Correlation of99mTc-DPD SPECT/CT Scan Findings and Diagnostic Blockades of Lumbar Medial Branches in Patients with Unspecific Low Back Pain in a Randomized-Controlled Trial
| العنوان: | Correlation of99mTc-DPD SPECT/CT Scan Findings and Diagnostic Blockades of Lumbar Medial Branches in Patients with Unspecific Low Back Pain in a Randomized-Controlled Trial |
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| المؤلفون: | Stefan Schaeren, Armin Aeschbach, Denis Bilecen, Augustinus Ludwig Jacob, David Freiermuth, Martin Kretzschmar, Wilhelm Ruppen |
| المصدر: | Pain Medicine. 16:1916-1922 |
| بيانات النشر: | Oxford University Press (OUP), 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Statistics as Topic, Zygapophyseal Joint, Placebo, Multimodal Imaging, Sensitivity and Specificity, law.invention, Lumbar, Randomized controlled trial, law, medicine, Humans, Single-Blind Method, Aged, Pain Measurement, Aged, 80 and over, Tomography, Emission-Computed, Single-Photon, Lumbar Vertebrae, Diphosphonates, medicine.diagnostic_test, business.industry, Reproducibility of Results, Nerve Block, Organotechnetium Compounds, General Medicine, Odds ratio, Infant, Low Birth Weight, Middle Aged, Placebo Effect, Denervation, Low back pain, Confidence interval, Treatment Outcome, Anesthesiology and Pain Medicine, Female, Neurology (clinical), Radiology, Radiopharmaceuticals, medicine.symptom, Tomography, X-Ray Computed, business, Low Back Pain, Emission computed tomography |
| الوصف: | Objective Zygapophyseal joints are the origin of pain in up to 30% of those with unspecific chronic low back pain. Until recently, no reliable clinical tests have been found to identify the patients who would benefit from denervation of the zygapophyseal joints by medial branch blockades. Design We performed a prospective randomized placebo-controlled trial to evaluate the value of high-resolution single-photon emission computed tomography (SPECT)/computed tomography (CT) of the lumbar spine prior to any diagnostic infiltration of the medial branches. Methods Patients with suspected zygapophyseal joint-related pain were included in the study. After obtaining a SPECT/CT scan of the lumbar spine a set of infiltrations of the medial branches was done with local anesthetics and placebo on different days. Patients and anesthetists were blinded to the results of SPECT/CT and to the infiltrated agents. Results In a total of 29 study patients, 7 had positive and 22 negative infiltration tests, and 9 had positive and 20 negative SPECT/CT findings. Sensitivity of SPECT/CT for a positive response after diagnostic infiltration was 0.57 (95% confidence interval [CI] 0.18–0.90); specificity was 0.77 (CI 95% 0.55–0.92); odds ratio was 4.53 (CI 95% 0.75–27.40); and diagnostic accuracy was 0.72. Conclusion Compared with diagnostic infiltrations SPECT/CT scans showed only a moderate sensitivity and specificity and, therefore, may not be recommended as a first line diagnostic tool prior to diagnostic infiltrations. |
| تدمد: | 1526-4637 1526-2375 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::83f575118e7b716a142db3af73d4142a https://doi.org/10.1111/pme.12841 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....83f575118e7b716a142db3af73d4142a |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15264637 15262375 |
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