Dar G, Peleg S, Masharawi Y, Steinberg N, May H, Hershkovitz I. Demographical aspects of Schmorl nodes: A skeletal study. Spine 2009; 34: 312-5. [Crossref]

17. Mok FP, Samartzis D, Karppinen J, Luk KD, Fong DY, Cheung KM. ISSLS prize winner: Prevalence, determinants, and association of Schmorl nodes of the lumbar spine with disc degeneration: A population-based study of 2449 individuals. Spine (Phila Pa 1976) 2010; 35: 1944-52. [Crossref]

18. Williams FM, Manek NJ, Sambrook PN, Spector TD, Macgregor AJ. Schmorl’s nodes: common, highly heritable, and related to lumbar disc disease. Arthritis Rheum 2007; 57: 855-60. [Crossref]

19. Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990- 2010: A systematic analysis for the global burden of disease study 2010. Lancet 2012; 380: 2163-96. [Crossref]

20. Moustarhfir M, Bresson B, Koch P, et al. MR imaging of Schmorl’s nodes: Imaging characteristics and epidemio-clinical relationships. Diagn Interv Imaging 2016; 97: 411-7. [Crossref]

21. Fahey V, Opeskin K, Silberstein M, Anderson R, Briggs C. The pathogenesis of Schmorl’s nodes in relation to acute trauma. An autopsy study. Spine (PhilaPa 1976) 1998; 23: 2272-5. [Crossref]

22. Sward L, Hellstrom M, Jacobsson B, Nyman R, Peterson L. Disc degeneration and associated abnormalities of the spine in elite gymnasts. A magnetic resonance imaging study. Spine (PhilaPa 1976) 1991; 16: 437-43. [Crossref]
Acta Orthopaedica et Traumatologica Turcica-Cover
  • ISSN: 1017-995X
  • Başlangıç: 2015
  • Yayıncı: Türk Ortopedi ve Travmatoloji Derneği
Sayıdaki Diğer Makaleler

The effect of bone mineral density on development of Schmorl’s nodes in young patients

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