Inclusion Criteria:  Lower back pain (in extension +/- pain in buttocks, groin, thigh) without radicular pain Symptoms > 6 months after the failure of conservative management in the primary care setting MRI signs of degenerative disc disease or facet arthropathy Two- or more levels of positivity on lumbar SPECT/CT  Exclusion Criteria:  Other spinal pathology (tumors, congenital defects, spondylolysis, or spondylolisthesis) Intolerance of SPECT examination Pregnancy