Diagnostic Value Of SPECT/CT For Lumbar Spondylolysis

BackgroundLow back pain is a common and frequently-occurring disease in the modern society which seriously affect people’s life quality. Its etiology is very complex, among which spondylolysis is one of the very common cause of them but easy to be ignored. In a general population with low back pain the incidence of Lumbar spondylolysis is about 6% ~ 8%, however the incidence of adolescent athletes can be as high as 20%. Using effective imaging method to detect lumbar spondylolysis in early stage and conducting positive intervention treatment can effectively release the symptoms of low back pain, restore normal movement, and rebuilt spinal stability. Currently the diagnostic imaging methods are X ray, lumbar CT, MRI and bone scan. In recent years, the joint use of SPECT/CT in the application of spinal lesions has caused wide public concern. But up to now, there is no research reports of SPECT/CT in the diagnosis of lumbar spondylolysis yet.ObjectiveTo investigate the difference of SPECT, CT and SPECT/CT and to evaluate the value of SPECT/CT in the diagnosis of lumbar spondylolysis. In order to seek the best imaging examination method for clinical diagnosis of lumbar spondylolysis.Materials and Methods58 patients with low back pain received bone scan and SPECT/CT. The data were analyzed by two independent reviewers; SPECT, CT and SPECT/CT images were read respectively. Statistical analysis was performed using χ~2-test.ResultsAt last, 28 cases were diagnosed as lumbar spondylolysis. 30 cases were not diagnosed as lumbar spondylolysis.1. The data of SPECT imaging for the diagnosis of lumbar spondylolysis were as follows: sensitivity 53.6%(15/28), specificity 43.3%(13/30), accuracy 48.3%(28/58), positive predictive value 46.9%(15/32), negative predictive value 50.0%(13/26).2. The data of CT imaging for the diagnosis of lumbar spondylolysis were as follows: sensitivity 78.6%(22/28), specificity 100.0%(30/30), accuracy 89.7%(52/58), positive predictive value 100.0%(22/22), negative predictive value 83.3%(30/36).3. The data of SPECT/CT imaging for the diagnosis of lumbar spondylolysis were as follows: sensitivity 100.0%(28/28), specificity 86.7%(26/30), accuracy 93.1%(54/58), positive predictive value 93.3%(28/30), negative predictive value 100.0%(26/26).4.The diagnostic performance comparison of SPECT/CT and SPECT is that SPECT/CT proved to be more accurate than SPECT(χ~2=28.13,P<0.05). The diagnostic performance comparison of SPECT/CT and CT is that SPECT/CT have no advantage of diagnosis accuracy over CT(χ~2=0.44,P>0.05).ConclusionSPECT/CT bone scan can investigate lumbar spondylolysis in early stage and has a valuable application in evaluation of prognosis. Its advantage is as follows: 1. SPECT/CT fusion imaging improve the diagnostic accuracy of lumbar spondylolysis; 2. SPECT/CT fusion imaging can investigate lumbar spondylolysis in early stage; 3. SPECT/CT fusion imaging can identify symptomatic lumbar spondylolysis; 4. SPECT/CT fusion imaging can guide lumbar spondylolysis treatment and evaluate prognosis.