Hybrid Bone SPECT/CT Imaging in Analysis of Continual 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 the usage of 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 recognized or suspected malignancy, trauma, infectious processes, power inflammatory ailments, and former surgical procedure have been excluded. The impact of LBP on the every 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 delicate degeneration) on CT, 35% have been grade 2 (average degeneration), and 16% have been grade Three (extreme degeneration). Sixty-seven p.c of the sufferers had scintigraphically lively FJs on SPECT/CT. Sixty-nine p.c of Pathria grade Three FJs have been scintigraphically lively; 5.5% and 16.eight% of Pathria grade Zero-1 and Pathria grade 2, respectively, have been lively. Of the metabolically lively FJs, 71.four% have been on the L4-5/L5-S1 ranges.
CONCLUSIONS: The power of SPECT/CT to exactly localize scintigraphically lively FJs might present vital enchancment within the analysis and remedy of sufferers with LBP. On this examine we exhibit 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]