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The value of SPECT in the detection of stress injury to the pars interarticularis in patients with low back pain

Authors :
Grant Frederick D
Curtis Christine
Zukotynski Katherine
Micheli Lyle
Treves S Ted
Source :
Journal of Orthopaedic Surgery and Research, Vol 5, Iss 1, p 13 (2010)
Publication Year :
2010
Publisher :
BMC, 2010.

Abstract

Abstract The medical cost associated with back pain in the United States is considerable and growing. Although the differential diagnosis of back pain is broad, epidemiological studies suggest a correlation between adult and adolescent complaints. Injury of the pars interarticularis is one of the most common identifiable causes of ongoing low back pain in adolescent athletes. It constitutes a spectrum of disease ranging from bone stress to spondylolysis and spondylolisthesis. Bone stress may be the earliest sign of disease. Repetitive bone stress causes bone remodeling and may result in spondylolysis, a non-displaced fracture of the pars interarticularis. A fracture of the pars interarticularis may ultimately become unstable leading to spondylolisthesis. Results in the literature support the use of bone scintigraphy to diagnose bone stress in patients with suspected spondylolysis. Single photon emission computed tomography (SPECT) provides more contrast than planar bone scintigraphy, increases the sensitivity and improves anatomic localization of skeletal lesions without exposing the patient to additional radiation. It also provides an opportunity for better correlation with other imaging modalities, when necessary. As such, the addition of SPECT to standard planar bone scintigraphy can result in a more accurate diagnosis and a better chance for efficient patient care. It is our expectation that by improving our ability to correctly diagnose bone stress in patients with suspected injury of the posterior elements, the long-term cost of managing this condition will be lowered.

Details

Language :
English
ISSN :
1749799X
Volume :
5
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Journal of Orthopaedic Surgery and Research
Publication Type :
Academic Journal
Accession number :
edsdoj.5975d04dbfd04a80ba51dddf2e8bc20e
Document Type :
article
Full Text :
https://doi.org/10.1186/1749-799X-5-13