Bone SPECT of the back after lumbar surgery

Area of Science:

• Orthopedics
• Radiology
• Spine Surgery

Background:

• Evaluating back pain after spinal surgery is challenging due to potential complications like infection or unstable fusion.
• Symptoms can arise from pre-existing conditions or new issues post-operation.

Purpose of the Study:

• To assess the utility of bone SPECT imaging in diagnosing bony abnormalities in patients with persistent back pain following lumbar spinal surgery.
• To correlate SPECT findings with surgical history and other diagnostic imaging.

Main Methods:

• Bone SPECT examinations were performed on 63 patients with a history of lumbar spinal surgery and back pain.
• Patients had undergone various procedures including laminectomy, fusion, and discectomy.
• SPECT results were correlated with clinical data and diagnostic radiologic studies.

Main Results:

• Bone SPECT successfully excluded bony abnormalities in 7 out of 63 patients.
• 132 lesions were identified, with facet abnormalities (51) and disc space-centered conditions (29) being most common.
• Abnormalities were located in the operative field (60%), above (29%), and below (11%) the surgical site.

Conclusions:

• Bone SPECT is valuable for evaluating post-surgical back pain.
• It can exclude bony lesions and identify specific abnormalities such as pseudarthrosis, facet joint issues, disc space lesions, and sacroiliitis.