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Percutaneous Vertebroplasty in a Patient with Chronic Back Pain Caused by Multiple Schmorl’s Nodes: A Case Report

Background and Objectives: Schmorl’s nodes (SNs), formed by the herniation of intervertebral discs into adjacent vertebral bodies, are generally asymptomatic and do not require treatment. However, certain types of SNs can cause intractable back pain. Case Presentation: A 63-year-old man presented to...

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Autores principales: Park, Hyung-Joon, Jo, Hyun-Ji, Lee, Jaeeun, Choi, Sang-Sik, Lee, Chung-Hun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10608530/
https://www.ncbi.nlm.nih.gov/pubmed/37893557
http://dx.doi.org/10.3390/medicina59101839
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author Park, Hyung-Joon
Jo, Hyun-Ji
Lee, Jaeeun
Choi, Sang-Sik
Lee, Chung-Hun
author_facet Park, Hyung-Joon
Jo, Hyun-Ji
Lee, Jaeeun
Choi, Sang-Sik
Lee, Chung-Hun
author_sort Park, Hyung-Joon
collection PubMed
description Background and Objectives: Schmorl’s nodes (SNs), formed by the herniation of intervertebral discs into adjacent vertebral bodies, are generally asymptomatic and do not require treatment. However, certain types of SNs can cause intractable back pain. Case Presentation: A 63-year-old man presented to our hospital with back pain after a fall 1 month prior. Physical examination revealed back pain that worsened with movement and paraspinal tenderness. Magnetic resonance imaging (MRI) performed immediately after presentation revealed subacute to chronic compression fractures with SNs at the upper endplates of the 11th and 12th thoracic and 1st lumbar vertebrae. Pain (numeric rating scale (NRS), 7–8/10) persisted despite 6 months of conservative treatment and MRI revealed increased signal intensity in T2-weighted images in the regions around the SNs. Based on these findings, an epidural nerve block was performed, and then repeated; however, no significant improvement was observed. Percutaneous vertebroplasty (PVP) was performed at the 11th and 12th thoracic and 1st lumbar vertebrae. Pain levels decreased substantially 1 week after PVP (NRS, 3–4/10). Subsequent treatment with non-steroidal anti-inflammatory drugs (NSAIDs) and steroids for two weeks further reduced pain levels (NRS, 1–2/10), following which steroid use was discontinued and NSAID use became intermittent. At the six-month follow-up, pain levels remained low and the patient reported an improvement in activity levels of 90% or more. Conclusions: This case report demonstrates that PVP safely and effectively improved symptoms in a patient with multiple SNs and intractable back pain. Nevertheless, further research, particularly large-scale randomized prospective studies, is necessary to validate the long-term efficacy and safety of this intervention.
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spelling pubmed-106085302023-10-28 Percutaneous Vertebroplasty in a Patient with Chronic Back Pain Caused by Multiple Schmorl’s Nodes: A Case Report Park, Hyung-Joon Jo, Hyun-Ji Lee, Jaeeun Choi, Sang-Sik Lee, Chung-Hun Medicina (Kaunas) Case Report Background and Objectives: Schmorl’s nodes (SNs), formed by the herniation of intervertebral discs into adjacent vertebral bodies, are generally asymptomatic and do not require treatment. However, certain types of SNs can cause intractable back pain. Case Presentation: A 63-year-old man presented to our hospital with back pain after a fall 1 month prior. Physical examination revealed back pain that worsened with movement and paraspinal tenderness. Magnetic resonance imaging (MRI) performed immediately after presentation revealed subacute to chronic compression fractures with SNs at the upper endplates of the 11th and 12th thoracic and 1st lumbar vertebrae. Pain (numeric rating scale (NRS), 7–8/10) persisted despite 6 months of conservative treatment and MRI revealed increased signal intensity in T2-weighted images in the regions around the SNs. Based on these findings, an epidural nerve block was performed, and then repeated; however, no significant improvement was observed. Percutaneous vertebroplasty (PVP) was performed at the 11th and 12th thoracic and 1st lumbar vertebrae. Pain levels decreased substantially 1 week after PVP (NRS, 3–4/10). Subsequent treatment with non-steroidal anti-inflammatory drugs (NSAIDs) and steroids for two weeks further reduced pain levels (NRS, 1–2/10), following which steroid use was discontinued and NSAID use became intermittent. At the six-month follow-up, pain levels remained low and the patient reported an improvement in activity levels of 90% or more. Conclusions: This case report demonstrates that PVP safely and effectively improved symptoms in a patient with multiple SNs and intractable back pain. Nevertheless, further research, particularly large-scale randomized prospective studies, is necessary to validate the long-term efficacy and safety of this intervention. MDPI 2023-10-16 /pmc/articles/PMC10608530/ /pubmed/37893557 http://dx.doi.org/10.3390/medicina59101839 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Park, Hyung-Joon
Jo, Hyun-Ji
Lee, Jaeeun
Choi, Sang-Sik
Lee, Chung-Hun
Percutaneous Vertebroplasty in a Patient with Chronic Back Pain Caused by Multiple Schmorl’s Nodes: A Case Report
title Percutaneous Vertebroplasty in a Patient with Chronic Back Pain Caused by Multiple Schmorl’s Nodes: A Case Report
title_full Percutaneous Vertebroplasty in a Patient with Chronic Back Pain Caused by Multiple Schmorl’s Nodes: A Case Report
title_fullStr Percutaneous Vertebroplasty in a Patient with Chronic Back Pain Caused by Multiple Schmorl’s Nodes: A Case Report
title_full_unstemmed Percutaneous Vertebroplasty in a Patient with Chronic Back Pain Caused by Multiple Schmorl’s Nodes: A Case Report
title_short Percutaneous Vertebroplasty in a Patient with Chronic Back Pain Caused by Multiple Schmorl’s Nodes: A Case Report
title_sort percutaneous vertebroplasty in a patient with chronic back pain caused by multiple schmorl’s nodes: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10608530/
https://www.ncbi.nlm.nih.gov/pubmed/37893557
http://dx.doi.org/10.3390/medicina59101839
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