The value of nuclear medicine for the diagnosis of spine diseases

Nuclear medicine examinations hold an important position in the diagnosis of diseases of the spine. During the las decade, decisive progress has been made in the field of instrumentation and radiopharmaceutical techniques: the use of high resolution collimators and the introduction of emission computer tomography as examples of improved instrumentation as well as 99m-Technetium red blood cell labelling as a new radiopharmaceutical technique. These present some of the developments responsible for the growing importance of scintigraphical diagnosis. Inflammatory processes of the vertebrae and the surrounding soft tissues can be detected or excluded with high reliability by the use of radionuclide-labelled granulocytes. The important role of bone scintigraphy in the differential diagnosis of neoplastic bone disease relies on its high sensitivity combined with the quantitative analysis of increased bone metabolism. Furthermore, it provides exact information about the extent and a possible metastatic spread of bone tumours. In the field of orthopaedy and surgery, skeletal scintigraphy is of growing importance as a highly sensitive procedure in the detection of special traumatic lesions such as acute vertebral compression fractures and in the follow-up of patients after bone surgical interventions. Despite the progress of other imaging modalities such as computer tomography and magnetic resonance imaging, nuclear medicine today is well-established in the assessment of diseases of the vertebral column. Among all scintigraphical diagnostic procedures, bone scintigraphy and the different techniques of inflammation imaging are of special importance.