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Rami Communicans Nerve Block for the Treatment of Symptomatic Schmorl's Nodes -A Case Report-

  • Jang, Ji-Su (Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Kwon, Hyung-Ki (Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Lee, Jae-Jun (Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Hwang, Sung-Mi (Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Lim, So-Young (Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University)
  • Received : 2010.09.27
  • Accepted : 2010.11.02
  • Published : 2010.12.01

Abstract

Histologically, Schmorl's nodes are defined as the loss of nuclear material through the cartilage plate, growth plate, and end plate into the vertebral body. Most Schmorl's nodes are asymptomatic, although there are some reports of symptomatic Schmorl's nodes, which should be treated similarly to vertebral compression fractures, with conservative treatment as the first choice. We report the case that we reduced the pain by blocking the ramus communicans nerve in a patient with Schmorl's node.

Keywords

References

  1. Hasegawa K, Ogose A, Morita T, Hirata Y. Painful Schmorl's node treated by lumbar interbody fusion. Spinal Cord 2004; 42: 124-8. https://doi.org/10.1038/sj.sc.3101506
  2. Tsuji H, Yoshioka T, Sainoh H. Developmental balloon disc of the lumbar spine in healthy subjects. Spine 1985; 10: 907-11. https://doi.org/10.1097/00007632-198512000-00008
  3. Takahashi K, Takata K. A large painful Schmorl's node: a case report. J Spinal Disord 1994; 7: 77-81. https://doi.org/10.1097/00002517-199407010-00011
  4. Takahashi K, Miyazaki T, Ohnari H, Takino T, Tomita K. Schmorl's nodes and low-back pain. Analysis of magnetic resonance imaging findings in symptomatic and asymptomatic individuals. Eur Spine J 1995; 4: 56-9. https://doi.org/10.1007/BF00298420
  5. Chandler G, Dalley G, Hemmer J Jr, Seely T. Gray ramus communicans nerve block: novel treatment approach for painful osteoporotic vertebral compression fracture. South Med J 2001; 94: 387-93.
  6. Walters G, Coumas JM, Akins CM, Ragland RL. Magnetic resonance imaging of acute symptomatic Schmorl's node formation. Pediatr Emerg Care 1991; 7: 294-6. https://doi.org/10.1097/00006565-199110000-00009
  7. Hauger O, Cotten A, Chateil JF, Borg O, Moinard M, Diard F. Giant cystic Schmorl's nodes: imaging findings in six patients. AJR Am J Roentgenol 2001; 176: 969-72. https://doi.org/10.2214/ajr.176.4.1760969
  8. Fahey V, Opeskin K, Silberstein M, Anderson R, Briggs C. The pathogenesis of Schmorl's nodes in relation to acute trauma. An autopsy study. Spine 1998; 23: 2272-5. https://doi.org/10.1097/00007632-199811010-00004
  9. Stabler A, Bellan M, Weiss M, Gartner C, Brossmann J, Reiser MF. MR imaging of enhancing intraosseous disk herniation (Schmorl's nodes). AJR Am J Roentgenol 1997; 168: 933-8. https://doi.org/10.2214/ajr.168.4.9124143
  10. Wagner AL, Murtagh FR, Arrington JA, Stallworth D. Relationship of Schmorl's nodes to vertebral body endplate fractures and acute endplate disk extrusions. AJNR Am J Neuroradiol 2000; 21: 276-81.
  11. Vogler JB 3rd, Murphy WA. Bone marrow imaging. Radiology 1988; 168: 679-93. https://doi.org/10.1148/radiology.168.3.3043546
  12. Bogduk N. Clinical anatomy of the lumbar spine and sacrum. 3rd ed. New York, Bath press Ltd. 1997, pp 127-43.
  13. Tae HS, Kim SD, Park JY, Kim SH, Lim DJ, Suh JK. Gray ramus communicans nerve block: a useful therapeutic adjuvant for painful osteoporotic vertebral compression fracture. J Korean Neurosurg Soc 2003; 34: 505-8.

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