title: Is hybrid imaging (SPECT/CT) a useful adjunct in the management of suspected facet joints arthropathy?
abstract: OBJECTIVE
  The purpose of this study was to assess the value of SPECT/CT imaging in patients with chronic spinal pain.
  
  
  METHODS
  This was a retrospective consecutive study. Patients with chronic neck or back pain from outpatient spinal clinics with clinical features raising the possibility of a facetogenic pain generator and non-conclusive MRI/CT findings were included. Imaging was performed on a dual-headed, hybrid SPECT/CT γ-camera with a low-dose CT transmission scan acquired after the SPECT study. SPECT/CT studies were viewed in the coronal, axial, and sagittal planes and in 3-dimensional mode. Descriptive statistical analysis was performed.
  
  
  RESULTS
  Seventy-two patients were included (37 females, 35 males, mean age of 53.9 years). There were 25 cervical spine scans and 49 lumbar spine scans. In the cervical spine group, 13 (52 %) patients had scintigraphically active cervical facet joint arthropathy and ten (36 %) had other pathology identified. Two thirds of patients diagnosed with facet joint arthropathy received steroid guided injections following their scans. In the lumbar spine group 34 (69.4 %) patients had scintigraphically active lumbar facet joint arthropathy and eight had other pathology identified. Twenty patients (58.8 %) diagnosed with facet joint arthropathy subsequently received steroid guided injections.
  
  
  CONCLUSIONS
  Hybrid SPECT/CT imaging identified potential pain generators in 92 % of cervical spine scans and 86 % of lumbar spine scans. The scan precisely localised SPECT positive facet joint targets in 65 % of the referral population and a clinical decision to inject was made in 60 % of these cases.
authors: Nuclear Medicine, Royal Free Hospital, Pond Street, London, NW3 2QG, UK. hematar@doctors.org.uk
authors: Hosam E
authors: HE
authors: Matar
authors: Shaunak
authors: S
authors: Navalkissoor
authors: Marko
authors: M
authors: Berovic
authors: Rohit
authors: R
authors: Shetty
authors: Nicholas
authors: N
authors: Garlick
authors: Adrian T H
authors: AT
authors: Casey
authors: Ann-Marie
authors: AM
authors: Quigley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000175:diagnosis*; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis* / Q000209:etiology; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D055815:Young Adult; D021801:Zygapophyseal Joint / Q000473:pathology*