Abstract：
METHODS: Retrospective Cohort Study.
OBJECTIVE: Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) is emerging as a valuable imaging test for identifying pain generators within the lumbar spine. The relationship between radiotracer uptake on SPECT/CT and anatomic biomechanical parameters has not been previously studied.
METHODS: We performed a retrospective review of all patients seen at our institution between 2021-2023 who obtained SPECT/CT scans for workup of thoracolumbar back pain. Patient data including demographic, clinical symptoms, and surgical history were collected. Radiology reports were reviewed for evidence of pathologic degeneration and increased bone metabolism on SPECT/CT. Biomechanical parameters were measured from standing scoliosis plain radiographs. Patients were stratified into two cohorts by either presence or absence of asymmetric coronal uptake on SPECT/CT.
RESULTS: 160 patients met inclusion criteria. Patients were primarily male (55%) with average age 55 ± 15 years. 87 (54%) patients demonstrated asymmetric uptake on SPECT/CT. These patients were older (P < 0.001), but with similar gender, prior fusion history, sacroiliitis, adjacent segment degeneration, and pseudoarthrosis (P > 0.05). This cohort had more disc disease, facet arthropathy, and greater degree of coronal scoliosis and coronal imbalance (P < 0.001). There were significantly more sites of uptake in the asymmetric cohort, and uptake was preferentially observed in the concavity of the lumbar curve (P < 0.001). There were no significant differences in sagittal balance or spinopelvic mismatch between cohorts (P > 0.05).
CONCLUSIONS: Asymmetric uptake on SPECT/CT was associated with coronal deformity in patients with low back pain. Further prospective studies are warranted to assess the effect of coronal deformity on pain generation.
OBJECTIVE: Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) is emerging as a valuable imaging test for identifying pain generators within the lumbar spine. The relationship between radiotracer uptake on SPECT/CT and anatomic biomechanical parameters has not been previously studied.
METHODS: We performed a retrospective review of all patients seen at our institution between 2021-2023 who obtained SPECT/CT scans for workup of thoracolumbar back pain. Patient data including demographic, clinical symptoms, and surgical history were collected. Radiology reports were reviewed for evidence of pathologic degeneration and increased bone metabolism on SPECT/CT. Biomechanical parameters were measured from standing scoliosis plain radiographs. Patients were stratified into two cohorts by either presence or absence of asymmetric coronal uptake on SPECT/CT.
RESULTS: 160 patients met inclusion criteria. Patients were primarily male (55%) with average age 55 ± 15 years. 87 (54%) patients demonstrated asymmetric uptake on SPECT/CT. These patients were older (P < 0.001), but with similar gender, prior fusion history, sacroiliitis, adjacent segment degeneration, and pseudoarthrosis (P > 0.05). This cohort had more disc disease, facet arthropathy, and greater degree of coronal scoliosis and coronal imbalance (P < 0.001). There were significantly more sites of uptake in the asymmetric cohort, and uptake was preferentially observed in the concavity of the lumbar curve (P < 0.001). There were no significant differences in sagittal balance or spinopelvic mismatch between cohorts (P > 0.05).
CONCLUSIONS: Asymmetric uptake on SPECT/CT was associated with coronal deformity in patients with low back pain. Further prospective studies are warranted to assess the effect of coronal deformity on pain generation.
摘要：
方法：回顾性队列研究。
目的：单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）正在成为一种有价值的影像学检查，用于识别腰椎内的疼痛发生器。先前尚未研究过SPECT/CT上的放射性示踪剂摄取与解剖生物力学参数之间的关系。
方法：我们对2021-2023年间在我们机构就诊的所有患者进行了回顾性研究，这些患者获得了SPECT/CT扫描以进行胸腰椎背痛检查。患者数据，包括人口统计，临床症状,收集手术史。在SPECT/CT上对放射学报告进行了审查，以了解病理性变性和骨代谢增加的证据。从站立的脊柱侧凸X线片测量生物力学参数。通过在SPECT/CT上存在或不存在不对称的冠状摄取，将患者分为两组。
结果：160例患者符合纳入标准。患者主要为男性（55％），平均年龄为55±15岁。87例（54％）患者在SPECT/CT上表现出不对称摄取。这些患者年龄较大（P<0.001），但是性别相似，先前的聚变历史，骶髂关节炎,相邻节段变性，假关节(P>0.05)。这个队列有更多的椎间盘疾病，关节面关节病,冠状脊柱侧凸和冠状失衡程度较大(P<0.001)。在不对称队列中有明显更多的摄取位点，在腰椎曲线的凹陷中优先观察到吸收（P<0.001）。两组矢状面平衡和脊柱骨盆不匹配差异无统计学意义(P>0.05)。
结论：下背痛患者SPECT/CT的不对称摄取与冠状畸形相关。需要进一步的前瞻性研究来评估冠状畸形对疼痛产生的影响。
目的：单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）正在成为一种有价值的影像学检查，用于识别腰椎内的疼痛发生器。先前尚未研究过SPECT/CT上的放射性示踪剂摄取与解剖生物力学参数之间的关系。
方法：我们对2021-2023年间在我们机构就诊的所有患者进行了回顾性研究，这些患者获得了SPECT/CT扫描以进行胸腰椎背痛检查。患者数据，包括人口统计，临床症状,收集手术史。在SPECT/CT上对放射学报告进行了审查，以了解病理性变性和骨代谢增加的证据。从站立的脊柱侧凸X线片测量生物力学参数。通过在SPECT/CT上存在或不存在不对称的冠状摄取，将患者分为两组。
结果：160例患者符合纳入标准。患者主要为男性（55％），平均年龄为55±15岁。87例（54％）患者在SPECT/CT上表现出不对称摄取。这些患者年龄较大（P<0.001），但是性别相似，先前的聚变历史，骶髂关节炎,相邻节段变性，假关节(P>0.05)。这个队列有更多的椎间盘疾病，关节面关节病,冠状脊柱侧凸和冠状失衡程度较大(P<0.001)。在不对称队列中有明显更多的摄取位点，在腰椎曲线的凹陷中优先观察到吸收（P<0.001）。两组矢状面平衡和脊柱骨盆不匹配差异无统计学意义(P>0.05)。
结论：下背痛患者SPECT/CT的不对称摄取与冠状畸形相关。需要进一步的前瞻性研究来评估冠状畸形对疼痛产生的影响。
