MRI study: link between Schmorl’s nodes in the lumbar spine and various types of Modic changes

Abstract Background: Modic changes (MC) and Schmorl’s nodes (SN) are commonly observed spinal abnormalities in lumbar magnetic resonance imaging (MRI) studies. MC is categorized into three types: type I (inflammatory), type II (fatty degeneration), and type III (sclerotic). SN refers to the herniation of the nucleus pulposus into adjacent vertebrae, often resembling an “ice-cream scoop” on imaging. Materials and Methods: This study analyzed MRI scans of the lumbar spine from 500 patients to evaluate the presence of SN and MC alongside other spinal conditions. Participants were divided into four groups: •Group A: Control group with no SN, MC, or other spinal pathologies. •Group B: Patients without SN or MC presenting conditions like spinal straightening or altered lordosis. •Group C: Individuals with MC, classified by type (type I, II, and III) and location (superior, inferior, right, left, and multilevel). •Group D: Patients with SN, categorized by shape (round, sharp, irregular, and small) and location, including cases with multiple nodes across levels. Results: Type II MC was the most prevalent subtype observed. Gender differences were noted: males were more commonly affected in the right superior region, whereas females showed a higher incidence in the right inferior region. MC was significantly associated with aging ( P < 0.05). SN was predominantly spherical and centrally located. Females demonstrated a higher prevalence of SN (8.5%) than males (6.5%), with a significant age-related correlation ( P < 0.05). Notably, 24% of females exhibited both SN and MC in the same region. Conclusion: The study highlights gender-specific patterns in MC and SN. It reveals that type 2 MC is most commonly observed at the L4 and L5 vertebrae, particularly in the “LEFT” and “SUPERIOR” regions. SN is more frequently found in females, with a higher incidence of multilevel occurrences. Notably, the co-occurrence of MC and SN at the same vertebral sites was observed in 24% of females. Type 2 MC was especially prominent in these cases, suggesting a potential relationship between the two conditions.