ÖZET
Schmorl nodülü (SN), kıkırdak uç plakanın bozulması ve kıkırdak plakası yoluyla nükleer madde kaybolduktan sonraki dönemde, nükleus pulposusun vertebra gövdesine herniasyonudur. Bir trafik kazasında yaralanan 12 yaşında bir erkek çocuğu hakkındaki bu makalede, travmatik vertebra kompresyon kırığı tanımlanmış ve bu lezyon ile trafik kazası arasında bir nedensellik bağı tespit edilmişti. Beyin cerrahisi, Radyoloji ve Pediatrik Radyoloji ile yapılan değerlendirmeler sonucu bu lezyonun SN olduğu ve trafik kazası ile ilişkili olmadığı sonucuna varıldı. Bu makalede sunulan olgu ile ilgili literatür gözden geçirilerek adli rapor hazırlanırken nedenselliğin tesis edilmesinin önemi ve bu tür durumlarda multidisipliner yaklaşımın gerekliliği vurgulanmıştır.
References
1
Nogueira-Barbosa MH, Crema MD, da Silva Herrero CFP, Pasqualini W, Aparecido Defino HL. The several faces of schmorl’s node: pictorial essay. Coluna. 2015;14(4):320-323. https://doi.org/10.1590/S1808-185120151404151248
2
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(21):2272-2275. https://doi.org/10.1097/00007632-199811010-00004
3
Hasegawa K, Ogose A, Morita T, Hirata Y. Painful schmorl’s node treated by lumbar interbody fusion. Spinal Cord. 2004;42(2):124-128. https://doi.org/10.1038/sj.sc.3101506
4
Kyere KA, Than KD, Wang AC, Rahman SU, Valdivia-Valdivia JM, La Marca F, et al. Schmorl’s Nodes. Eur Spine J. 2012;21(11):2115-2121. https://doi.org/10.1007/s00586-012-2325-9.
5
Takahashi K, Takata K. A large painful schmorl’s node: a case report. J Spinal Disord. 1994;7(1):77-81. https://doi.org/10.1097/00002517-199407010-00011
6
Batts M, Michagan AA. Rupture of the nucleus pulposus. J Bone Jt Surg. 1939;21(1):121-126.
7
Resnick D, Niwayama G. Intravertebral disk herniations: cartilaginous (schmorl’s) nodes. Radiology. 1978;126(1):57-65. https://doi.org/10.1148/126.1.57
8
Pfirrmann CW, Resnick D. Schmorl nodes of the thoracic and lumbar spine: radiographic-pathologic study of prevalence, characterization, and correlation with degenerative changes of 1,650 spinal levels in 100 cadavers. Radiology. 2001;219(2):368-374. https://doi.org/10.1148/radiology.219.2.r01ma21368
9
Hilton RC, Ball J, Benn RT. Vertebral end-plate lesions (schmorl’s nodes) in the dorsolumbar spine. Ann Rheum Dis. 1976;35(2):127-132. https://doi.org/10.1136/ard.35.2.127
10
Stäbler A, Bellan M, Weiss M, Gärtner C, Brossmann J, Reiser MF. MR imaging of enhancing intraosseous disk herniation (schmorl’s nodes). AJR Am J Roentgenol. 1997;168(4):933-938. https://doi.org/10.2214/ajr.168.4.9124143
11
Sonne-Holm S, Jacobsen S, Rovsing H, Monrad H. The epidemiology of schmorl’s nodes and their correlation to radiographic degeneration in 4,151 subjects. Eur Spine J. 2013;22(8):1907-1912. https://doi.org/10.1007/s00586-013-2735-3
12
Sandelich SM, Adirim TA. An unusual cause of back pain in a 10-year-old girl. Pediatr Emerg Care. 2017;33(5):352-355. https://doi.org/10.1097/PEC.0000000000000808
13
Fukuta S, Miyamoto K, Iwata A, Hosoe H, Iwata H, Shirahashi K, et al. Unusual back pain caused by intervertebral disc degeneration associated with schmorl node at th11/12 in a young athlete, successfully treated by anterior interbody fusion: a case report. Spine. 2009;34(5):E195-E198. https://doi.org/10.1097/BRS.0b013e318198c60cXXX
14
Walters G, Coumas JM, Akins CM, Ragland RL. Magnetic resonance imaging of acute symptomatic schmorl’s node formation. Pediatr Emerg Care. 1991;7(5):294-296. https://doi.org/10.1097/00006565-199110000-00009
15
Swischuk LE, John SD, Allbery S. Disk degenerative disease in childhood: scheuermann’s disease, schmorl’s nodes, and the limbus vertebra: MRI findings in 12 patients. Pediatr Radiol. 1998;28(5):334-338. https://doi.org/10.1007/s002470050368
16
Zeyfeoğlu Y, Uluçay T, Yavuz MS, Aşirdizer M. Incorrect identification in forensic medicine (wrong conclusion): a case report. Ulus Travma Acil Cerrahi Derg. 2010;16(2):185-188.
17
Reynolds R. Pediatric spinal injury. Curr Opin Pediatr. 2000;12(1):67-71. https://doi.org/10.1097/00008480-200002000-00013.
18
Rudert M, Tillmann B. Lymph and blood supply of the human intervertebral disc. cadaver study of correlations to discitis. Acta Orthop Scand. 1993;64(1):37-40. https://doi.org/10.3109/17453679308994524
19
Saul D, Dresing K. Epidemiology of vertebral fractures in pediatric and adolescent patients. Pediatr Rep. 2018;10(1):7232. https://doi.org/10.4081/pr.2018.7232
20
Mauch JT, Carr CM, Cloft H, Diehn FE. Review of the imaging features of benign osteoporotic and malignant vertebral compression fractures. AJNR Am J Neuroradiol. 2018;39(9):1584-1592. https://doi.org/10.3174/ajnr.A5528
21
Panda A, Das CJ, Baruah U. Imaging of vertebral fractures. Indian J Endocrinol Metab. 2014;18(3):295-303. https://doi.org/10.4103/2230-8210.131140
22
Joffe A, Bartley CE, Bastrom TP, Newton PO, Yaszay B. Thoracic and lumbar compression fractures in patients presenting to a pediatric institution. WScJ. 2015;6(3):115-121.
23
Guglielmi G, Muscarella S, Leone A, Peh WC. Imaging of metabolic bone diseases. Radiol Clin North Am. 2008;46(4):735-754. https://doi.org/10.1016/j.rcl.2008.04.010 https://doi.org/10.1016/j.rcl.2008.04.010
24
Kumar Y, Hayashi D. Role of magnetic resonance imaging in acute spinal trauma: a pictorial review. BMC Musculoskelet Disord. 2016;17:310. https://doi.org/10.1186/s12891-016-1169-6.
