Single photon emission computed tomography (SPECT) is a method of scintigraphy that provides sectional and multi-planar imaging that should improve the sensitivity for diagnosis in remote areas of the spine. To test this hypothesis, the authors reviewed 15 patients with low-back pain and compared the results of the radiographs, planar bone scans (PBS), and SPECT. Four of 15 had normal examinations with all three methods of imaging. The rest had a positive test in at least one of the three methods. Single photon emission computed tomography was positive in eleven, PBS in six, and the radiograph in three of the 11 patients. It appears that the SPECT was the most sensitive method of imaging and greatly enhanced our diagnostic acumen for stress fractures or stress reactions of the spine.