Percutaneous vertebroplasty (PVP) to treat specialized type of endplate fractures around the Schmorl's node: A prospective study of 65 patients

Abstract

Background: The Schmorl's nodes (SNs) are defined as the herniation of the intervertebral disc into the vertebral body. Endplate fractures around the Schmorl's node could result in severe back pain that is similar to vertebral compression fractures. The objective of this study was to prospectively analyze the surgical effectiveness and safety of percutaneous vertebroplasty (PVP) for endplate fractures around the SNs. Methods: Seventy-one consecutive patients with the fresh endplate fracture around SNs from October 2017 to February 2018 were enrolled in this study. The visual analog scale (VAS) and Oswestry disability index (ODI) scores of low back pain were evaluated in all patients preoperatively, postoperatively, and at 1 month, 6 months, and 1 year after primary single level PVP. Surgery-related data including duration of the operation, injected cement volumes, and surgical complications were recorded. Results: Sixty-five patients with fresh endplate fractures around the SNs were treated successfully via percutaneous vertebroplasty. Our study showed that the VAS scores and ODI scores of patients were obviously improved after operation. Cement leakage into the disc space occurred in 5 patients (7.7%), and adjacent segment refractures occurred in 2 patients (3.1%). No other surgical complications, including infections or nerve root injuries were encountered. Conclusions: Based on the results of this prospective study, PVP was an effective and safe procedure for endplate fractures around the SNs. Trial registration: ChiCTR, ChiCTR1800016453. Registered 2 June 2018 - retrospectively registered, http://www.chictr.org.cn/com/25/historyversionpuben.aspx?regno=ChiCTR1800017602