The study was undertaken to assess the diagnostic accuracy and clinical usefulness of computed tomography (CT)-guided biopsies and fine needle aspirates of musculoskeletal lesions. The analysis compared the accuracy according to anatomical location, size, type of lesion, and histology. On the basis of the information obtained by reviewing the report of the CT biopsy and comparing it with the final diagnosis for 359 cases, the overall accuracy was determined to be 71%. The accuracy for 101 fine needle aspirations was 63% and for 258 CT-guided core biopsies was 74%. It is of note that the biopsies of 81 pelvic lesions had higher rates of diagnostic accuracy (81%) than those of 278 non-pelvic sites (68%), and especially 94 lesions of the spine (61%). The lowest success rates occurred in 26 patients with infectious diseases (50%). We conclude that these procedures remain the logical and safe choice for diagnostic studies of patients with lesions of the musculoskeletal system.

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Our results indicate that implant removal and wide debridement for postoperative infection after posterior instrumented spine fusion can provide satisfactory results and could be one treatment option. However, the collapse of the disc space, loss of normal lordosis, and pseudoarthrosis are inevitable in patients with early postoperative infection.

Generalized low bone mass and osteopenia in both axial and peripheral skeletons have been reported in adolescent idiopathic scoliosis (AIS). However, the mechanism and causes of bone loss in AIS have not been identified. Therefore, this study examined the relationship between the osteogenic and adipogenic differentiation abilities of mesenchymal stem cells (MSCs) and bone mass in 19 patients with AIS and compared these with those of 16 age- and gender-matched patients with lower leg fracture. Mean lumbar spinal bone mineral density (LSBMD) in AIS patients was found to be lower than in controls (P = 0.037) and the osteogenic differentiation abilities and alkaline phosphatase activities of MSCs from patients were also found to be lower than those of controls (P = 0.0073 and P = 0.001, respectively), but the abilities of the MSCs of patients and controls to undergo adipogenic differentiation were similar. The osteogenic differentiation ability was found to be positively correlated with alkaline phosphatase activity in the AIS group. However, the osteogenic and adipogenic abilities were not found to be correlated with LSBMD in either patients or controls. These findings suggest that the decreased osteogenic differentiation ability of MSCs might be one of the possible mechanisms leading to low bone mass in AIS. However, we did not determine definite mechanisms of low bone mass in AIS. Therefore, further study with large scale will be needed to identify the mechanism involved.