Abstract
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Objectives: To evaluate the feasibility of using Bone SPECT-CT imaging to identify the cause of persistent, recurrent or new back or radicular pain after spine surgery.
Methods: SPECT-CT imaging was performed after the injection of 20 mCi of 99mTc-MDP in patients undergoing evaluation for pain after spine surgery. Symptoms at the time of the study were related to the findings on the scan.
Results: Findings in the first 25 patients have been reveiwed, but complete follow up data are only available in a small number of patients. Findings on SPECT-CT that appear to explain the patients' pain included several cases of facet joint arthritis, at least 4 cases of failed fusion, 2 cases of hardware fracture, 2 cases of loose hardware and at least one case of sacroiliitis. In over 90% of the cases, the findings on the study appeared to correlate with the clinical symptoms, even when the findings were not suspected by the referring physician.
Conclusions: MRI and CT evaluations of post-operative pain are limited by the presence of hardware and postoperative changes. Bone scanning is exquisitely sensitive to stresses that may cause post-operative symptoms. SPECT-CT helps to localize the abnormalities and explain post-operative pain in many patients.
- Society of Nuclear Medicine, Inc.