Value of Bone Scintigraphy and Single Photon Emission Computed Tomography (SPECT) in Lumbar Facet Disease and Prediction of Short-term Outcome of Ultrasound Guided Medial Branch Block with Bone SPECT

Overview

Journal Korean J Pain

Date 2011 Jul 1

PMID 21716615

Citations 11

Authors

Won Uk Koh

Sung Hoon Kim

Bo Young Hwang

Woo Jong Choi

Jun Gul Song

Jeong Hun Suh

Jeong Gill Leem

Jin Woo Shin

Affiliations

Soon will be listed here.

Abstract

Background: Facet joint disease plays a major role in axial low-back pain. Few diagnostic tests and imaging methods for identifying this condition exist. Single photon emission computed tomography (SPECT) is reported that it has a high sensitivity and specificity in diagnosing facet disease. We prospectively evaluated the use of bone scintigraphy with SPECT for the identification of patients with low back pain who would benefit from medial branch block.

Methods: SPECT was performed on 33 patients clinically suspected of facet joint disease. After SPECT, an ultrasound guided medial branch block was performed on all patients. On 28 SPECT-positive patients, medial branch block was performed based on the SPECT findings. On 5 negative patients, medial branch block was performed based on clinical findings. For one month, we evaluated the patients using the visual analogue scale (VAS) and Oswestry disability index. SigmaStat and paired t-tests were used to analyze patient data and compare results.

Results: Of the 33 patients, the ones who showed more than 50% reduction in VAS score were assigned 'responders'. SPECT positive patients showed a better response to medial branch blocks than negative patients, but no changes in the Oswestry disability index were seen.

Conclusions: SPECT is a sensitive tool for the identification of facet joint disease and predicting the response to medial branch block.

Citing Articles

Association Between MRI Findings of Facet Arthropathy and Synovitis With Health-Related Outcome and Pain Scores Following Therapeutic Lumbar Facet Injections.

Green M, Hal M, Onimus M, Hoffman C, Goyal D, Potigailo V Anesthesiol Res Pract. 2024; 2024:7889539.

PMID: 39464206 PMC: 11511585. DOI: 10.1155/2024/7889539.

Reporting of Facet Joint Inflammation in Lumbar Spine MRI Studies in Patients With Low Back Pain.

Acosta Julbe J, Gottreich J, Ermann J, Isaac Z, DeFilipp M, Andrew M Spine (Phila Pa 1976). 2024; 49(10):733-740.

PMID: 38229507 PMC: 11042993. DOI: 10.1097/BRS.0000000000004923.

Predictors of Outcomes After Lumbar Intra-Articular Facet Joint Injections and Medial Branch Blocks: A Scoping Review.

Acosta Julbe J, Mandell J, Ermann J, Isaac Z, Gottreich J, Zampini J Spine (Phila Pa 1976). 2023; 48(20):1455-1463.

PMID: 37470372 PMC: 10528906. DOI: 10.1097/BRS.0000000000004776.

Low back pain of disc, sacroiliac joint, or facet joint origin: a diagnostic accuracy systematic review.

Han C, Hancock M, Sharma S, Sharma S, Harris I, Cohen S EClinicalMedicine. 2023; 59:101960.

PMID: 37096189 PMC: 10121397. DOI: 10.1016/j.eclinm.2023.101960.

Consensus practice guidelines on interventions for lumbar facet joint pain from a multispecialty, international working group.

Cohen S, Bhaskar A, Bhatia A, Buvanendran A, Deer T, Garg S Reg Anesth Pain Med. 2020; 45(6):424-467.

PMID: 32245841 PMC: 7362874. DOI: 10.1136/rapm-2019-101243.

References

Manchikanti L, Pampati V, Fellows B, Bakhit C . The diagnostic validity and therapeutic value of lumbar facet joint nerve blocks with or without adjuvant agents. Curr Rev Pain. 2000; 4(5):337-44. DOI: 10.1007/s11916-000-0016-4. View

Bogduk N . Diagnosing lumbar zygapophysial joint pain. Pain Med. 2005; 6(2):139-42. DOI: 10.1111/j.1526-4637.2005.05023.x. View

Greher M, Scharbert G, Kamolz L, Beck H, Gustorff B, Kirchmair L . Ultrasound-guided lumbar facet nerve block: a sonoanatomic study of a new methodologic approach. Anesthesiology. 2004; 100(5):1242-8. DOI: 10.1097/00000542-200405000-00028. View

Manchikanti L, Pampati V, Fellows B, Bakhit C . Prevalence of lumbar facet joint pain in chronic low back pain. Pain Physician. 2006; 2(3):59-64. View

Schwarzer A, Wang S, ODriscoll D, Harrington T, Bogduk N, Laurent R . The ability of computed tomography to identify a painful zygapophysial joint in patients with chronic low back pain. Spine (Phila Pa 1976). 1995; 20(8):907-12. DOI: 10.1097/00007632-199504150-00005. View

Pneumaticos S, Chatziioannou S, Hipp J, Moore W, Esses S . Low back pain: prediction of short-term outcome of facet joint injection with bone scintigraphy. Radiology. 2006; 238(2):693-8. DOI: 10.1148/radiol.2382041930. View

Ha D, Shim D, Kim T, Kim Y, Choi S . Comparison of ultrasonography- and fluoroscopy-guided facet joint block in the lumbar spine. Asian Spine J. 2010; 4(1):15-22. PMC: 2900164. DOI: 10.4184/asj.2010.4.1.15. View

Lehman Jr R, Helgeson M, Keeler K, Bunmaprasert T, Riew K . Comparison of magnetic resonance imaging and computed tomography in predicting facet arthrosis in the cervical spine. Spine (Phila Pa 1976). 2009; 34(1):65-8. DOI: 10.1097/BRS.0b013e3181919526. View

Kalichman L, Li L, Kim D, Guermazi A, Berkin V, ODonnell C . Facet joint osteoarthritis and low back pain in the community-based population. Spine (Phila Pa 1976). 2008; 33(23):2560-5. PMC: 3021980. DOI: 10.1097/BRS.0b013e318184ef95. View

10.

Cohen S, Raja S . Pathogenesis, diagnosis, and treatment of lumbar zygapophysial (facet) joint pain. Anesthesiology. 2007; 106(3):591-614. DOI: 10.1097/00000542-200703000-00024. View

11.

Manchikanti L, Singh V, Falco F, Cash K, Pampati V . Evaluation of lumbar facet joint nerve blocks in managing chronic low back pain: a randomized, double-blind, controlled trial with a 2-year follow-up. Int J Med Sci. 2010; 7(3):124-35. PMC: 2880841. DOI: 10.7150/ijms.7.124. View

12.

Carrino J, Lurie J, Tosteson A, Tosteson T, Carragee E, Kaiser J . Lumbar spine: reliability of MR imaging findings. Radiology. 2008; 250(1):161-70. PMC: 2657480. DOI: 10.1148/radiol.2493071999. View

13.

Manchikanti L, Singh V, Pampati V . Are diagnostic lumbar medial branch blocks valid? Results of 2-year follow-up. Pain Physician. 2006; 6(2):147-53. View

14.

Greher M, Kirchmair L, Enna B, Kovacs P, Gustorff B, Kapral S . Ultrasound-guided lumbar facet nerve block: accuracy of a new technique confirmed by computed tomography. Anesthesiology. 2004; 101(5):1195-200. DOI: 10.1097/00000542-200411000-00020. View

15.

Manchikanti L, Pampati V, Fellows B, Baha A . The inability of the clinical picture to characterize pain from facet joints. Pain Physician. 2006; 3(2):158-66. View

16.

Laslett M, Oberg B, Aprill C, McDonald B . Zygapophysial joint blocks in chronic low back pain: a test of Revel's model as a screening test. BMC Musculoskelet Disord. 2004; 5:43. PMC: 534802. DOI: 10.1186/1471-2474-5-43. View

17.

Holder L, Machin J, Asdourian P, Links J, Sexton C . Planar and high-resolution SPECT bone imaging in the diagnosis of facet syndrome. J Nucl Med. 1995; 36(1):37-44. View

18.

Schwarzer A, Aprill C, Derby R, Fortin J, Kine G, Bogduk N . Clinical features of patients with pain stemming from the lumbar zygapophysial joints. Is the lumbar facet syndrome a clinical entity?. Spine (Phila Pa 1976). 1994; 19(10):1132-7. DOI: 10.1097/00007632-199405001-00006. View

19.

Revel M, Poiraudeau S, Auleley G, Payan C, Denke A, Nguyen M . Capacity of the clinical picture to characterize low back pain relieved by facet joint anesthesia. Proposed criteria to identify patients with painful facet joints. Spine (Phila Pa 1976). 1998; 23(18):1972-6; discussion 1977. DOI: 10.1097/00007632-199809150-00011. View

20.

Stojanovic M, Sethee J, Mohiuddin M, Cheng J, Barker A, Wang J . MRI analysis of the lumbar spine: can it predict response to diagnostic and therapeutic facet procedures?. Clin J Pain. 2010; 26(2):110-5. DOI: 10.1097/AJP.0b013e3181b8cd4d. View