Hernia intraesponjosa de Schmörl sintomática. [Symptomatic intraosseous Schmörl herniation]

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Joint Halley Guimbard Pérez
Andrés Barriga-Martín
Luis María Romero-Munóz

Resumen

Las hernias discales intraesponjosas vertebrales o nódulos de Schmörl consisten en una herniación o una extrusión del núcleo pulposo del disco intervertebral a través del platillo vertebral hacia el cuerpo adyacente. Suelen asociarse a deformidades vertebrales, como la enfermedad de Scheuermann, o a enfermedades reumáticas, como la espondilitis anquilopoyética. En general, son hallazgos casuales y cuadros asintomáticos; son pocos los casos publicados de nódulos sintomáticos. Su aparición estaría relacionada con un platillo vertebral debilitado por traumatismo o estrés repetido. Cuando el nódulo es agudo o reciente, puede ser difícil diferenciar la degeneración benigna de una infiltración maligna o una infección. Presentamos un caso inusual de un nódulo de Schmörl doloroso en un hombre sin antecedentes de relevancia, que enmascaró una lesión metastásica de carcinoma pancreático a nivel lumbar. Se realiza una revisión bibliográfica.  ABSTRACTIntraosseous disc herniation –or Schmörl nodes (SN)– are a herniation or prolapse of the nucleus pulposus of the intervertebral disc through the vertebral plate and into the adjacent vertebral body. They are usually associated with vertebral deformities, suchas Scheuermann’s disease, or rheumatic diseases, such as ankylopoietic spondylitis. In general, they are spontaneous and asymptomatic findings, and there are only a few reported cases of symptomatic nodes. The etiology is supposedly related to a weakened spinal plate due to trauma or repeated stress. When the node is acute or recent, it can be difficult to differentiate a benign degeneration from a malignant infiltration or infection. In this paper, we discuss the unusual case of a painful Schmörl node in a man with no relevant history and a masked metastatic lumbar spinal tumor originated from pancreatic cancer. We performed a literature review.

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Guimbard Pérez, J. H., Barriga-Martín, A., & Romero-Munóz, L. M. (2019). Hernia intraesponjosa de Schmörl sintomática. [Symptomatic intraosseous Schmörl herniation]. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 84(3), 273-285. https://doi.org/10.15417/issn.1852-7434.2019.84.3.847
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Presentación de casos
Biografía del autor/a

Joint Halley Guimbard Pérez, Sanatorio Allende, Córdoba, Argentina

Servicio de Patología Espinal en Instituto Allende de Cirugia reconstructiva de los miembros.Sanatorio Allende, Córdoba, Argentina

Andrés Barriga-Martín, Hospital Nacional de Parapléjicos, Toledo, España.

Jefe de Servicio de Ortopedia y Traumatología del Hospital Nacional de Parapléjicos de Toledo, España

Luis María Romero-Munóz, Hospital Nacional de Parapléjicos, Toledo, España.

Médico adjunto de Ortopedia y Traumatología del Hospital Nacional de Parapléjicos de Toledo, España

Citas

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