Relevance between Schmorl's Node and Lumbar Intervertebral Disc Degeneration Quantified with Magnetic Resonance Imaging T2 Mapping in Chronic Low Back Pain.

ABSTRACT

STUDY DESIGN: Cross-sectional study. PURPOSE: The purpose of this study was to elucidate the relevance among Schmorl's node (SN), chronic low back pain (CLBP), and intervertebral disc degeneration (IVDD) with the use of magnetic resonance imaging T2 mapping. OVERVIEW OF LITERATURE SN may be combined with CLBP and/or IVDD; however, their relationship has not been determined to date. METHODS: A total of 105 subjects were included (48 men and 57 women; mean age, 63.2±2.7 years; range, 22-84 years). We analyzed five functional spinal unit levels (L1-S1) and evaluated the T2 values of the anterior annulus fibrosus (AF), nucleus pulposus, and posterior AF. We compared the low back pain (LBP) Visual Analog Scale (VAS) scores and the T2 values in each decade with or without SN. RESULTS: There were no remarkable differences in SN prevalence rate regarding age decade or gender. SNs were more prevalent in the upper 2 levels (70.3%). LBP VAS scores with and without SN were 64.7±4.3 mm and 61.9±2.8 mm, respectively, with no significant differences between the groups (p=0.62). The T2 values of anterior AF with SN were significantly lower than those without SN in patients in their 50s, 60s, 70s, and 80s (p<0.01). CONCLUSIONS: SN presence is not itself a risk factor for CLBP; however, it indicates IVDD of the anterior AF in subjects with SN who are ≥50 years old.