. 2021 Nov 11;47(1):3–59. doi: 10.1136/rapm-2021-103031

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 2017⁹²	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 2014⁹⁰	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 2013⁸⁹	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 2020⁴¹⁴	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.