Purpose To present a case series with PVP for symptomatic Schmorls nodes (SNs) not responding to conservative therapy and assess the efficacy and safety for such treatment with long-term follow-up. To present a review of the literature regarding SNs and treatment options. Methods Between January 2008 and December 2013, 11 patients suffering from symptomatic SNs that were refractory to medical or physical therapy, underwent PVP procedures in our department. All patients had a definitive diagnosis of SNs by magnetic resonance imaging (MRI) and computed tomography (CT). The visual analog scale (VAS) was assessed pre-operatively at four hours, at one month and every six months post-operatively during the long term (mean: 58.0 months) follow up period. Results Each of the 11 patients reported an immediate and distinct relief of their back pain. No one reported a worsening of symptoms. The VAS decreased from an average pre-procedural score of 7.9 pre-procedure to a post-procedural score of 2.1 at four hours. The VAS averaged 1.8 during the mean follow up period of 58.0 (range 24.1 to 98.9) months. There were no postoperative complications during the follow up period. At the end of the follow up period, all 11 patients were unrestricted in their activities. Conclusions PVP is an effective and safe procedure for the treatment of symptomatic SNs, which are refractory to medical or physical therapy.