18F-NaF and 18F-FDG PET/CT imaging of spinal instrumentation: case report and review of the literature.

This report describes the 18F-sodium fluoride (18F-NaF) and 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging of spinal instrumentation incidentally found in a 71-year-old male with extensive degenerative spinal disease. Hardware was noted at L5-S1, a common site of lumbar degeneration and cause of radiculopathy. 18F-NaF showed intense focal uptake at the instrumentation site, while 18F-FDG demonstrated minimal uptake. These findings suggest remodeling of bone (18F-NaF) at the site of instrumentation in the setting of benign physiological metabolic activity (18F-FDG). Other signs of structural deterioration were observed in the cervical and thoracic regions, such as osteophytes and ossification of the posterior longitudinal ligament. We present these findings in the context of a literature review of published studies that utilized 18F-NaF or 18F-FDG PET imaging for the assessment and monitoring of patients with spinal instrumentation.