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SPECT-CT Assessment of Pseudarthrosis after Spinal Fusion: Diagnostic Pitfall due to a Broken Screw
Olivier Rager1, Gaël Amzalag, Arthur Varoquaux
1Nuclear Medicine Department, Geneva University Medical Center, Faculty of Medicine, University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland.
Abstract:
A 43-year-old drug addicted female was referred for a L5-S1 posterolateral in situ fixation with autologous graft because of an L5/S1 severe discopathy with listhesis. After six months, low back pain recurred. A Tc-99m HDP SPECT-CT diagnosed a pseudarthrosis with intense uptake of the L5-S1 endplates and a fracture of the right S1 screw just outside the metal-bone interface without any uptake or bone resorption around the screw. The absence of uptake around a broken screw is a pitfall that the physician should be aware of.
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