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施莫尔氏结节:当前的病理生理学、诊断和治疗模式。

Schmorl's nodes: current pathophysiological, diagnostic, and therapeutic paradigms.

机构信息

Department of Neurosurgery, University of Illinois College of Medicine at Peoria, 828 NE Glen Oak, #302, Peoria, IL, 61603, USA,

出版信息

Neurosurg Rev. 2014 Jan;37(1):39-46. doi: 10.1007/s10143-013-0488-4. Epub 2013 Aug 18.

Abstract

Schmorl's nodes were first described by the pathologist Christian Schmorl in 1927 as a herniation of the nucleus pulposus through the cartilaginous and bony endplate into the vertebral body. Although such lesions present most commonly as incidental findings in asymptomatic patients (or in patients with back or radicular pain due to other etiology), there have been several reports emphasizing the deleterious effects of the inflammatory response and endplate changes elicited by the herniation of for such reasons, Schmorl's nodes have been occasionally implicated in the etiology of chronic axial pain as well as in pathological osteoporotic fractures. In this article, a thorough literature review about the most relevant historical studies on Schmorl's nodes previously published is performed. Furthermore, the authors provide an overview about the recent advances in basic science research on the pathophysiology of such lesions, as well as on current diagnostic and therapeutic paradigms.

摘要

施莫尔氏结节于 1927 年由病理学家克里斯蒂安·施莫尔(Christian Schmorl)首次描述为髓核通过软骨和骨终板向椎体疝出。尽管此类病变最常作为无症状患者(或因其他病因导致背痛或神经根痛的患者)的偶然发现,但已有数份报告强调了此类疝出引起的炎症反应和终板变化的有害影响,因此,施莫尔氏结节偶尔与慢性轴性疼痛的病因以及病理性骨质疏松性骨折有关。本文对之前发表的关于施莫尔氏结节的最相关历史研究进行了全面的文献回顾。此外,作者还概述了此类病变的病理生理学基础科学研究的最新进展,以及当前的诊断和治疗范例。

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