A semiautomatic method to identify vertebral end plate lesions (Schmorl's nodes)

Newell, Nicolas, Grant, Caroline A., Izatt, Maree T., Little, J. Paige, Pearcy, Mark J., & Adam, Clayton J. (2015) A semiautomatic method to identify vertebral end plate lesions (Schmorl's nodes). The Spine Journal, 15(7), pp. 1665-1673.

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Background Context

There are differences in definitions of end plate lesions (EPLs), often referred to as Schmorl’s nodes, that may, to some extent, account for the large range of reported prevalence (3.8 to 76%).


To develop a technique to measure the size, prevalence and location of EPLs in a consistent manner.

Study Design/Setting

This study proposed a method using a detection algorithm which was applied to five adolescent females (average age 15.1 years, range 13.0 to 19.2 years) with idiopathic scoliosis (average major Cobb angle 60°, range 55 to 67°).


Existing low-dose, computed tomography scans were segmented semi-automatically to extract 3D morphology of each vertebral endplate. Any remaining attachments to the posterior elements of adjacent vertebrae or endplates were then manually sectioned. An automatic algorithm was used to determine the presence and position of EPLs.


EPLs were identified in 15 of the 170 (8.8%) endplates analysed with an average depth of 3.1mm. 11/15 of the EPLs were seen in the lumbar spine. The algorithm was found to be most sensitive to changes in the minimum EPL gradient at the edges of the EPL.


This study describes an imaging analysis technique for consistent measurement of the prevalence, location and size of EPLs. The technique can be used to analyse large populations without observer errors in EPL definitions.

Impact and interest:

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ID Code: 87370
Item Type: Journal Article
Refereed: Yes
Keywords: end plate lesion, schmorl's node, scoliosis, adolescent idiopathic scoliosis, computed tomography
DOI: 10.1016/j.spinee.2015.04.027
ISSN: 1529-9430
Subjects: Australian and New Zealand Standard Research Classification > ENGINEERING (090000) > BIOMEDICAL ENGINEERING (090300)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Orthopaedics (110314)
Divisions: Current > Schools > School of Chemistry, Physics & Mechanical Engineering
Current > Institutes > Institute of Health and Biomedical Innovation
Current > QUT Faculties and Divisions > Science & Engineering Faculty
Copyright Owner: Copyright 2015 Elsevier Inc.
Deposited On: 18 Sep 2015 04:38
Last Modified: 03 Jul 2016 06:39

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