Journal of Palliative Care & Medicine
Open Access

Abstract

Background: Success of interventional procedures for LBP management is dependent on a thorough history, clinical examination and assessment of radiological investigations. Quite frequently the structures that show abnormal morphology may not be the cause of LBP. This discord between the interpretation of diagnostic anatomical imaging with CT, MRI and clinical examination often leads to wrong diagnosis in turn resulting in failure of procedures. We wished to evaluate the role of Functional imaging in the form of bone scan along with SPECT/CT in management of patients of low back pain. Methods: Study was performed after approval from institutional ethics committee. 80 consecutive adults, 20-80 years, ASA physical status I and II, were randomised into 2 groups of 40 each i.e. bone scan and control groups. Based on the clinical features and radiological findings a clinical diagnosis was made. Following clinical diagnosis patients in bone scan group were subjected to bone scan and SPECT/CT and a new working diagnosis was made and interventions performed accordingly. Diagnostic blocks were performed with local anesthetic. Results: In both the groups, sacroilitis was the common diagnosis followed by L4-5 facet joint and the L5S1 facet joints. The number of patients obtaining pain relief of more than 50% was significantly higher in the bone scan group as compared to the control group. Conclusion: Inclusion of SPECT /CT in low back pain management protocol helps in minimizing the number of diagnostic blocks needed to identify the etiology of the LBP.

Biography

Anil Agarwal has completed his MBBS from Bundelkhand University and Post-doctoral studies from Bundelkhand University. He is the Director of Pain and Palliative Care division at Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India, a tertiary care hospital in north of India. He has published more than 150 papers in reputed journals and has been serving as an Editorial Board Member of repute.

Email: anil_sgpgi@hotmail.com