SPECT/CT in failed back syndrome

Abstract

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Learning Objectives: 1. To understand the use SPECT/CT to evaluate common disorders causing back pain in failed back syndrome. 2. Pattern recognition on SPECT/CT following laminectomy, common spine stabilization devices and instrumentation for increased diagnostic specificity. 3. To understand the use of SPECT/CT in evaluation of back pain in patients without surgical backs.

Abstract Body: Back pain is a major health problem costing millions of health dollars annually. It accounts for 14% of new patient visits to primary care doctors. 15% of workman’s compensation is related to back pain. 300,000 laminectomies are performed annually with up to 40% of patients complaining of back pain at some time post-surgery causing ‘Failed Back Syndrome’. Diagnosis in these patients may be complex even with good physical examination, planar scintigraphy or radiography because the symptomatology may include a combination of possible presurgical abnormalities and post-operative complications related to loosening of instrumentation device, infection and pseudoarthrosis. This exhibit will illustrate the abnormal patterns seen on SPECT/CT in cases of failed back syndrome which are not always evident on CT/MRI or scintigraphy alone.