The value of SPECT/CT in localizing pain site and prediction of treatment response in patients with chronic low back pain

J Korean Med Sci. 2014 Dec;29(12):1711-6. doi: 10.3346/jkms.2014.29.12.1711. Epub 2014 Nov 21.

Abstract

In many circumstances, causing sites of low back pain (LBP) cannot be determined only by anatomical imaging. Combined functional and morphological imaging such as bone scan with single-photon emission computed tomography/computed tomography (SPECT/CT) may be helpful in identifying active lesions. The purpose of this study was to evaluate the usefulness of bone SPECT/CT in localizing the pain site and the treatment of chronic LBP. One hundred seventy-five patients suffering from chronic LBP who underwent SPECT/CT were included, retrospectively. All of the patients received multiple general treatments according to the symptoms, and some of them underwent additional target-specific treatment based on SPECT/CT. Numerical rating scale (NRS) pain score was used to assess the pain intensity. Of 175 patients, 127 showed good response to the given therapies, while the rest did not. Overall, 79.4% of patients with definite active lesions showed good response. Patients with mild active or no lesions on SPECT/CT had relatively lower response rate of 63.0%. Good response was observed by the treatment with the guidance of active lesions identified on SPECT/CT. SPECT/CT could be useful in identifying active lesions in patients with chronic LBP and guiding the clinicians to use adequate treatment.

Keywords: Low Back Pain; Pain Management; Technetium-99m (Tc-99m), Methylene Diphosphonate (MDP); Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Pain / diagnosis*
  • Chronic Pain / therapy*
  • Female
  • Humans
  • Low Back Pain / diagnosis*
  • Low Back Pain / therapy*
  • Lumbar Vertebrae / diagnostic imaging
  • Male
  • Middle Aged
  • Multimodal Imaging / methods
  • Pain Measurement / methods*
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome
  • Young Adult