Table 9.
Studies evaluating the association between SPECT and PET imaging modalities and facet pain
| Author, year | Patient population | Design | Results | Comments |
|---|---|---|---|---|
| Sawicki et al 2017 [92] | 10 pts with suspected cervical facet joint pain | Retrospective case–control | F-FDG PET/MRI was used to determine the location of MBB in 6 pts. Landmarks were used in 4 PET-negative pts. The PET-positive pts had significantly less pain up to 3 months after MBB | CT-guided MBB done with 3 mL of LA and steroid. Pain did not decrease in PET-negative pts |
| Lehman et al 2014 [90] | 74 pts with SPECT/CT scan of the cervical spine who underwent IA facet joint injection or dual comparative MBB | Retrospective | 18 pts received cervical IA facet joint injections and 1 received cervical MBB. 52 pts (70%) had at least one discrepancy between facet joint activity on SPECT/CT and clinical treatment | 103 of 195 (53%) active facet joint(s) observed on SPECT/CT did not correlate with clinical findings |
| Matar et al 2013 [89] | 72 pts with clinically suspected facet-mediated neck and back pain and non-conclusive MRI/CT findings | Retrospective | Among the 24 cervical SPECT-CT scans, 13 (52%) had evidence of active cervical facet joint arthropathy and 10 (36%) demonstrated other pathology | No correlation with outcomes from IA facet joint blocks |
| Perez-Roman et al 2020 [414] | 190 pts with axial neck (n=25) or back pain underwent high-resolution SPECT/CT scan | Retrospective | A total of 202 hypermetabolic facet joints in 85 pts (48%) were identified. Lumbar facet joints were most commonly affected (69%), followed by cervical (24%) and thoracic regions (6%). C1–2 and C2–3 (22% each) were the most commonly affected in the neck. In the 37 pts who reported axial neck pain, 16 (43.2%) were found to have cervical facet hypermetabolism | Diagnostic facet blocks were not performed. Injection techniques were not described |
CT, computed tomography; F-FDG, F-fluorodeoxyglucose; MBB, medial branch block; MRI, magnetic resonance imaging; PET, positron emission tomography; pts, patients; SPECT, single photon emission CT.