Schmorl's Node

Schmorl's nodes occur when the cartilage of the intervertebral disc protrude through the vertebral body endplate into the adjacent vertebra. These protrusions may contact the bone marrow of the vertebra and lead to inflammation. These protrusions may also be responsible for necrosis ( condition of death) of the vertebral bone. They may or may not be symptomatic, and it is questionable whether or not it will cause back pain.




The T-2 weighted image on the left shows a Schmorl's node in the lumbar region and has protruded into the vertebral body of L-3. Although Schmorl's node can be seen radiographically, the modality of choice would be either MRI or a CT scan for a much better and more diagnostic image.

It is believed that Schmorl's nodes develop after some type of back trauma, but the fact is that Schmorl's nodes are not well understood.

Thoracic Fracture

The spine is made up of bones called vertebrae. Vertebrae can break just like any other bone in the body. If a person takes a very hard fall or suffers from osteoporosis these vertebrae can collapse resulting in a compression fracture which occurs most commonly in the thoracic region of the spine.

Symptoms of a compression fracture are back pain, as well as leg pain. If enough compression fractures occur your spine may give the appearance of a hunchback. If the pain is severe and the compression fracture is problematic, vertebroplasty can be done. The height of the vertebrae can be restored by injecting cement into the vertebral body to expand and or prevent further collapse of the vertebra.

This image on the left is an example of vertebroplasty. The dark area in the middle of the vertebral body is the cement used to fill and expand the collapsed vertebra. It is injected under fluoroscopy and viewed in near real time so the Dr can see what and where they are to complete the procedure.

The CT image on the left hear shows a clear break in the vertebrae indicated by the yellow arrow, and a mild compression shown by the red arrow.

C- Spine Disc Herniation

Spinal disc herniation is often mistakenly called a slipped disc, it is a medical condition in which the fibrous ring, the outer layer of the disc tears and allows the soft central portion (nucleus pulposus) to bulge out. This tear in the disc ring can result in inflammatory chemical mediators being released causing severe pain even when nerve roots are not involved.

The image to the left of a c spine taken during an autopsy shows the nucleus pulposus extruding through the ruptured annulus, and compressing the spinal cord at C5-C6.

Disc herniations can occur simply from normal wear and tear during our lives especially with jobs that require a lot of lifting. Trauma injuries from falling, blunt force, or motor vehicle accidents. Simply from sitting or bending to lift, the internal pressure of the disc can go from 17 psi to 300 psi while lifting. The disc can be under a tremendous amount of pressure without getting into a strain. While these discs are quite tough, they have there limits and when reached can cause us great pain, so proper lifting techniques are important.

Disc herniation usually occurs from the front side being compressed while bending forward or just bad posture, which will cause the back side of the disc to bulge and eventually tear.