Case Report: Nerve Root Entrapment Due to Epidural Fibrosis in a Patient With Failed Back Surgery Syndrome: Value of 2-18F-Fluorodeoxyglucose Simultaneous Positron Emission Tomography-Magnetic Resonance Imaging

Yueh-Hsun Tsai; Guo-Shu Huang; Chi-Tun Tang; Wei-Chou Chang; Yi-Chih Hsu

doi:10.3389/fmed.2022.860545

Case Report: Nerve Root Entrapment Due to Epidural Fibrosis in a Patient With Failed Back Surgery Syndrome: Value of 2-¹⁸F-Fluorodeoxyglucose Simultaneous Positron Emission Tomography-Magnetic Resonance Imaging

Front Med (Lausanne). 2022 Apr 25:9:860545. doi: 10.3389/fmed.2022.860545. eCollection 2022.

Authors

Yueh-Hsun Tsai¹, Guo-Shu Huang^{2

3}, Chi-Tun Tang⁴, Wei-Chou Chang², Yi-Chih Hsu²

Affiliations

¹ Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.
² Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.
³ Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.
⁴ Department of Neurosurgery, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.

Abstract

Failed back surgery syndrome (FBSS) is a highly prevalent condition in patients after spine surgery. Although magnetic resonance imaging (MRI) is the gold standard for the diagnosis of epidural fibrosis, it is sometimes difficult to determine if epidural fibrosis contributes to radiculopathy. Herein, we share our experience in locating radiculopathy lesions using simultaneous positron emission tomography (PET)/MRI. 2-[¹⁸F]-FDG (¹⁸F-fluorodeoxyglucose) simultaneous PET/MRI maps of body glucose metabolism detected using PET can be used to correlate anatomical details provided by MRI to offer a very clear picture of neural inflammation due to extensive epidural fibrosis. More applications of 2-[¹⁸F]-FDG simultaneous PET/MRI in low back pain and other musculoskeletal diseases should be further investigated in the future.

Keywords: case report; epidural fibrosis; failed back surgery syndrome; magnetic resonance imaging; positron emission tomography.

Publication types

Case Reports