Table 9

Studies evaluating the association between SPECT and PET imaging modalities and facet pain

Author, yearPatient populationDesignResultsComments
Sawicki et al 20179210 pts with suspected cervical facet joint painRetrospective case–controlF-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 MBBCT-guided MBB done with 3 mL of LA and steroid.
Pain did not decrease in PET-negative pts
Lehman et al 20149074 pts with SPECT/CT scan of the cervical spine who underwent IA facet joint injection or dual comparative MBBRetrospective18 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 treatment103 of 195 (53%) active facet joint(s) observed on SPECT/CT did not correlate with clinical findings
Matar et al 20138972 pts with clinically suspected facet-mediated neck and back pain and non-conclusive MRI/CT findingsRetrospectiveAmong the 24 cervical SPECT-CT scans, 13 (52%) had evidence of active cervical facet joint arthropathy and 10 (36%) demonstrated other pathologyNo correlation with outcomes from IA facet joint blocks
Perez-Roman et al 2020414190 pts with axial neck (n=25) or back pain underwent high-resolution SPECT/CT scanRetrospectiveA 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 hypermetabolismDiagnostic 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.