Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: SPECT/CT imaging of the lumbar spine in chronic low back pain: a case report. | Carstensen et al. Chiropractic Manual Therapies 2011 19 2 http content 19 1 2 CHIROPRACTIC MANUAL THERAPIES C MT CASE REPORT Open Access SPECT CT imaging of the lumbar spine in chronic low back pain a case report Michael H Carstensen Mashael Al-Harbi Jean-Luc Urbain Tarik-Zine Belhocine Abstract Mechanical low back pain is a common indication for Nuclear Medicine imaging. Whole-body bone scan is a very sensitive but poorly specific study for the detection of metabolic bone abnormalities. The accurate localisation of metabolically active bone disease is often difficult in 2D imaging but single photon emission computed tomography computed tomography SPECT CT allows accurate diagnosis and anatomic localisation of osteoblastic and osteolytic lesions in 3D imaging. We present a clinical case of a patient referred for evaluation of chronic lower back pain with no history of trauma spinal surgery or cancer. Planar whole-body scan showed heterogeneous tracer uptake in the lumbar spine with intense localisation to the right lateral aspect of L3. Integrated SPECT CT of the lumbar spine detected active bone metabolism in the right L3 L4 facet joint in the presence of minimal signs of degenerative osteoarthrosis on CT images while a segment demonstrating more gross degenerative changes was more quiescent with only mild tracer uptake. The usefulness of integrated SPECT CT for anatomical and functional assessment of back pain opens promising opportunities both for multi-disciplinary clinical assessment and treatment for manual therapists and for research into the effectiveness of manual therapies. Background The concept of lumbar facet joints causing or contributing to mechanical low back pain syndromes has been debated in the health care literature for decades 1 . Practitioners of the various manual therapies commonly treat patients presenting with low back pain but are faced with the diagnostic challenge of trying to identify a tissue source of low back pain. While
