Table 1. A Summary Table of the Published Studies Related to Acute Schmorl's Nodes (SN).
| Author (year) | No. | Age (years) | Gender | Pathology | Back Pain History | Mechanism | Presentation | Diagnosis | Laboratory Exams | Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Lipson et al15 (1985) | 1 | 49 | M | Painful C5 SN | − | − | Progressive right neck pain | Tomography: lucency surrounded by sclerosis Discometrics: reproduced the pain |
Normal | ACDF | Gradual reduction of pain in three months |
| McCall et al27 (1985) | 8 | 16.4 (12–22) | 6M, 2F | L1-L2: 4 T12-L1: 2 L2-L3: 1 L4-L5: 1 |
Paralyric scoliosis (1), Scheurmann's kyphosis (3), spondylo-lysis (2) | Acute vertical compression (blast explosion, motor vehicle accident, rugby injuries, falls) | Acute progressive back-pain, limited radiation to the thigh | Radiographs: end-plate fracture Discography: reproduced pain |
− | Conservative | − |
| Kornberg20 (1988) | 1 | 27 | M | L4 | − | Forced lumbar flexion | Acute lumbar pain | MRI: intraosseousdisc heriation | Normal | − | − |
| Walters et al17 (1991) | 1 | 14 | F | L4 | − | Competitive exercise | Acute low back-pain | MRI: inflammation and edema around the SN | − | Conservative | Improvement over four months, return to sports |
| Takahashi and Takata33 (1994) | 5 | 14–81 | 2M, 3F | Lumbar | − | − | Low back pain | MRI: T1 low intensity, T2 high intensity | − | 3 conservative, 2 ALIF | Improvement over three to four months |
| Tosi et al19 (1996) | 1 | 16 | F | T12 and L1 SN leading to fibrocartilage-nous embolism | Good health | Hand-standing | Acute back-pain, progressive paraplegia, complete sensory loss under T12 | MRI: intraosseous disc herniation | Normal | Conservative | Complete paraplegia |
| Leibner and Floman26 (1998) | 1 | 19 | M | L4 SN | Fall from height before 6 years of age | Motor vehicle accident | Acute low back pain | CT: osteolytic lesion with sclerotic margins and tunneling of the L4 vertebral body | − | − | − |
| Seymour et al18 (1998) | 8 | 49 (13-63) | 3M, 5F | SN at: T6 (1) T9 (1) T10 (3) T11 (3) L1 (1) L2 (3) L3 (1) |
− | Injury related in 2/8 | Acute or exacerbation of chronic back pain | MRI: intraosseous disc herniation with perinodal edema | No infection or malignancy | Conservative | Significant reduction of edema in 7–10 months, complete edema resolution and fatty degeneration in 18 months |
| Grive et al21 (1999) | 2 | 68 and 38 | 1M, 1F | T11, L3 | L5-S1 spondylolisthesis, plasmacy-toma | Dorsolubar flexion injury, physical exercise | Acute back pain without sciatica | CT: radiolucent rim around a sclerotic area MRI: low signal in T1 and high signal in T2 surrounded by edema and inflamation |
Normal | Conservative | Gradual pain reduction by the second month |
| Khashaba31 (2000) | 1 | 14 | F | L4 | − | Motor vehicle accident | Acute abdominal pain and lower spinal pain, painful flexion | CT: irregular lucent are in the VB MRI: end-plate defect and intraosseous disc herniation |
− | − | − |
| Leone et al29 (2000) | 1 | 76 | F | T12-L3 | Pre-B acute lympobla-stic leukemia | − | Chronic back pain | MRI | Lymphobla-stic leukemia | Conservative | Death due to primary disorder |
| Wagner et al32 (2000) | 14 | 30 (19-45) | 12M, 2F | Thoraco-lumbar region | − | 9 motor vehicle accidents, 5 ski jumping | Acute low back pain without radiculopathy | MRI: end plate defects and marrow edema | − | Conservative | Improvement |
| Hasegawa et al10 (2004) | 1 | 55 | F | L3 | Recurrent low back pain | No obvious injury | Acute exacerbation low back pain | Discography demonstrated the leakage into the VB, MRI | − | L2-L3 interbody fusion | Improvement |
| Masala et al14 (2006) | 23 | 72.5 (61–84) | 7M, 16F | Chronic painful spinal SN | − | − | Back pain for 6 months | CT, MRI | − | Percutaneous vertebroplasty | 18 improved, 3 did not worsen |
| Crawford and Van der Wall28 (2007) | 1 | 57 | F | SN at L4 | Scheurmann's disease | Gardening plus minor trauma | Acute back pain | Bone scintigraphy: increased uptake MRI: bone marrow edema |
Normal | Conservative | Substantial edema resolution after 18 months |
| Park et al24 (2007) | 1 | 52 | F | SN at T8 | Mid thoracic back pain radiating to right scapula | Fall | Acute exacerbation of the back pain | MRI: Contrast enhancing lesion marrow edema | − | Conservative | Reduction of the edema but persistence of the enhancement at 5 and 9 months; no enhancement by the 26th month; clinical improvement |
| Fucuta et al12 (2009) | 1 | 19 | M | SN at T11, T12 | Back pain for over two years | Soccer player, no obvious injury | Chronic progressive pain | MRI, discography reproduced the pain | − | Anterior interbody fusion | Return to play |
| Pilet et al22 (2009) | 1 | 36 | M | SN at L3 and L4 | Long history of back pain, mini-discectomy at L5-S1 before 17 years of age | Discography-induced SN | Acute back pain, different from the pre-existing one | MRI: subchondral bone marrow edema, no enhancement | Normal CRP, high ESR | Conservative | Schmorl node by the 7th week; persistence of findings by the 5th month |
| Wegner and Markwalder11 (2009) | 1 | 31 | M | L4 SN | Healthy | No obvious injury | Progressive lumbalgia | MRI: marked rim of bone edema at the VB | − | Orthosis followed by fluoronavigation-assisted vertebroplasty | Improvement |
| Jang et al23 (2010) | 1 | 82 | M | L4 SN | − | No obvious injury | Acute back pain | MRI: SN with adjacent marrow edema | Normal | Rami communicantes nerve block | Improvement |
| Mittal et al25 2010) | 1 | 10 | M | Acute painful SN at T12 and L1 | Acute calcific discitis | Yoga session | − | MRI: SN with adjacent marrow edema and calcification | − | Conservative | Improvement |
| Paterakis et al (2011) | 1 | 16 | M | L5 | No past medical problems | Monofin swimming | Acute back pain | MRI: SN with adjacent marrow edema | Normal | Conservative | Improvement |
M, male; F, female; CT, computerized tomography; MRI, magnetic resonance imaging; VB, vertebral body.