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Published in: CardioVascular and Interventional Radiology 1/2006

01-02-2006 | CLINICAL INVESTIGATION

Percutaneous Vertebroplasty in Painful Schmorl Nodes

Authors: Salvatore Masala, Vincenzo Pipitone, Marco Tomassini, Francesco Massari, Andrea Romagnoli, Giovanni Simonetti

Published in: CardioVascular and Interventional Radiology | Issue 1/2006

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Abstract

The Schmorl node represents displacement of intervertebral disc tissue into the vertebral body. Both Schmorl nodes and degenerative disc disease are common in the human spine. We performed a retrospective study, for the period from January 2003 to February 2005, evaluating 23 patients affected by painful Schmorl nodes, who underwent in our department percutaneous transpedicular injection of polymethylmethacrylate (vertebroplasty) in order to solve their back pain not responsive to medical and physical management. Eighteen patients reported improvement of the back pain and no one reported a worsening of symptoms. Improvement was swift and persistent in reducing symptoms. Painful Schmorl nodes, refractory to medical or physical therapy, should be considered as a new indication within those vertebral lesions adequately treatable utilizing Vertebroplasty procedure.
Literature
1.
go back to reference Lee P, Helewa A, Goldsmith CH, et al. (2001) Low back pain: prevalence and risk factors in an industrial setting. J Rheumatol 28(2):346–351PubMed Lee P, Helewa A, Goldsmith CH, et al. (2001) Low back pain: prevalence and risk factors in an industrial setting. J Rheumatol 28(2):346–351PubMed
2.
go back to reference Roland MO, Morrell DC, Morris RW (1983) Can general practitioners predict the outcome of episodes of back pain? Br Med J (Clin Res Ed) 286(6364):523–525 CrossRef Roland MO, Morrell DC, Morris RW (1983) Can general practitioners predict the outcome of episodes of back pain? Br Med J (Clin Res Ed) 286(6364):523–525 CrossRef
3.
go back to reference Lee P (1994) The economic impact of musculoskeletal disorders. Qual Life Res 3(suppl 1):S85–S91 PubMed Lee P (1994) The economic impact of musculoskeletal disorders. Qual Life Res 3(suppl 1):S85–S91 PubMed
4.
go back to reference Kawakami M, Tamaki T, Hayashi N, et al. (1998) Possible mechanism of painful radiculopathy in lumbar disc herniation. Clin Orthop Relat Res 351:241–251 PubMed Kawakami M, Tamaki T, Hayashi N, et al. (1998) Possible mechanism of painful radiculopathy in lumbar disc herniation. Clin Orthop Relat Res 351:241–251 PubMed
5.
go back to reference Long DM, Filtzer DL, BenDebba M, et al. (1988) Clinical features of the failed-back syndrome. J Neurosurg 69(1):61–71PubMed Long DM, Filtzer DL, BenDebba M, et al. (1988) Clinical features of the failed-back syndrome. J Neurosurg 69(1):61–71PubMed
6.
go back to reference Stilwell DL Jr (1956) The nerve supply of the vertebral column and its associated structures in the monkey. Anat Rec 125(2):139–169 CrossRefPubMed Stilwell DL Jr (1956) The nerve supply of the vertebral column and its associated structures in the monkey. Anat Rec 125(2):139–169 CrossRefPubMed
7.
go back to reference Gangi A, Wong LLS, Guth S, et al. (2002) Percutaneous vertebroplasty: indications, technique, and results. Semin Intervent Radiol 19: 265–270 Gangi A, Wong LLS, Guth S, et al. (2002) Percutaneous vertebroplasty: indications, technique, and results. Semin Intervent Radiol 19: 265–270
8.
go back to reference Riggs BL, Melton LJ 3rd (1995) The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 17(5 suppl):505S–511S PubMed Riggs BL, Melton LJ 3rd (1995) The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 17(5 suppl):505S–511S PubMed
9.
go back to reference Gangi A, Kastler BA, Dietemann JL (1994) Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. Am J Neuroradiol 15(1):83–86 PubMed Gangi A, Kastler BA, Dietemann JL (1994) Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. Am J Neuroradiol 15(1):83–86 PubMed
10.
go back to reference Jensen ME, Evans AJ, Mathis JM, et al. (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. Am J Neuroradiol 18(10):1897–1904 PubMed Jensen ME, Evans AJ, Mathis JM, et al. (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. Am J Neuroradiol 18(10):1897–1904 PubMed
11.
go back to reference Takahashi K, Takata K (1994) A large painful Schmorl’s node: a case report. J Spinal Disord 7(1):77–81PubMedCrossRef Takahashi K, Takata K (1994) A large painful Schmorl’s node: a case report. J Spinal Disord 7(1):77–81PubMedCrossRef
12.
go back to reference Walters G, Coumas JM, Akins CM, et al. (1991) Magnetic resonance imaging of acute symptomatic Schmorl’s node formation. Pediatr Emerg Care 7(5):294–296 PubMed Walters G, Coumas JM, Akins CM, et al. (1991) Magnetic resonance imaging of acute symptomatic Schmorl’s node formation. Pediatr Emerg Care 7(5):294–296 PubMed
13.
go back to reference Galibert P, Deramond H, Rosat P, et al. (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 33:166–168PubMed Galibert P, Deramond H, Rosat P, et al. (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 33:166–168PubMed
14.
go back to reference Masala S, Lunardi P, Fiori R, et al. (2004) Vertebroplasty and kyphoplasty in the treatment of malignant vertebral fractures. J Chemother 16(suppl 5):30–33 PubMed Masala S, Lunardi P, Fiori R, et al. (2004) Vertebroplasty and kyphoplasty in the treatment of malignant vertebral fractures. J Chemother 16(suppl 5):30–33 PubMed
15.
go back to reference Stallmeyer MJ, Zoarski GH, Obuchowski AM (2003) Optimizing patient selection in percutaneous vertebroplasty. J Vasc Intervent Radiol 14:683–696 Stallmeyer MJ, Zoarski GH, Obuchowski AM (2003) Optimizing patient selection in percutaneous vertebroplasty. J Vasc Intervent Radiol 14:683–696
16.
go back to reference Hamanishi C, Kawabata T, Yosii T, et al. (1994) Schmorl’s nodes on magnetic resonance imaging. Their incidence and clinical relevance. Spine 19(4):450–453PubMed Hamanishi C, Kawabata T, Yosii T, et al. (1994) Schmorl’s nodes on magnetic resonance imaging. Their incidence and clinical relevance. Spine 19(4):450–453PubMed
17.
go back to reference Uetani M, Hashmi R, Hayashi K (2004) Malignant and benign compression fractures: differentiation and diagnostic pitfalls on MRI. Clin Radiol 59(2):124–131CrossRefPubMed Uetani M, Hashmi R, Hayashi K (2004) Malignant and benign compression fractures: differentiation and diagnostic pitfalls on MRI. Clin Radiol 59(2):124–131CrossRefPubMed
18.
go back to reference Tan DY, Tsou IY, Chee TS (2002) Differentiation of malignant vertebral collapse from osteoporotic and other benign causes using magnetic resonance imaging. Ann Acad Med Singapore 31(1):8–14 PubMed Tan DY, Tsou IY, Chee TS (2002) Differentiation of malignant vertebral collapse from osteoporotic and other benign causes using magnetic resonance imaging. Ann Acad Med Singapore 31(1):8–14 PubMed
19.
go back to reference Amar AP, Larsen DW, Esnaashari N, et al. (2001) Percutaneous transpedicular polymethylmethacrylate vertebroplasty for the treatment of spinal compression fractures. Neurosurgery 49:1105–1114PubMed Amar AP, Larsen DW, Esnaashari N, et al. (2001) Percutaneous transpedicular polymethylmethacrylate vertebroplasty for the treatment of spinal compression fractures. Neurosurgery 49:1105–1114PubMed
20.
go back to reference Masala S, Fiori R, Massari F, et al. (2004) Percutaneous kyphoplasty: indications and technique in the treatment of vertebral fractures from myeloma. Tumori 90(1):22–26 PubMed Masala S, Fiori R, Massari F, et al. (2004) Percutaneous kyphoplasty: indications and technique in the treatment of vertebral fractures from myeloma. Tumori 90(1):22–26 PubMed
21.
go back to reference Jensen ME, Kallmes DE (2002) Percutaneous vertebroplasty in the treatment of malignant spine disease. Cancer J 8:194–206PubMedCrossRef Jensen ME, Kallmes DE (2002) Percutaneous vertebroplasty in the treatment of malignant spine disease. Cancer J 8:194–206PubMedCrossRef
22.
go back to reference Masala S, Roselli M, Massari F, et al. (2004) Radiofrequency heat ablation and vertebroplasty in the treatment of neoplastic vertebral body fractures. Anticancer Res 24(5B):3129–3133PubMed Masala S, Roselli M, Massari F, et al. (2004) Radiofrequency heat ablation and vertebroplasty in the treatment of neoplastic vertebral body fractures. Anticancer Res 24(5B):3129–3133PubMed
23.
go back to reference McGraw JK, Strnad BT, Patzik SB, et al. (2000) Carbon dioxide and gadopentetate dimeglumine venography to guide percutaneous vertebroplasty. Cardiovasc Intervent Radiol 23(6):485–487CrossRefPubMed McGraw JK, Strnad BT, Patzik SB, et al. (2000) Carbon dioxide and gadopentetate dimeglumine venography to guide percutaneous vertebroplasty. Cardiovasc Intervent Radiol 23(6):485–487CrossRefPubMed
24.
go back to reference Masala S, Cesaroni A, Sergiacomi G, et al. (2004) Percutaneous kyphoplasty: new treatment for painful vertebral body fractures. In Vivo 18(2):149–153PubMed Masala S, Cesaroni A, Sergiacomi G, et al. (2004) Percutaneous kyphoplasty: new treatment for painful vertebral body fractures. In Vivo 18(2):149–153PubMed
26.
go back to reference Fordyce WE (1995) What is pain? In: Fordyce WE (ed) Back Pain in the Workplace: Management of Disability in Nonspecific Conditions. IASP Press. Seattle, pp 11–17 Fordyce WE (1995) What is pain? In: Fordyce WE (ed) Back Pain in the Workplace: Management of Disability in Nonspecific Conditions. IASP Press. Seattle, pp 11–17
27.
go back to reference Bogduk N (1988) Acute back pain: what is the lesion? Proceedings of a symposium on Acute Back Pain, 2nd European Congress on back pain. Montreux, pp 6–16 Bogduk N (1988) Acute back pain: what is the lesion? Proceedings of a symposium on Acute Back Pain, 2nd European Congress on back pain. Montreux, pp 6–16
28.
go back to reference Frymoyer JW, Moskowitz RW (1991) Spinal degeneration. Pathogenesis and medical management. In: Frymoyer JW, ed. The Adult Spine: Principle and Practice. New York: Raven Press. pp 611–636 Frymoyer JW, Moskowitz RW (1991) Spinal degeneration. Pathogenesis and medical management. In: Frymoyer JW, ed. The Adult Spine: Principle and Practice. New York: Raven Press. pp 611–636
29.
go back to reference Takahashi K, Miyazaki T, Ohnari H, et al. (1995) Schmorl’s nodes and low-back pain. Analysis of magnetic resonance imaging findings in symptomatic and asymptomatic individuals. Eur Spine J 4(1):56–59 CrossRefPubMed Takahashi K, Miyazaki T, Ohnari H, et al. (1995) Schmorl’s nodes and low-back pain. Analysis of magnetic resonance imaging findings in symptomatic and asymptomatic individuals. Eur Spine J 4(1):56–59 CrossRefPubMed
30.
go back to reference Hasegawa K, Ogose A, Morita T, et al. (2004) Painful Schmorl’s node treated by lumbar interbody fusion. Spinal Cord 42(2):124–128CrossRefPubMed Hasegawa K, Ogose A, Morita T, et al. (2004) Painful Schmorl’s node treated by lumbar interbody fusion. Spinal Cord 42(2):124–128CrossRefPubMed
Metadata
Title
Percutaneous Vertebroplasty in Painful Schmorl Nodes
Authors
Salvatore Masala
Vincenzo Pipitone
Marco Tomassini
Francesco Massari
Andrea Romagnoli
Giovanni Simonetti
Publication date
01-02-2006
Publisher
Springer-Verlag
Published in
CardioVascular and Interventional Radiology / Issue 1/2006
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-005-0153-6

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