Upright radiographs provide useful functional information about axial loading. Flexion and extension radiographs can be used to look for abnormal motion/increased dynamic mobility [50]. SPECT or SPECT/CT are not the initial imaging modality but may be an adjunct in cases of painful pseudoarthrosis or periprosthetic loosening in patients with previous lumbar fusion [51-54]. Bone Scan Whole Body with SPECT or SPECT/CT Complete Spine SPECT or SPECT/CT are not the initial imaging modality but may be an adjunct in cases of painful pseudoarthrosis or periprosthetic loosening in patients with previous lumbar fusion [51-54]. CT Lumbar Spine With IV Contrast CT lumbar spine with IV contrast to is not necessary to evaluate bony fusion and hardware but may be useful to assess for epidural abscess in patients for this clinical scenario and for patients with suspected infection [45-47]. Low Back Pain CT Lumbar Spine Without and With IV Contrast CT lumbar spine without and with IV contrast is not typically performed as there is no diagnostic advantage to performing a single study with or without IV contrast. CT Lumbar Spine Without IV Contrast CT lumbar spine without IV contrast can be helpful in assessing osseous fusion. CT can detect potentially painful hardware failure, including prosthetic loosening, malalignment, or metallic fracture [44]. Additionally, CT lumbar spine without IV contrast is equal to MRI for predicting significant spinal stenosis and excluding cauda equina impingement [27]. CT Myelography Lumbar Spine CT myelography of the lumbar spine can be useful in assessing the patency of the spinal canal/thecal sac and of the subarticular recesses and neural foramen [22]. It has safety advantages over MRI for patients who have implanted medical devices that are not MRI safe or conditional and can be useful in patients with significant artifact from metallic surgical hardware on MRI [23].
Low Back Pain PCAs. Upright radiographs provide useful functional information about axial loading. Flexion and extension radiographs can be used to look for abnormal motion/increased dynamic mobility [50]. SPECT or SPECT/CT are not the initial imaging modality but may be an adjunct in cases of painful pseudoarthrosis or periprosthetic loosening in patients with previous lumbar fusion [51-54]. Bone Scan Whole Body with SPECT or SPECT/CT Complete Spine SPECT or SPECT/CT are not the initial imaging modality but may be an adjunct in cases of painful pseudoarthrosis or periprosthetic loosening in patients with previous lumbar fusion [51-54]. CT Lumbar Spine With IV Contrast CT lumbar spine with IV contrast to is not necessary to evaluate bony fusion and hardware but may be useful to assess for epidural abscess in patients for this clinical scenario and for patients with suspected infection [45-47]. Low Back Pain CT Lumbar Spine Without and With IV Contrast CT lumbar spine without and with IV contrast is not typically performed as there is no diagnostic advantage to performing a single study with or without IV contrast. CT Lumbar Spine Without IV Contrast CT lumbar spine without IV contrast can be helpful in assessing osseous fusion. CT can detect potentially painful hardware failure, including prosthetic loosening, malalignment, or metallic fracture [44]. Additionally, CT lumbar spine without IV contrast is equal to MRI for predicting significant spinal stenosis and excluding cauda equina impingement [27]. CT Myelography Lumbar Spine CT myelography of the lumbar spine can be useful in assessing the patency of the spinal canal/thecal sac and of the subarticular recesses and neural foramen [22]. It has safety advantages over MRI for patients who have implanted medical devices that are not MRI safe or conditional and can be useful in patients with significant artifact from metallic surgical hardware on MRI [23].