Can an Incidental Schmorl’s Node Be a Cause for Low Backache? – Enigma Resolved By a First Ever Prospective Case Control Study in A South Indian Town Population
Journal Title: Journal of Medical Science And clinical Research - Year 2016, Vol 4, Issue 10
Abstract
INTRODUCTION: Schmorl’s nodes are intraosseous cartilaginous nodes representing vertical disk prolapses through areas of weakness in the vertebral endplates. Whether or not they are responsible for low backache has always been an enigma posing difficulties in giving specific treatment for the same. To our knowledge, this is the first ever prospective case control study in a south Indian town population demonstrating low backache because of Schmorl’s nodes. AIM: This study is aimed to assess the role of Schmorl’s nodes as a cause of low backache in a south Indian town population. MATERIALS AND METHODS: Hospital based Prospective Case Control Study among patients with low back ache with no known cause identified, attending the radiology department of a south Indian town hospital was done in 1.5 T MRI.Age and sex matched controls of same number without low backache were selected and studied after informed written consent. RESULTS: Of the total 568 patients presenting with low backache, 336 patients had known cause for low backache at the time of MRI. 232 patients were subjected MRI LS spine. The cause of low backache was identified in MRI spine study for 141 patients with diagnosis other than Schmorl’s nodes. Of the remaining 81 subjects, 68 had Schmorl’s nodes and no other significant pathology as a cause for their symptom and the rest 13 had normal MRI LS spine. Age and sex matched asymptomatic controls showed Schmorl’s nodes without surrounding edema in 6 individuals. The occurrence of schmorl’s node was very high in cases (84%) than in controls (7.4%). The chi-square test of association 2 = 1.239, P = 0.266 was insignificant. It was hence inferred that Schmorl’s nodes does cause low backache. CONCLUSION: Schmorl’s node does cause low backache! The knowledge of this will help clinicians do timely intervention and treat the same
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Saraswathi S
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