spectct imaging of the lumbar spine in chronic low back pain a case reportspectct成像腰椎的慢性下腰痛病例报告.pdfVIP

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spectct imaging of the lumbar spine in chronic low back pain a case reportspectct成像腰椎的慢性下腰痛病例报告.pdf

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spectct imaging of the lumbar spine in chronic low back pain a case reportspectct成像腰椎的慢性下腰痛病例报告

Carstensen et al. Chiropractic Manual Therapies 2011, 19:2 /content/19/1/2 CHIROPRACTIC MANUAL THERAPIES CASE REPORT Open Access SPECT/CT imaging of the lumbar spine in chronic low back pain: a case report * Michael H Carstensen , Mashael Al-Harbi, Jean-Luc Urbain, Tarik-Zine Belhocine Abstract Mechanical low back pain is a common indication for Nuclear Medicine imaging. Whole-body bone scan is a very sensitive but poorly specific study for the detection of metabolic bone abnormalities. The accurate localisation of metabolically active bone disease is often difficult in 2D imaging but single photon emission computed tomography/computed tomography (SPECT/CT) allows accurate diagnosis and anatomic localisation of osteoblastic and osteolytic lesions in 3D imaging. We present a clinical case of a patient referred for evaluation of chronic lower back pain with no history of trauma, spinal surgery, or cancer. Planar whole-body scan showed heterogeneous tracer uptake in the lumbar spine with intense localisation to the right lateral aspect of L3. Integrated SPECT/CT of the lumbar spine detected active bone metabolism in the right L3/L4 facet joint in the presence of minimal signs of degenerative osteoarthrosis on CT images, while a segment demonstrating more gross degenerative changes was more quiescent with only mild tracer uptake. The usefulness of integrated SPECT/CT for anatomical and functional assessment of back pain opens promising opportunities both for multi-disciplinary clinical assessment and treatment for manual therapists and for research into the effectiveness of manual therapies. Background subsisted on similar occupations since arriv