Korean J Pain.  2011 Jun;24(2):81-86. 10.3344/kjp.2011.24.2.81.

Value of Bone Scintigraphy and Single Photon Emission Computed Tomography (SPECT) in Lumbar Facet Disease and Prediction of Short-term Outcome of Ultrasound Guided Medial Branch Block with Bone SPECT

• Koh WU
• Kim SH
• Hwang BY
• Choi WJ
• Song JG
• Suh JH
• Leem JG
• Shin JW

• KMID: 2074002
• DOI: http://doi.org/10.3344/kjp.2011.24.2.81

Abstract

BACKGROUND
Facet joint disease plays a major role in axial low-back pain. Few diagnostic tests and imaging methods for identifying this condition exist. Single photon emission computed tomography (SPECT) is reported that it has a high sensitivity and specificity in diagnosing facet disease. We prospectively evaluated the use of bone scintigraphy with SPECT for the identification of patients with low back pain who would benefit from medial branch block.
METHODS
SPECT was performed on 33 patients clinically suspected of facet joint disease. After SPECT, an ultrasound guided medial branch block was performed on all patients. On 28 SPECT-positive patients, medial branch block was performed based on the SPECT findings. On 5 negative patients, medial branch block was performed based on clinical findings. For one month, we evaluated the patients using the visual analogue scale (VAS) and Oswestry disability index. SigmaStat and paired t-tests were used to analyze patient data and compare results.
RESULTS
Of the 33 patients, the ones who showed more than 50% reduction in VAS score were assigned 'responders'. SPECT positive patients showed a better response to medial branch blocks than negative patients, but no changes in the Oswestry disability index were seen.
CONCLUSIONS
SPECT is a sensitive tool for the identification of facet joint disease and predicting the response to medial branch block.

Keyword

facet; medial branch block; SPECT

MeSH Terms

Diagnostic Tests, Routine
Humans
Low Back Pain
Prospective Studies
Sensitivity and Specificity
Tomography, Emission-Computed, Single-Photon
Zygapophyseal Joint

Figure

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  Fig. 1 (A) Negative planar bone scintigraphy. (B) Positive planar bone scintigraphy.

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  Fig. 2 VAS and Oswestry disability index changes in patients whom are suspected facet disease (*means P value < 0.05).

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