%0 Journal Article
%T Correlation of MRI-Evaluated Degenerative Disc Disease with Positivity on Single-Photon Emission Computed Tomography Imaging in Patients with Chronic Low Back Pain.
%A Varga M
%A Štulík J
%A Pivarči F
%A Geri G
%A Malík J
%A Lang O
%A Srikandarajah N
%A Kaiser R
%J World Neurosurg
%V 0
%N 0
%D 2024 Jul 27
%M 39074580
%F 2.21
%R 10.1016/j.wneu.2024.07.163
%X <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.