Closed vertebral biopsy

Abstract

A study of cadaveric vertebral biopsy and a review of 100 clinical biopsies has shown that needles and trephines producing tissue specimens of two millimetres or more in diameter can be expected to give a high degree of diagnostic accuracy. The erythrocyte sedimentation rate was a more useful screening investigation than were estimations of serum alkaline phosphatase. The complications are described. It is suggested that patients with painful thoracic metastases and evidence of progressive cord compression should have early decompression after open biopsy if further neurological compromise is to be prevented.

Histological evaluation of bone biopsy results during PVP or PKP of vertebral compression fractures

“…The posterolateral approach is normally used for obtaining biopsy under fluoroscopic or CT guidance in cases of thoracic or lumbar spine (19)(20)(21). However, the risk correlated with this process varies from 0 to 26% and is associated with various complications, including pneumothorax, hematoma, neurological lesions, root pain and infective disorders.…”

The Michel Benoist and Robert Mulholland Yearly European Spine Journal Review: a survey of the “surgical and research” articles in the European Spine Journal, 2013

“…In 2001 Stirling [6][7][8][9] using serological tests demonstrated [10] that culture of intervertebral disc material from 36 patients operated upon for severe sciatica, showed that 53 % grew Propionebacterium acnes. In the knowledge that Modic changes-bone oedema are present in only 6 % of the general population [11], but are present in 35 % of a back pain population, and the knowledge that these changes may be due to infection, Albert et al [12] asked the question whether nuclear tissue so infected led to such changes.…”

“…They emphasise the importance of obtaining bacteriological confirmation by needle biopsy. Unfortunately since these investigations are now frequently carried out by Radiologists, and they use fine diameter needles, and achieve only 70 % positive culture, rather than using a 2 mm or more diameter needle, where positive bacteriology is obtained in over 90 % of biopsies [7]. They draw attention to the indications for surgery, as intractable pain, instability, and neurological changes, but make the point that minor neurology may resolve.…”

Fluroscopic guided percutaneous transpedicular biopsy of vertebral body lesion: a safe and effective procedure

“…To avoid pulmonary complications from posterolateral approach in thoracic, the transpedicular approach under fluoroscopic guidance gives best results. 13,14 The most common complications are pulmonary, neurologic, and infective disorders in these orders respectively. There were no such complications in our study.…”