Yang Seoyon, Chang Min Cheol
Department of Rehabilitation Medicine, School of Medicine, Ewha Woman's University Seoul Hospital, Seoul, South Korea.
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, South Korea.
J Pain Res. 2025 May 14;18:2453-2458. doi: 10.2147/JPR.S522930. eCollection 2025.
Chronic neck pain is a prevalent condition that significantly impairs quality of life and contributes to disability. The cervical facet joint (CFJ) is a common source of neck pain, and intraarticular (IA) corticosteroid injections are widely utilized for symptom relief. However, accurately predicting treatment outcomes remains challenging. This study aimed to evaluate the utility of bone single-photon emission computed tomography (SPECT) in predicting the therapeutic response to IA corticosteroid injections in patients with CFJ-origin neck pain.
A retrospective analysis was conducted on 102 patients who underwent IA CFJ corticosteroid injections between March 2010 and December 2020. Patients were stratified into two groups based on bone SPECT findings: those with increased CFJ radiotracer uptake (SPECT+ group, n=60) and those without (SPECT- group, n=42). Pain intensity was assessed using the numeric rating scale (NRS) before treatment and at the 1-month follow-up. Treatment success was defined as a ≥50% reduction in NRS scores. Statistical analyses were performed to compare outcomes between groups.
Both the SPECT+ and SPECT- groups exhibited significant pain reduction following IA corticosteroid injection ( < 0.001 for both groups). However, the SPECT+ group demonstrated significantly greater pain relief compared to the SPECT- group at the 1-month follow-up ( = 0.007). Furthermore, the treatment success rate was significantly higher in the SPECT+ group (63.3%) than in the SPECT- group (38.1%) ( = 0.012).
Bone SPECT is a valuable imaging modality for predicting the therapeutic efficacy of IA corticosteroid injections in patients with CFJ-origin neck pain. The findings suggest that increased CFJ radiotracer uptake is associated with a greater likelihood of achieving significant pain relief, underscoring the potential role of inflammation in treatment response.
慢性颈部疼痛是一种普遍存在的疾病，严重影响生活质量并导致残疾。颈椎小关节（CFJ）是颈部疼痛的常见来源，关节内（IA）注射皮质类固醇被广泛用于缓解症状。然而，准确预测治疗结果仍然具有挑战性。本研究旨在评估骨单光子发射计算机断层扫描（SPECT）在预测CFJ源性颈部疼痛患者IA皮质类固醇注射治疗反应中的效用。
对2010年3月至2020年12月期间接受IA CFJ皮质类固醇注射的102例患者进行回顾性分析。根据骨SPECT检查结果将患者分为两组：CFJ放射性示踪剂摄取增加的患者（SPECT+组，n=60）和未增加的患者（SPECT-组，n=42）。在治疗前和1个月随访时使用数字评分量表（NRS）评估疼痛强度。治疗成功定义为NRS评分降低≥50%。进行统计分析以比较两组之间的结果。
IA皮质类固醇注射后，SPECT+组和SPECT-组的疼痛均显著减轻（两组均P<0.001）。然而，在1个月随访时，SPECT+组的疼痛缓解明显大于SPECT-组（P=0.007）。此外，SPECT+组的治疗成功率（63.3%）显著高于SPECT-组（38.1%）（P=0.012）。
骨SPECT是预测CFJ源性颈部疼痛患者IA皮质类固醇注射治疗效果的一种有价值的成像方式。研究结果表明，CFJ放射性示踪剂摄取增加与实现显著疼痛缓解的可能性更大相关，强调了炎症在治疗反应中的潜在作用。
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