Metabolic Imaging of Pain Matrix Using 18 F Fluoro-deoxyglucose Positron Emission Tomography/Computed Tomography for Patients Undergoing L2 Dorsal Root Ganglion Stimulation for Low Back Pain.

摘要: INTRODUCTION Nociceptive signals from lumbar intervertebral discs ascend in the sympathetic chain via L2 dorsal root ganglion (L2 DRG), a potential target for discogenic low back pain neuromodulation. Positron Emission Tomography/Computed Tomography (PET-CT) measures functional changes brain metabolic activity, identified by regional cerebral blood flow (rCBF) as determined of F-18 Fluoro-deoxyglucose (18 F FDG) tracer within tissues. METHODS AND MATERIALS Nine patients were recruited to explore PET-CT imaging at baseline and four-weeks post implantation bilateral DRG neurostimulation leads implantable pulse generator (IPG). scans performed 30 min following an IV injection 250±10% MBq 18 FDG tracer. Fifteen frames acquired 15 min. PET list-mode raw data reconstructed normalized appropriately anatomical atlas. RESULTS study, where five analyzed. The right left insular cortex, primary secondary somato-sensory cortices, prefrontal anterior cingulate thalamus, amygdala, hippocampus midline periaqueductal areas, assessed any activity. A total 85 matrix regions delineated SUV (standardized uptake value)MAX , MEAN  ± SD, SUVPEAK calculated each these compared pre- post-L2 stimulation. Sixty-one matrices showed increase activity whereas 24 reduction CONCLUSION This is first ever study reporting multi-frame static after stimulation pain. Predominantly increased nociceptive are seen with F18