Hybrid Bone SPECT/CT Imaging in Analysis of Persistent Low Again Ache: Correlation with Side Joint Arthropathy.
World Neurosurg. 2017 Nov;107:732-738
Authors: Russo VM, Dhawan RT, Baudracco I, Dharmarajah N, Lazzarino AI, Casey AT
BACKGROUND: Proof to assist using bone hydroxydiphosphonate (HDP) single photon emission computed tomography (SPECT/CT) in sufferers with facetogenic low again ache (LBP) remains to be restricted. On this examine we in contrast the scintigraphic patterns on bone SPECT/CT with the diploma of structural aspect joint (FJ) degeneration on CT in sufferers with LBP.
METHODS: Ninety-nine consecutive sufferers with LBP have been prospectively evaluated. Sufferers with identified or suspected malignancy, trauma, infectious processes, power inflammatory illnesses, and former surgical procedure have been excluded. The impact of LBP on the each day high quality of life was assessed with the Oswestry incapacity index (ODI). The Pathria grading system was used to attain FJ degeneration on CT scans. The correlation between the diploma of FJ degeneration and osteoblastic exercise on SPECT/CT was analyzed with Kappa statistics.
RESULTS: Ninety-nine sufferers have been included (59 feminine, imply age 56.2 years). The imply ODI rating was 38.5% (vary, eight% to 72%). In all, 792 FJ (L2-Three to L5-S1) have been examined. Of the FJs, 49.6% have been Pathria grade Zero-1 (regular to gentle degeneration) on CT, 35% have been grade 2 (average degeneration), and 16% have been grade Three (extreme degeneration). Sixty-seven % of the sufferers had scintigraphically energetic FJs on SPECT/CT. Sixty-nine % of Pathria grade Three FJs have been scintigraphically energetic; 5.5% and 16.eight% of Pathria grade Zero-1 and Pathria grade 2, respectively, have been energetic. Of the metabolically energetic FJs, 71.four% have been on the L4-5/L5-S1 ranges.
CONCLUSIONS: The power of SPECT/CT to exactly localize scintigraphically energetic FJs could present vital enchancment within the prognosis and remedy of sufferers with LBP. On this examine we show that in >40% of FJs, the scintigraphic patterns on SPECT/CT didn’t correlate with the diploma of degeneration on CT.
PMID: 28847557 [PubMed – indexed for MEDLINE]