Pendleton James, Ng Andrew
Jefferson Pain Center, Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
Curr Pain Headache Rep. 2023 Nov;27(11):729-735. doi: 10.1007/s11916-023-01177-4. Epub 2023 Oct 14.
The purpose of this review is to evaluate the role of SPECT/CT in identifying facet joint arthropathy and the outcomes of interventions with SPECT/CT as an adjunct.
A positive finding of facet arthropathy on SPECT/CT is associated with a higher likelihood of a unilateral procedure and a significantly more effective intervention compared with those performed on patients with facet arthropathy diagnosed only by clinical and/or radiologic examination. Surgical treatment of SPECT/CT-positive findings appears to have a good effect; however, due to limitations in the available studies, no strong conclusion can be drawn. SPECT/CT has a good correlation identifying pain generators in chronic neck and back pain. SPECT/CT-targeted facet interventions demonstrate a higher success rate, but SPECT/CT is not recommended as a first-line diagnostic tool prior to diagnostic facet interventions. More robust studies are needed to confirm the higher success of surgical treatment for SPECT/CT-positive facet arthropathy.
本综述旨在评估单光子发射计算机断层扫描/计算机断层扫描(SPECT/CT)在识别小关节病中的作用以及以SPECT/CT作为辅助手段的干预效果。
与仅通过临床和/或放射学检查诊断为小关节病的患者相比,SPECT/CT上小关节病的阳性发现与单侧手术的可能性更高以及干预效果显著更有效相关。对SPECT/CT阳性结果进行手术治疗似乎有良好效果;然而,由于现有研究存在局限性,无法得出强有力的结论。SPECT/CT在识别慢性颈痛和背痛的疼痛根源方面具有良好的相关性。以SPECT/CT为靶点的小关节干预显示出更高的成功率,但在诊断性小关节干预之前,不建议将SPECT/CT作为一线诊断工具。需要更有力的研究来证实对SPECT/CT阳性小关节病进行手术治疗具有更高的成功率。