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Spine

IS THERE A ROLE FOR SINGLE POSITRON EMISSION COMPUTERIZED TOMOGRAPHY (SPECT) IN THE DIAGNOSIS OF DEGENERATIVE LUMBO-SACRAL FACET JOINT ARTHROPATHY? A SYSTEMATIC REVIEW OF THE LATEST EVIDENCE, 2019

The Society for Back Pain Research (SBPR) Annual General Meeting 2019, ‘From Bench to Bedside’. Sheffield, England, 5–6 September 2019.



Abstract

Background Context

SPECT-CT is a hybrid imaging modality, which has become very well established in the diagnosis of inflammatory, vascular and malignant processes affecting the spine. However, little evidence exists on its application with degenerative pathologies.

Purpose & Study Design

Systematic review on the use of SPECT-CT in the diagnosis of degenerative facet joint arthropathy.

Patient Sample

824 patients across 10 studies conducted over the last 6 years (2012 – 2018), with a mean age of 51.8 years old. All studies excluded patients with malignancy, infection or inflammatory aetiologies or those related to acute trauma. Only degenerative pathologies of the lumbar spine in an adult population were included.

Methods

A systematic review of the literature available on the topic was conducted using the PubMed, Cochrane, Medline and Embase online databases of journal articles.

Results

Five studies focused on SPECT-CT alone / versus CT. Two focused on SPECT-CT vs MRI, and three focussed on SPECT-CT guided facet joint injections. Of these 10 studies, seven concluded with results supporting SPECT CT's use, two reported discordance between SPECT-CT findings with those diagnosed from clinical examination / MRI scans, and one study's conclusions were equivocal.

Conclusion

SPECT-CT shows promise as an imaging adjunct in assisting with the diagnosis and subsequent treatment of degenerative facet joint arthropathies. In patients whose MRI scans reveal multiple potential pain generators, SPECT-CT could help differentiate between clinically significant sources of pain and may even serve a purpose in guiding facet joint injections in patients with inconclusive MRI / CT scans.

No conflicts of interest

No funding obtained


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