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“Visualization” of pain using cerebral 18F-FDG PET/CT following surgical treatment of lumbar disc herniation

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Abstract

Purpose

We hypothesized that unilateral leg pain following surgical treatment of lumbar disc herniation (LDH) is associated with an increase in the glucose metabolism of the contralateral thalamus.

Methods

Patients scheduled for surgery due to LDH underwent 18F-fluorodeoxyglucose positron emission tomography/computed tomography less than two weeks prior to surgery. Their thalamic FDG uptake was measured and expressed as the mean and partial volume corrected mean standardized uptake values (SUVmean and cSUVmean). These measures were compared with patient-related outcome measures collected pre- and 1-year post-operatively: back and leg pain on a 0–100 VAS scale and health-related quality of life as measured by the EuroQol-5D (EQ-5D).

Results

Twenty-six patients (ten females) aged 49.7 ± 7.4 (mean ± SD) years were included. There was a significant correlation between painful body side and increased contralateral thalamic uptake of FDG, with regard to cSUVmean values. Correlation analyses including clinical parameters and cSUVmean indicated some association with 1-year change in EQ-5D.

Conclusion

These preliminary data sustain the hypothesis that unilateral pain in patients with LDH is associated with increased glucose metabolism in the contralateral thalamus, suggesting a central role of thalamus in chronic pain perception.

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Funding

This work was supported in part by 1-year PhD scholarship to CCS from the Faculty of Health Sciences, University of Southern Denmark, from the Lillebaelt Hospital Research Council, and the IMK Almene Fond.

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Authors and Affiliations

  1. Center for Spine Surgery and Research, Lillebaelt Hospital, Middelfart, Denmark

    Christian Christensen Støttrup & Mikkel Østerheden Andersen

  2. Department of Regional Health Research, University of Southern Denmark, Odense, Denmark

    Christian Christensen Støttrup & Mikkel Østerheden Andersen

  3. Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark

    Caius Holst Mortensen, Reza Piri, Peter Grupe & Poul Flemming Høilund-Carlsen

  4. Department of Clinical Research, University of Southern Denmark, Odense, Denmark

    Caius Holst Mortensen, Reza Piri & Poul Flemming Høilund-Carlsen

  5. Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA

    Mohsen Khosravi & Abass Alavi

  6. Department of Radiology, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, PA, USA

    Andrew Newberg

Authors
  1. Christian Christensen Støttrup
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  2. Caius Holst Mortensen
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  3. Reza Piri
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  4. Mohsen Khosravi
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  5. Andrew Newberg
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  6. Mikkel Østerheden Andersen
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  7. Abass Alavi
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  8. Peter Grupe
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  9. Poul Flemming Høilund-Carlsen
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Contributions

CCS, MØA, AA, and PFHC contributed to conception and design, drafted or revised the manuscript. Together with CCS, CC and RP made the data analysis twice. MK collaborated with regard to methodology and interpretation. AN made contribution to interpretation of the data and revised the manuscript. All authors approved the submitted version of the manuscript and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Poul Flemming Høilund-Carlsen.

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Støttrup, C.C., Mortensen, C.H., Piri, R. et al. “Visualization” of pain using cerebral 18F-FDG PET/CT following surgical treatment of lumbar disc herniation. Eur Spine J 32, 555–561 (2023). https://doi.org/10.1007/s00586-022-07442-1

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  • DOI: https://doi.org/10.1007/s00586-022-07442-1

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