The findings by a research group from Prague, Czech Republic, led by Dr. Radek Kaiser have revealed the potential of SPECT/CT in identifying pain sources in patients with degenerative spine disease.
Published in Acta Neurochirurgica (1), the study reports significant improvements in pain and disability among patients undergoing spinal fusion for SPECT/CT-positive lumbar degenerative disc disease.
“Our findings suggest that SPECT/CT could be a valuable tool for differentiating patients with unclear MRI findings who might benefit from surgical treatment,” said Dr. Kaiser. This research underscores the importance of precise diagnostic tools in enhancing treatment outcomes for spinal degeneration.
Improving diagnostic accuracy
The team conducted a systematic review (2) assessing the diagnostic accuracy and effectiveness of SPECT/CT imaging for neck and back pain caused by degenerative disc disease or facet arthropathy. “We found that SPECT/CT was more accurate than MRI in diagnosing facet arthropathy,” Dr. Kaiser noted. “It was also more effective in guiding treatment decisions.” This review highlights SPECT/CT’s role in improving diagnostic precision and clinical communication.
Correlating MRI and SPECT/CT findings
In a recent study (3), the team examined the correlation between MRI findings and SPECT/CT positivity in chronic low back pain patients. The results indicated a strong correlation between SPECT/CT positivity and higher classifications of degenerative changes. However, not all severely affected segments showed positivity on SPECT, suggesting that SPECT may only identify the “active” degeneration causing pain. “This study supports SPECT/CT as a valuable tool in managing degenerative spine disease,” said Dr. Kaiser. By providing additional functional data, SPECT/CT enhances the understanding of pain mechanisms, aiding in tailored treatment plans.
Guiding spinal fusion surgery
The SPINUS I study (1) demonstrated the effectiveness of SPECT/CT in guiding spinal fusion surgeries. By precisely identifying pain generators, SPECT/CT allows for more targeted surgical interventions. The study reported significant improvements in pain and disability scores, with high patient satisfaction. The mean preoperative visual analogue scale (VAS) score of 8.4 decreased to 3.2 (p<0.001) and the mean preoperative Oswestry Disability Index (ODI) of 51.5 improved to 20.7 (p<0.001) at a 2-year follow-up. A minimum clinically important difference (30% reduction in VAS and ODI) was achieved in 84.2% of patients. “Using SPECT/CT to guide spinal fusion surgeries has significantly improved patient outcomes,” stated Dr. Kaiser.
Future implications for spinal health
This research is paving the way for advanced diagnostics and treatments for degenerative spine conditions. Integrating SPECT/CT into clinical practice provides more accurate diagnoses and personalized treatments, improving the quality of life for patients worldwide.
References
- Kaiser R, Varga M, Lang O, Waldauf P, Vaněk P, Saur K, Beneš V, Netuka D. The effectiveness of lumbar fusion in one-level SPECT/CT positive degenerative disc disease: The SPINUS I Study. Acta Neurochir. 2023; 165(9): 2633–2640.
- Varga M, Kantorová L, Langaufová A, Štulík J, Lančová L, Srikandarajah N, Kaiser R. Role of Single-Photon Emission Computed Tomography imaging in the diagnosis and treatment of chronic neck or back pain caused by spinal degeneration: A systematic review. World Neurosurg. 2023; 173(5):65-78.
- Varga M, Štulík J, Pivarči F, Geri G, Malík J, Lang O, Srikandarajah N, Kaiser R. Correlation of MRI- evaluated degenerative disc disease with positivity on Single-Photon Emission Computed Tomography Imaging in patients with chronic low back pain. World Neurosurg. 2024; e504-e512.
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