Schmorl’s nodes are associated with prevalent osteoporotic vertebral fracture and low bone mineral density: a population-based thoracic spine MRI study in older men and women

Quantitative Imaging in Medicine and Surgery

article

Yì Xiáng J. Wáng¹  Xiao-Rong Wang¹  Jason C. S. Leung³  Blanche W. M. Yu³  James F. Griffith¹  Timothy C. Y. Kwok³ 

[1] Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong;Department of Radiology , Ningbo First Hospital;JC Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong;Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong

关键词: Schmorl’s node (SN);    osteoporosis;    vertebral fracture;    magnetic resonance imaging (MRI);    thoracic spine;   

DOI  :  10.21037/qims-22-1410

学科分类：外科医学

来源: AME Publications

【 摘 要 】

Background: Schmorl’s node (SN) corresponds to nucleus pulposus herniation into the vertebral spongy bone with thickened trabeculae around the formed node. We hypothesize that a pathway may exist that: osteoporosis → weakened endplate → SN development ↔ endplate fracture of an osteoporotic vertebra. Methods: For osteoporotic fractures in men (MrOS) and in women (MsOS) Hong Kong studies, at 14-year follow-up, thoracic spine magnetic resonance imaging (MRI) was sampled in 270 males (mean: 82.9±3.7 years) and 150 females (mean: 81.5±4.3 years). SN and Modic change were assessed as existed or not existed. For posterior disc protrusion, ligamentum flavum ossification, and spinal canal stenosis, semi-quantitative gradings were applied. For each vertebra in women, a score of 0, 0.5, 1, 1.5, 2, 2.5, 3 was assigned for no osteoporotic vertebral fracture (OVF) or OVF of <1/5, ≥1/5–1/4, ≥1/4–1/3, ≥1/3–2/5, ≥2/5–2/3, and ≥2/3 vertebral height loss, respectively, and a summed score was calculated by summing up the scores of vertebrae T1 to T12. For men, those of minimal grade were not considered as OVF and assigned a ‘0’ score. Results: SN prevalence in women (55.5%) almost doubled that in men (25.9%). SN was statistically significantly correlated with lower bone mineral density (BMD) derived femoral neck T-score, while the other four spine degeneration changes were not statistically significantly correlated with the T-score. SN were statistically significantly correlated with OVF score. Subjects with SN were more likely to have OVF, with odds ratio for men of 4.32 [95% confidence interval (CI): 1.70–11.00, P=0.002] and odds ratio for women of 3.28 (95% CI: 1.23–8.74, P=0.018). Conclusions: Among older population, many features of SN parallel those of OVF.

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