Outcomes Of Intraarticular Corticosteroid Injections into the Cervical Facet Joint Based on Single-Photon Emission Computed Tomography Imaging

Purpose: Chronic neck pain is a prevalent condition that significantly impairs quality of life and contributes to disability. The cervical facet joint (CFJ) is a common source of neck pain, and intraarticular (IA) corticosteroid injections are widely utilized for symptom relief. However, accurately predicting treatment outcomes remains challenging. This study aimed to evaluate the utility of bone single-photon emission computed tomography (SPECT) in predicting the therapeutic response to IA corticosteroid injections in patients with CFJ-origin neck pain. Patients and Methods: A retrospective analysis was conducted on 102 patients who underwent IA CFJ corticosteroid injections between March 2010 and December 2020. Patients were stratified into two groups based on bone SPECT findings: those with increased CFJ radiotracer uptake (SPECT+ group, n=60) and those without (SPECT− group, n=42). Pain intensity was assessed using the numeric rating scale (NRS) before treatment and at the 1-month follow-up. Treatment success was defined as a ≥50% reduction in NRS scores. Statistical analyses were performed to compare outcomes between groups. Results: Both the SPECT+ and SPECT− groups exhibited significant pain reduction following IA corticosteroid injection (P < 0.001 for both groups). However, the SPECT+ group demonstrated significantly greater pain relief compared to the SPECT− group at the 1-month follow-up (P = 0.007). Furthermore, the treatment success rate was significantly higher in the SPECT+ group (63.3%) than in the SPECT− group (38.1%) (P = 0.012). Conclusion: Bone SPECT is a valuable imaging modality for predicting the therapeutic efficacy of IA corticosteroid injections in patients with CFJ-origin neck pain. The findings suggest that increased CFJ radiotracer uptake is associated with a greater likelihood of achieving significant pain relief, underscoring the potential role of inflammation in treatment response.