Abstract：
OBJECTIVE: Chronic low back pain, affecting up to 58% of the population, often stems from intervertebral disc degeneration. Although magnetic resonance imaging (MRI) is commonly used for diagnostics, challenges arise in pinpointing pain sources due to frequent asymptomatic findings. Single-photon emission tomography (SPECT) integrated with computed tomography (CT) offers a promising approach, enhancing sensitivity and specificity.
METHODS: In this retrospective study, spanning 2016 to 2022, SPECT/CT imaging was performed on 193 patients meeting specific criteria. We correlated SPECT/CT findings with lumbar MRI results, utilizing Pfirrmann and Rajasekaran classifications for disc degeneration and endplate damage assessment. Logistic regression analysis adjusted for age and sex evaluated associations.
RESULTS: Of 965 spinal levels assessed, SPECT/CT positivity strongly correlated with higher Pfirrmann grades and Rajasekaran endplate classifications. Notably, Modic changes (MCs) on MRI displayed a nonsignificant relationship with SPECT/CT positivity. Significant associations were observed in older patients with positive MCs, Pfirrmann grades, and Rajasekaran classifications.
CONCLUSIONS: This comprehensive study, the largest of its kind, establishes a significant link between SPECT/CT positivity and advanced lumbar degenerative changes. Higher Pfirrmann grades and increased Rajasekaran endplate damage demonstrated substantial correlations with SPECT/CT positivity. Notably, MCs did not exhibit such association. Our findings underscore the potential of SPECT/CT in identifying pain generators in degenerative spinal conditions, offering valuable insights for future interventions.
METHODS: In this retrospective study, spanning 2016 to 2022, SPECT/CT imaging was performed on 193 patients meeting specific criteria. We correlated SPECT/CT findings with lumbar MRI results, utilizing Pfirrmann and Rajasekaran classifications for disc degeneration and endplate damage assessment. Logistic regression analysis adjusted for age and sex evaluated associations.
RESULTS: Of 965 spinal levels assessed, SPECT/CT positivity strongly correlated with higher Pfirrmann grades and Rajasekaran endplate classifications. Notably, Modic changes (MCs) on MRI displayed a nonsignificant relationship with SPECT/CT positivity. Significant associations were observed in older patients with positive MCs, Pfirrmann grades, and Rajasekaran classifications.
CONCLUSIONS: This comprehensive study, the largest of its kind, establishes a significant link between SPECT/CT positivity and advanced lumbar degenerative changes. Higher Pfirrmann grades and increased Rajasekaran endplate damage demonstrated substantial correlations with SPECT/CT positivity. Notably, MCs did not exhibit such association. Our findings underscore the potential of SPECT/CT in identifying pain generators in degenerative spinal conditions, offering valuable insights for future interventions.
摘要：
目标：慢性下腰痛（CLBP），影响了高达58%的人口，常源于椎间盘退变。尽管磁共振成像（MRI）通常用于诊断，由于频繁的无症状发现,在确定疼痛来源方面出现了挑战.单光子发射断层扫描（SPECT）与计算机断层扫描（CT）集成提供了一种有前途的方法，增强敏感性和特异性。
方法：在这项回顾性研究中，从2016年到2022年,我们对符合特定标准的193例患者进行了SPECT/CT成像.我们将SPECT/CT结果与腰椎MRI结果相关联，利用Pfirrmann和Rajasekaran分类进行椎间盘退变和终板损伤评估。Logistic回归分析校正了年龄和性别评估的关联。
结果：在评估的965个脊柱水平中，SPECT/CT阳性与较高的Pfirrmann等级和Rajasekaran终板分类密切相关。值得注意的是,MRI上的Modic变化与SPECT/CT阳性无关。在Modic变化呈阳性的老年患者中观察到显着的关联，Pfirrmann成绩,和Rajasekaran分类。
结论：这项综合研究，同类中最大的，在SPECT/CT阳性与晚期腰椎退行性改变之间建立了重要联系。较高的Pfirrmann等级和增加的Rajasekaran终板损伤表明与SPECT/CT阳性具有实质性相关性。值得注意的是,Modic变化没有表现出这种关联。我们的发现强调了SPECT/CT在确定退行性脊柱疾病中疼痛发生器的潜力，为未来的干预提供有价值的见解。
方法：在这项回顾性研究中，从2016年到2022年,我们对符合特定标准的193例患者进行了SPECT/CT成像.我们将SPECT/CT结果与腰椎MRI结果相关联，利用Pfirrmann和Rajasekaran分类进行椎间盘退变和终板损伤评估。Logistic回归分析校正了年龄和性别评估的关联。
结果：在评估的965个脊柱水平中，SPECT/CT阳性与较高的Pfirrmann等级和Rajasekaran终板分类密切相关。值得注意的是,MRI上的Modic变化与SPECT/CT阳性无关。在Modic变化呈阳性的老年患者中观察到显着的关联，Pfirrmann成绩,和Rajasekaran分类。
结论：这项综合研究，同类中最大的，在SPECT/CT阳性与晚期腰椎退行性改变之间建立了重要联系。较高的Pfirrmann等级和增加的Rajasekaran终板损伤表明与SPECT/CT阳性具有实质性相关性。值得注意的是,Modic变化没有表现出这种关联。我们的发现强调了SPECT/CT在确定退行性脊柱疾病中疼痛发生器的潜力，为未来的干预提供有价值的见解。
