SPECT-CT Assessment of Pseudarthrosis after Spinal Fusion: Diagnostic Pitfall due to a Broken Screw

Olivier Rager; Gaël Amzalag; Arthur Varoquaux; Karl Schaller; Osman Ratib; Enrico Tessitore

doi:10.1155/2013/502517

Case Reports in Orthopedics (Jan 2013)

SPECT-CT Assessment of Pseudarthrosis after Spinal Fusion: Diagnostic Pitfall due to a Broken Screw

Olivier Rager,
Gaël Amzalag,
Arthur Varoquaux,
Karl Schaller,
Osman Ratib,
Enrico Tessitore

Affiliations

Olivier Rager: Nuclear Medicine Department, Geneva University Medical Center, Faculty of Medicine, University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland
Gaël Amzalag: Nuclear Medicine Department, Geneva University Medical Center, Faculty of Medicine, University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland
Arthur Varoquaux: Department of Radiology, Geneva University Medical Center, Faculty of Medicine, University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland
Karl Schaller: Department of Neurosurgery, Geneva University Medical Center, Faculty of Medicine, University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland
Osman Ratib: Nuclear Medicine Department, Geneva University Medical Center, Faculty of Medicine, University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland
Enrico Tessitore: Department of Neurosurgery, Geneva University Medical Center, Faculty of Medicine, University of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland

DOI: https://doi.org/10.1155/2013/502517
Journal volume & issue: Vol. 2013

Abstract

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A 43-year-old drug addicted female was referred for a L5-S1 posterolateral in situ fixation with autologous graft because of an L5/S1 severe discopathy with listhesis. After six months, low back pain recurred. A Tc-99m HDP SPECT-CT diagnosed a pseudarthrosis with intense uptake of the L5-S1 endplates and a fracture of the right S1 screw just outside the metal-bone interface without any uptake or bone resorption around the screw. The absence of uptake around a broken screw is a pitfall that the physician should be aware of.

Published in Case Reports in Orthopedics

ISSN: 2090-6749 (Print); 2090-6757 (Online)
Publisher: Hindawi Limited
Country of publisher: United Kingdom
LCC subjects: Medicine: Surgery: Orthopedic surgery
Website: https://onlinelibrary.wiley.com/journal/9192

About the journal