# Prevalence of Degenerative Spinal Hot Spots on Bone Scintigraphy Among Orthopedic Patients

## TL;DR

This study finds that spinal hot spots on bone scans are common in orthopedic patients and often correlate with spinal symptoms.

## Contribution

The study provides new prevalence data for spinal hot spots in orthopedic patients scanned for non-spinal reasons.

## Key findings

- Spinal hot spots were most prevalent in the lumbar spine (33.3%) and least in the thoracic spine (10%).
- Most cervical and lumbar hot spots were associated with documented spinal symptoms like pain or stiffness.
- Thoracic hot spots showed weaker correlation with clinical complaints.

## Abstract

Purpose: Emerging nuclear imaging technologies are advancing the field of spinal diagnostics for degenerative changes. This study aimed to describe the prevalence of spinal hot spots in an orthopedic population undergoing bone scintigraphy (BS) for reasons unrelated to the spine and to assess the correlation of these hot spots with the presence of corresponding spinal complaints.

Methods: A retrospective analysis of patients from the Department of Orthopedic Surgery and Traumatology who provided general consent for the use of their medical data. Adult patients who underwent single photon emission computed tomography (SPECT) over a two-year period for non-spinal complaints, along with a corresponding whole-body BS, were included. The primary endpoint was the prevalence of degenerative spinal hot spots detectable on BS. The secondary endpoint evaluated clinical complaints recorded in medical records for each spinal region.

Results: Among 30 patients (mean age: 66.1 years; 30% male, 70% female), the prevalence of spinal hot spots on BS was 23.3% (n=7) in the cervical spine, 10% (n=3) in the thoracic spine, 33.3% (n=10) in the lumbar spine, and 6.7% (n=2) in the sacroiliac joint (SIJ). Most patients with cervical and lumbar hot spots had corresponding spinal symptoms, such as pain, tenderness, or stiffness, documented in their medical records, whereas thoracic complaints were less commonly noted.

Conclusion: The study outlines the prevalence of spinal hot spots in various spinal regions among a general orthopedic population undergoing bone scans for non-spinal complaints. A strong correlation was found between spinal complaints and high uptake in the cervical spine and lower back. These findings highlight the added value of comprehensive bone scan evaluations in clinical practice.