The Spectrum of Traumatic Schmorl's Nodes: Identification and Treatment Options in 3 Patients

Schmorl’s nodes may present as a simple endplate intravertebral herniation following trauma or as a large cystic lesion of the vertebral body.

In this article, we report on 3 patients with severe back pain following trauma resulting in traumatic Schmorl’s nodes and pathologic fracture of the vertebral body. All 3 cases had antecedent trauma. Radiographs showed a cystic lesion in the vertebral body with continuity into the disc space. T2-weighted magnetic resonance imaging showed herniation of the intervertebral disc into the vertebral body through the endplate with surrounding bony edema, indicative of fracture. In 2 cases, the integrity of the vertebral body was severely compromised, requiring vertebrectomy and fusion.

The wide spectrum of presentation and treatment options of traumatic Schmorl’s nodes are presented, ranging from symptoms that are responsive to treatment to pathologic fracture of the vertebral body leading to significant collapse and the need for major surgical stabilization.