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KMID : 1040020220130010036
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International Journal of Pain
2022 Volume.13 No. 1 p.36 ~ p.40
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Single-Photon Emission-Computed Tomography in Detection of Costovertebral Joint Injury after Cervical Spine Surgery: A Case Report
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Ko Byung-Woong
Park Sang-Jun
Kim Ki-Wook
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Abstract
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Costovertebral and costotransverse pain is usually associated with thoracic back pain but is easily underrecognized. A 40-year-old man was diagnosed with myelitis after diagnostic surgery under the impression of a cervical cord tumor. After surgery, the patient experienced thoracic back pain, which worsened one year prior. The symptom was constant and located near inferior scapular angles and flank areas, but did not radiate. Extensive conservative treatments, including nerve block and trigger point injection (TPI), achieved minimal temporary relief. Laboratory tests and cervical and thoracic magnetic resonance imaging (MRI) examinations revealed no abnormal findings. Single-photon emission-computed tomography (SPECT-CT) showed increased 99mtechnetium uptake at the left T3, 4, and right T5 costovertebral joint with mild uptake at the left T6 costovertebral joint. After diagnosing costovertebral joint arthropathy, we administered a medial branch block (MBB) and radiofrequency ablation (RFA) and achieved long-term effects. Therefore, RFA can be performed for long-term pain relief.
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KEYWORD
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costovertebral joint arthropathy, SPECT-CT, thoracic back pain
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