title: Potential use of (18)F-FDG-PET/CT to visualize hypermetabolism associated with muscle pain in patients with adult spinal deformity: a case report.
abstract: Patients with adult spinal deformity (ASD) are surgically treated for pain relief; however, visualization of the exact origin of the pain with imaging modalities is still challenging. We report the first case of a 60-year-old female patient who presented with painful degenerative kyphoscoliosis and was evaluated with flourine-18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ((18)F-FDG-PET/CT) preoperatively. Because her low back pain was resistant to conservative treatment, she was treated with posterior spinal correction and fusion surgery from Th2 to the ilium. One year after the surgery, her low back pain had disappeared completely. In accordance with her clinical course, (18)F-FDG-PET imaging revealed the uptake of (18)F-FDG in the paravertebral muscles preoperatively and showed the complete absence of uptake at 1 year after surgery. The uptake site coincided with the convex part of each curve of the lumbar spine and was thought to be the result of the increased activity of paravertebral muscles due to their chronic stretched state in the kyphotic posture. This case report suggests the possibility of using (18)F-FDG-PET/CT to visualize increased activity in paravertebral muscles and the ensuing pain in ASD patients.
authors: Department of Orthopedic Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. taniguchi-tky@umin.ac.jp.
authors: Yuki
authors: Y
authors: Taniguchi
authors: Division of Nuclear Medicine, Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Miwako
authors: M
authors: Takahashi
authors: Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Ko
authors: K
authors: Matsudaira
authors: Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical & Research Center, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Hiroyuki
authors: H
authors: Oka
authors: Division of Nuclear Medicine, Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Toshimitsu
authors: T
authors: Momose
mesh_terms: D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D063806:Myalgia / Q000000981:diagnostic imaging* / Q000209:etiology / Q000378:metabolism*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012600:Scoliosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism*; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18 F-FDG-PET/CT; Adult spinal deformity; Kyphosis; Low back pain; Muscle pain; Scoliosis