SPECT/CT in Differentiation of Pseudarthrosis From Other Causes of Back Pain in Lumbar Spinal Fusion

Rager, Olivier; Schaller, Karl; Payer, Michael; Tchernin, David Laurent; Ratib, Osman; Tessitore, Enrico

doi:10.1097/rlu.0b013e318239248b

Cited by 44 publications

(31 citation statements)

References 19 publications

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“…Damgaard et al [52] performed such a study and indeed showed that this evaluation confirmed the SPECT/CT diagnosis of metal loosening in their sample of nine patients suffering from lower back pain after lumbar instrumentation. Similar data have been published by Rager et al [53]: in their case series of ten patients, all screws deemed loosened on reoperation had corresponding increased tracer uptake on SPECT/CT. In six cases, metabolic activation was found in facet joints that had no CT abnormality, and in three of five subjects SPECT/CT did not confirm the CT diagnosis of nonunion through or around cages.…”

Section: Differential Diagnosis Of Pain Associated With the Musculosksupporting

confidence: 76%

Skeletal SPECT/CT: a review

Kuwert

2014

Clin Transl Imaging

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Skeletal scintigraphy is one of the most frequent in vivo procedures in the field of nuclear medicine. Visualizing bone metabolism, it exhibits a fairly high sensitivity to detect skeletal lesions, but has limitations in terms of specificity and spatial resolution, even when single-photon emission computed tomography (SPECT) is used. Combining SPECT with X-ray computed tomography helps overcome these limitations. This has, in particular, been shown when diagnosing bone involvement in malignant tumors. Emerging evidence indicates the benefit of hybrid imaging for bone scintigraphy during the workup of painful conditions affecting the back and the extremities. Methodological advances holding considerable promise for further improving its value are the quantitation of skeletal tracer uptake in absolute units, as well as multimodal image reconstruction techniques that have recently become available for use in clinical routine.

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Section: Differential Diagnosis Of Pain Associated With the Musculosksupporting

confidence: 76%

Skeletal SPECT/CT: a review

Kuwert

2014

Clin Transl Imaging

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“…These studies suggest that rigid fixation and fusion increase patient satisfaction. However, it was reported that pseudarthrosis may develop in 5-25% of patients who underwent PLF and 50% of patients with pseudarthrosis may be asymptomatic (23). Moreover, it was reported that short-term results of dynamic systems which have been started to be used in degenerative spondylolisthesis in recent times were successful and similar to the results of fixation and PLF (24,25).…”

Section: Discussionmentioning

confidence: 75%

Short and Medium Term Results of Posterior Segmental Instrumentation and Posterolateral Fusion in Female Patients with Spondylolisthesis: A Clinical Trial

Kızılay¹,

Topçu²,

Aydin³

et al. 2018

meandros

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Objective: Aim of this study was to short and medium term results of posterior segmental instrumentation and posterolateral fusion in female patients with spondylolisthesis. Materials and methods:Patients with lumbar sponylolisthesis who were performed convetional laminectomy, poliaxial secrew fixation and posterolateral fusion between the 2013 and 2015. The postoperative fusion of the female patients were evaluated through Lumbar 3D Computed Tomography and X-Ray imaging. The patients' low back pain and lower extremities's pain were evaluated with Oswestry disability index and Visual Analogue Score. Retrospective Patients' information were collected via file in May 2016. Result: When the pain scores of the patients who underwent segmental instrumentation were compared in the preoperative, postoperative periods there was the significant decrease in pain scores (p<0.001). Conclusion:The posterolateral fixation and fusion are an efficient treatment method in the medium and short term in female patients with spondylolisthesis. But, a secondary chronic disease such as osteoporosis associated with aging was added to impair bone quality, fusion success rate was seen to be decreased.

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“…Selon certaines guidelines, la scintigraphie osseuse n'est pas recommandée pour l'évaluation de la fusion osseuse [18], mais ces recommandations se basent sur un seul article déjà ancien et sans acquisition TEMP. Rager et al [19] ont comparé les résultats de scintigraphies osseuses par TEMP/TDM et des scanners de 10 patients. Ils ont montré une bonne sensibilité pour l'évaluation des DMA et des descellements de vis et une bonne spécificité pour la détection des PA inter-somatiques par rapport à la TDM.…”

Section: Discussionunclassified

“…La PA, qui est définie par une nonunion de la greffe 6 mois après l'intervention, est une complication fréquente des arthrodèses [23,24]. Son incidence varie de 5 à 56 % en fonction des séries [19]. Les facteurs de risque pour développer une PA sont l'âge du patient, la présence d'une ostéopénie, le tabagisme actif, la présence d'une infection postopératoire et les traitements par corticoïdes ou AINS [6,19].…”

Section: Les Pseudarthrosesunclassified

“…Son incidence varie de 5 à 56 % en fonction des séries [19]. Les facteurs de risque pour développer une PA sont l'âge du patient, la présence d'une ostéopénie, le tabagisme actif, la présence d'une infection postopératoire et les traitements par corticoïdes ou AINS [6,19]. La TDM avec reconstructions multiplanaires permet la visualisation d'un liseré clair au sein des greffes.…”

Section: Les Pseudarthrosesunclassified

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