Single photon emission computed tomography scan

Single photon emission computed tomography (SPECT) combines the virtues of bone scan and computed tomography. It provides axial views of areas of increased uptake of radioisotope. The utility of SPECT scanning in pain medicine, however, is far from demonstrated. For spinal disorders, interobserver agreement is poor,45 and the observed abnormalities lack any correlation with pain. A systematic review cast doubts on the utility of SPECT,46 and subsequent studies have not redressed its shortcomings.

Reports that SPECT scans can identify symptomatic lumbar zygapophysial joint lack foundation. None of the studies used controlled blocks of the purportedly symptomatic joints.47,48 When controlled blocks have been used, SPECT did not correlate with response to blocks.49

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