ABSTRACT Background: Lumbar facet syndrome is a common but often underdiagnosed cause of chronic low back pain. Diagnostic tools such as injection tests and spinal scintigraphy single-photon emission computed tomography/computed tomography (SPECT/CT) imaging, are frequently used to identify surgical candidates, though their predictive value remains debated. This study evaluates the diagnostic and prognostic significance of these modalities in patients undergoing inter-articular device surgery. Materials and Methods: A total of 118 patients with suspected facet joint-related low back pain underwent interarticular device implantation between June 2023 and October 2024. Of these, 112 received a diagnostic injection test, and 97 underwent preoperative SPECT/CT imaging. Pain and functional outcomes were assessed preoperatively and at 1, 2, and 3 months postoperatively using the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI). Statistical analyses were performed using a univariate general linear model. Results: All patient groups showed significant postoperative improvement in VAS and ODI scores. Patients with at least one positive diagnostic test (injection and/or SPECT/CT) demonstrated greater functional recovery, with a statistically significant improvement in ODI scores ( P = 0.049). However, no significant differences in VAS score reduction were found between groups based on preoperative test results. Notably, the injection test showed stronger predictive value for functional improvement than SPECT/CT alone. Conclusion: Interarticular device surgery is an effective treatment for lumbar facet syndrome, with significant pain and disability reduction observed across all patient groups. While preoperative diagnostic tests, particularly injection tests, may enhance patient selection and predict functional outcomes, surgical success appears largely independent of these test results. Larger studies are needed to refine diagnostic protocols and validate these findings.
Mostofi et al. (Fri,) studied this question.