Department of Clinical Physiology and Nuclear Medicine, Hvidovre Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Clin Nucl Med. 2010 Apr;35(4):234-6. doi: 10.1097/RLU.0b013e3181d18cdd.
It is difficult to evaluate the stability of the lumbar spondylodesis with metallic fixation devices by conventional imaging methods such as radiography or magnetic resonance imaging. It is unknown whether single photon emission computed tomography/computed tomography (SPECT/CT) may be useful to detect a lack of fixation of the pedicle screws and hence to predict instability of the fused vertebral segments.
A retrospective analysis of 9 patients who were referred to bone scintigraphy, including combined SPECT/CT, due to persistent pain or discomfort after stabilizing lumbar surgery with metallic implants. The SPECT/CT findings were compared with observations from subsequent surgical reexploration.
In 6 of 9 patients, the SPECT/CT fully or partially detected the vertebral level of loose pedicle screws. Of 9 cases, 2 were considered inconclusive, whereas in 1 case loose pedicle screws were detected at a wrong vertebral level.
SPECT/CT may be useful to detect a lack of fixation of the metallic implants, and hence instability of the spondylodesis by evaluating the focal bone mineralization activity in relation to the pedicle screws.
通过传统的影像学方法，如 X 线摄影或磁共振成像，难以评估金属固定装置的腰椎融合稳定性。目前尚不清楚单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）是否可用于检测椎弓根螺钉固定缺失，从而预测融合节段的不稳定性。
对 9 例因金属植入物稳定腰椎手术后持续疼痛或不适而转诊行骨闪烁显像，包括 SPECT/CT 检查的患者进行回顾性分析。将 SPECT/CT 检查结果与后续手术探查的观察结果进行比较。
在 9 例患者中，6 例 SPECT/CT 完全或部分检测到松动的椎弓根螺钉的椎体水平。9 例中，2 例结果不确定，1 例则错误地检测到松动的椎弓根螺钉位于错误的椎体水平。
SPECT/CT 可用于通过评估与椎弓根螺钉相关的局部骨矿物质化活性来检测金属植入物的固定缺失，从而检测融合术的不稳定性。
