Infected Schmorl's node: a case report

BMC Musculoskelet Disord. 2020 May 2;21(1):280. doi: 10.1186/s12891-020-03276-4.

Abstract

Background: Schmorls node (SN) are mostly asymptomatic and incidental findings on MRI. However, sometimes they present like acute onset low back pain or acute exacerbation of chronic back pain after minor trauma.

Case presentation: We present rare case of symptomatic infected SN in 67 years female patient presented with complains of low back pain radiating to right buttock. After initial conservative treatment failed subsequent imaging showed significant increase in size of lesion with focal signal changes in disc space gave suspicion of underlying secondary pathology. Patient operated for complete excision of lesion. Histopathological report was suggestive of pyogenic vertebral osteomyelitis. Patient improved well postoperatively.

Conclusion: Most of the time acute SN responds well to conservative treatment; however rapid deterioration of symptoms or persistent severe pain should give suspicion of underlying secondary pathology.

Keywords: Infected; MRI; Schmorl’s node; Symptomatic.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravenous
  • Aftercare
  • Aged
  • Aminoglycosides / administration & dosage
  • Aminoglycosides / therapeutic use
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Cephalosporins / administration & dosage
  • Cephalosporins / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Humans
  • Intervertebral Disc Degeneration / diagnostic imaging
  • Intervertebral Disc Degeneration / pathology*
  • Intervertebral Disc Degeneration / surgery
  • Intervertebral Disc Displacement / diagnostic imaging
  • Intervertebral Disc Displacement / pathology*
  • Intervertebral Disc Displacement / surgery
  • Low Back Pain / diagnosis
  • Low Back Pain / etiology*
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery
  • Magnetic Resonance Imaging / methods*
  • Osteomyelitis / diagnosis*
  • Osteomyelitis / drug therapy
  • Treatment Outcome

Substances

  • Aminoglycosides
  • Anti-Bacterial Agents
  • Cephalosporins

Supplementary concepts

  • Intervertebral disc disease