SPECT/CT Use as an Indicator of Low-Grade Infection in the Spine: Report of Two Cases

Low back pain is one of the most common pathologies worldwide. When conservative treatment fails to yield good results, surgery is the recommended approach. Despite spinal fusion, some patients continue to experience persistent low back pain. This is where a series of studies come into play to detect the source of treatment failure. The use of bone scintigraphy with SPECT (single-photon emission computed tomography) in combination with computed tomography (CT) has greatly improved the anatomical localization of abnormalities found in SPECT. While pseudoarthrosis is a significant cause of spinal fusion failure, in recent years, it has been observed that certain low-virulence pathogens are also implicated in persistent low back pain. This is the focus of our study, in which we identified two patients with persistent low back pain after surgery, both of whom tested positive for chronic low-grade infection using SPECT/CT.