SPECT/CT in Differentiation of Pseudarthrosis From Other Causes of Back Pain in Lumbar Spinal Fusion
| Autor: | Olivier Rager, David Laurent Tchernin, Enrico Tessitore, Karl Lothard Schaller, Michael Payer, Osman Ratib |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Lumbar Vertebrae/surgery medicine.medical_treatment Computed tomography Joint Diseases/complications ddc:616.0757 Multimodal Imaging Diagnosis Differential Recurrence medicine Back pain Humans Radiology Nuclear Medicine and imaging Aged Retrospective Studies Leg Lumbar Vertebrae medicine.diagnostic_test business.industry Pseudarthrosis/complications/etiology/radionuclide imaging General Medicine Middle Aged Back Pain/etiology medicine.disease ddc:616.8 Pseudarthrosis Spinal Fusion Treatment Outcome Back Pain Positron-Emission Tomography Spinal fusion Spinal Fusion/adverse effects Female Radiology Joint Diseases medicine.symptom Tomography X-Ray Computed business Nuclear medicine Lumbar spinal fusion |
| Zdroj: | Clinical Nuclear Medicine, Vol. 37, No 4 (2012) pp. 339-343 |
| ISSN: | 0363-9762 |
| DOI: | 10.1097/rlu.0b013e318239248b |
| Popis: | SPECT fused with computed tomography (CT) provides a new approach for more accurate diagnosis of pseudathrosis after spinal fusion procedures. The aim of this study was to compare the findings of SPECT fused with CT (SPECT/CT) with those of CT alone for the diagnosis of pseudarthrosis.SPECT and CT of 10 consecutive patients with recurrence of back and/or leg pain and with suspicion of pseudarthrosis on conventional radiologic imaging were analyzed retrospectively. All had previously undergone anterior and/or posterior lumbar fusion techniques. Presence of screw loosening, nonunion through or around the cages, and facet joint degeneration were assessed for diagnosis of pseudarthrosis. Based on SPECT/CT scan findings, the decision of surgical reintervention was made on 6 of 10 patients. The clinical follow-up (mean, 15.6 months; range, 5-29 months) was evaluated according to Macnab criteria (excellent, good, fair, poor).All patients showing screw loosening on CT alone showed also an abnormal uptake on SPECT/CT. SPECT/CT did not show abnormal uptake in 3 of 5 patients who had nonunion through/around the cages on CT alone. SPECT/CT was able to show increased uptake in 6 cases in which CT alone did not show facet joint degeneration.In the lumbar spine, SPECT/CT seems to increase specificity for detection of nonunion of interbody devices compared with CT alone. It is more sensitive than CT to detect facet joint degeneration, and it can detect screw loosening as well as CT. These findings can be helpful for surgeons in planning appropriate surgical revision strategy. |
| Databáze: | OpenAIRE |
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