Study On The Relationship Between Schmorl’s Node And Degenerative Lumbar Spinal Stenosis And Degenerative Lumbar Spondylolisthesis

Objective: To analyze the incidence and distribution of Schmorl’s node(SN)in degenerative lumbar spinal stenosis and degenerative lumbar spondylolisthesis and reveal the correlation between SN and the two diseases.Methods: The clinical data of 218 patients who were hospitalized in the First Affiliated Hospital of Nanchang University from January 1,2019 to August 31,2019 and diagnosed as degenerative lumbar spinal stenosis,degenerative lumbar spondylolisthesis were collected by retrospective analysis.Magnetic resonance imaging(MRI)data of each patient were reviewed.The differences of general data(gender,age),midline anteroposterior body diameter,anteroposterior dural sac diameter and Sagittal diameter ratio of dural sac to vertebral body(RDS)between SN group and non SN group were compared.The correlation between SN and the degree of lumbar canal stenosis and the incidence of lumbar spondylolisthesis was further analyzed.Results: Of the 218 patients,a total of 118(54.1%)had SN in 237 endplates.Among them,SN occurred only in a single endplate in 59(27.1%)patients,and multiple SN occurred in the other 59(27.1%)patients.The incidence of SN in l4/5 segment was the highest(26.6%),and the incidence of SN in cranial endplates was slightly higher than that in caudal endplates.The age of the SN group was greater than that of the non-SN group(60.3 VS 56.1).No significant difference was found between the SN group and the non-SN group(P=0.817)in the incidence of degenerative lumbar spondylolisthesis.The ratio of dural sac to vertebral body in the SN positive group was smaller than that in the SN negative group at segments L1/2,L2/3,and L4/5(P < 0.05).For all segments,the ratio of dural sac to vertebral body in the SN positive group(0.28±0.10)was significantly lower than that in the SN negative group(0.32±0.11,P < 0.001).Correlation analysis showed that there was a correlation between SN and the ratio of dural sac to vertebral body(r=-0.164,P < 0.001).Conclusion: SN is associated with degenerative lumbar spinal stenosis.Cases with SN are more severe DLSS.There was no significant correlation between SN and degenerative lumbar spondylolisthesis.The Schmorl’s node judged on MRI may be a kind of evidence of patients’ DLSS degree,and can also be used as a judgment indicator for the early prevention of DLSS.