Abstract [Objective] To investigate the diagnostic value of SPECT/CT bone quantitative SUV analysis in spinal bone metastases. [Methods] The data of 99mTC-MDP SPECT/CT bone imaging of 54 patients with spinal bone metastasis confirmed in our hospital from July 2020 to December 2021 were retrospectively analyzed. The differences of normal spine SUV between different genders were compared. The correlation between SUV and physical parameters of normal spine was analyzed. The SUV differences were compared between normal vertebral body and spinal bone metastases, between different primary tumors of spinal bone metastases, and between clear and unclear margin metastases. ROC curve was drawn to obtain the optimal critical values of SUVmax and SUVmean. [Results] There were no significant differences in SUVmax and SUVmean between different genders (P>0.05). SUVmean was negatively correlated with age (P<0.001). SUVmax and SUVmean were positively correlated with BMI (P<0.05). SUVmax of normal vertebral body and spinal bone metastases were 7.17±2.71 and 28.30±15.18, respectively (P<0.001), and SUVmean were 4.16±1.41 and 13.01±6.97, respectively (P<0.001). There was no significant difference in SUVmax and SUVmean between 31 cases of lung cancer, 13 cases of prostate cancer and 10 cases of other tumors with spinal bone metastases (P>0.05). There was no significant difference in SUVmax and SUVmean between clear and unclear spinal bone metastases (P>0.05). ROC curve showed that AUC were 0.983 (95%CI: 0.966-1.000) and 0.965 (95%CI: 0.928-1.000), sensitivity were 92.6% and 96.3%, specificity were 96.3% and 88.9%, respectively. The optimal diagnostic thresholds of SUVmax and SUVmean for spinal bone metastases were 11.470 and 5.655, respectively. [Conclusion] SUV of normal spinal bone is positively correlated with BMI. SPECT/CT quantitative SUV analysis of bone has certain clinical value in the diagnosis of spinal bone metastases.