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What are Schmorl's Nodes?

D. Jeffress
D. Jeffress

Schmorl's nodes are small protrusions of vertebral disk tissue that bulge through the ends of weakened vertebrae. They can emerge due to direct trauma to the spine, age-related disk degeneration, or an autoimmune condition that weakens vertebral tissue. In most cases, the nodes themselves are painless and unnoticeable to the naked eye. Pain, stiffness, and inflammation can occur around one, however, especially when a person suffers a major back injury. Most people can recover with bed rest and pain-relieving medications if there are no underlying injuries present.

Soft-tissue disks, which are found between each vertebrae, provide shock absorption for the spine. The interior of each disk is made up of gel-like material called nucleus pulposus. Schmorl's nodes are essentially masses of nucleus pulposus that bulge through weakened or damaged vertebrae. The material quickly calcifies once it bulges from a disk, resulting in a hard lump that puts pressure on the spine. In most cases, a node is forced either downward or upward from its disk into an adjoining vertebra.

Schmorl's nodes are small protrusions of vertebral disk tissue that protrude through through the ends of vertebrae, most commonly seen in adults over the age of 50.
Schmorl's nodes are small protrusions of vertebral disk tissue that protrude through through the ends of vertebrae, most commonly seen in adults over the age of 50.

These protrusions are most commonly seen in adults over the age of 50, since spinal disk tissue tends to erode and weaken with age. Osteoporosis, osteoarthritis, and some types of rheumatoid arthritis all increase the risk of disk degeneration. Weakened disks are highly prone to injury, and even a minor fall or a sudden twist can cause herniation. Younger people can also develop nodes if they suffer major spine trauma during a sporting event, car accident, or severe fall.

An illustration of a healthy spine and one with spinal osteoarthritis. If the material in the disks between the vertebrae protrude, it is called  Schmorl's nodes.
An illustration of a healthy spine and one with spinal osteoarthritis. If the material in the disks between the vertebrae protrude, it is called Schmorl's nodes.

A person who has Schmorl's nodes may or may not experience pain. Older people who are used to living with minor back pains and stiffness may not even know that herniation has occurred. The signs are much easier to identify if a major injury occurs. A medical professional can check for signs of nodes and other types of spine damage by asking about symptoms, performing a physical exam, and taking diagnostic imaging scans. When a node exists, X-rays and magnetic resonance imaging tests clearly show calcified nucleus pulposus protruding from a disk.

Patients with osteoporosis have an increased risk of developing Schmorl's nodes.
Patients with osteoporosis have an increased risk of developing Schmorl's nodes.

Treatment decisions depend on the amount of tissue damage and the severity of symptoms. People who do not experience overwhelming pain are usually able to get better by resting for several days and slowly returning to activity. If major damage has occurred to the vertebra and spinal cord, surgery may be necessary to excise a node, repair disk tissue, and realign bones. With months of rest and guided physical therapy, most people are eventually able to return to normal activity levels.

Discussion Comments

anon996459

To anon150981: I don't know when you posted this, but I can tell you how you could have Schmorl's nodes. I just went over results of my most recent MRI and evidently, the Schmorl's node has herniated into the actual bone. I have osteoporosis and recent disc degeneration from having been on steroids for another condition. I hope you don't have osteoporosis but suggest you follow up on this for your own peace of mind and to possibly prevent later issues.

anon331222

My daughter was diagnosed with a schmorl's node and the neurosurgeon told her she could never play ball or even run again. Can you tell us where we may can go for another opinion? We live in Texas, but will go anywhere Please help.

LauraAuld

I was wondering if anyone knows if my MRI shows anything?

I had an MRI done in December 2011 and I have the report here. This is what it says:

Final report

Exam: MRI lumbar spine without contrast

Clinical information: Low back pain. Left leg pain. Not responding to conservative treatment.

Findings:

Alignment of the lumbar spine is maintained. Vertebral body heights are maintained. Minimal to negligible schmorl's nodes are noted along the superior endplate of L2 on L3. There is a normal pattern of the bone marrow signal of the lumbar spine. The prevertebral and paraspinal soft tissues are unremarkable. The conus is unremarkable and terminates at the L1 level.

Negligible disc bulges at L4-L5 and L5-S1 are probably within normal variation for age. There is no significant disc bulge or disc herniation. There is no significant spinal canal or neural foramina stenosis.

Minimal to mild facet neuropathy is present at L4-L5 and L5-S1. There is a small 4mm synovial cyst extending into the paraspinal region at the L5-S1 level.

Impression: there is no significant spinal canal or neural foramina stenosis. Minimal to mild facet neuropathy at L4-L5 and L5-S1. This is most notable at the left L5-S1 facet joint.

I was curious on what this shows? And I saw "small 4mm cyst on L5-S1." Is this something to worry about and could that cause pain in my lower back?

anon150981

I have multiple spinal fusions in the area of T6-7, 8-9, 10-11 from several years ago. I had a car accident a few months ago and have experienced severe pain in this area. I just had an MRI and discovered that I have Schmorl's nodes in the area of T 6-7 through T10-11.

How can I have Schmorl's nodes when I've had disc fusions (with bone) in those areas?

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    • Schmorl's nodes are small protrusions of vertebral disk tissue that protrude through through the ends of vertebrae, most commonly seen in adults over the age of 50.
      By: Monkey Business
      Schmorl's nodes are small protrusions of vertebral disk tissue that protrude through through the ends of vertebrae, most commonly seen in adults over the age of 50.
    • An illustration of a healthy spine and one with spinal osteoarthritis. If the material in the disks between the vertebrae protrude, it is called  Schmorl's nodes.
      By: peterjunaidy
      An illustration of a healthy spine and one with spinal osteoarthritis. If the material in the disks between the vertebrae protrude, it is called Schmorl's nodes.
    • Patients with osteoporosis have an increased risk of developing Schmorl's nodes.
      By: peterjunaidy
      Patients with osteoporosis have an increased risk of developing Schmorl's nodes.
    • With several months of closely guided physical therapy, most people with Schmorl's nodes are eventually able to return to their previous activity levels.
      By: CandyBox Images
      With several months of closely guided physical therapy, most people with Schmorl's nodes are eventually able to return to their previous activity levels.
    • Schmorl's nodes may develop as a result of spinal injury from a car accident.
      By: Tom Wang
      Schmorl's nodes may develop as a result of spinal injury from a car accident.
    • Treatment for Schmorl's nodes may include bed rest.
      By: Dmitriy Melnikov
      Treatment for Schmorl's nodes may include bed rest.