title: 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.
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.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
authors.forename: Won Uk
authors.initials: WU
authors.lastname: Koh
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Bo Young
authors.initials: BY
authors.lastname: Hwang
authors.forename: Woo Jong
authors.initials: WJ
authors.lastname: Choi
authors.forename: Jun Gul
authors.initials: JG
authors.lastname: Song
authors.forename: Jeong Hun
authors.initials: JH
authors.lastname: Suh
authors.forename: Jeong Gill
authors.initials: JG
authors.lastname: Leem
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Shin