Computed Tomography-Guided Biopsy of the Spine

Kornblum, Martin B.; Wesolowski, David P.; Fischgrund, Jeffrey S.; Herkowitz, Harry N.

doi:10.1097/00007632-199801010-00018

Cited by 121 publications

(60 citation statements)

References 15 publications

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“…Also, with regard to biopsy, computed tomography-guided needle biopsy may be optimal to prevent contamination of tumor tissue. 33 In the current series, overall survival for patients who underwent either intralesional surgery or no surgery and received adjunctive irradiation was better compared with overall survival for patients without this modality, a phenomenon similar to that reported by Shives et al 5 Sundaresan et al 25 also suggested that the combination of complete tumor resection (spondylectomy) with chemotherapy and radiation may increase survival. In their report, three patients who underwent surgical tumor resection and irradiation with chemotherapy survived longer than 36 months without evidence of disease.…”

Section: Discussionsupporting

confidence: 85%

Osteosarcoma of the spine

Ozaki

Flege

Liljenqvist

et al. 2002

Cancer

235

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BACKGROUNDDue to the low incidence rate, the optimal strategy for the treatment of patients with spinal osteosarcoma is unknown.METHODSTwenty‐two patients with osteosarcoma of the spine (15 with tumors of the sacrum and 7 with tumors at other sites) who received chemotherapy according to the Cooperative Osteosarcoma Study Group protocol were analyzed. Six patients presented with metastasis, and 16 patients had no evidence of metastasis at the time of entry into the protocol. Of 12 patients who underwent excision of their tumors, 2 patients underwent wide excision, 3 patients underwent marginal excision, and 7 patients underwent intralesional excision. Eight patients received irradiation: Six patients received conventional radiotherapy only, one patient received neutron beam therapy, and one patient received samarium‐153‐ethylene diamine tetramethylene phosphonate therapy. Follow‐up ranged between 24 months and 105 months (median, 47 months).RESULTSThe median survival was 23 months, and three patients have survived without disease for > 6 years. Patients with primary metastases (P = 0.004), large tumors (P = 0.010), and sacral tumors (P = 0.048) had lower overall survival compared with patients who had no metastasis, small tumors, and nonsacral tumors, respectively. There was a significant difference in overall survival between 5 patients who underwent either wide or marginal surgery and 17 patients who underwent either intralesional surgery or no surgery (P = 0.033). Among 17 patients who underwent no surgery or intralesional surgery, overall survival tended to be better in 7 patients who received irradiation compared with the overall survival in 10 patients who did not receive irradiation (P = 0.059).CONCLUSIONSPatients with metastases, a large tumors, and sacral tumors had a poor prognosis in the current study with small numbers of patients. Wide or marginal excision of the tumor improved survival. Patients with osteosarcoma of the spine should be treated with a combination of chemotherapy and at least marginal excision for those with surgically accessible tumors. Postoperative radiotherapy may be beneficial. Cancer 2002;94:1069–77. © 2002 American Cancer Society.DOI 10.1002/cncr.10258

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Section: Discussionsupporting

confidence: 85%

Osteosarcoma of the spine

Ozaki

Flege

Liljenqvist

et al. 2002

Cancer

235

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“…In the past, lower accuracy rates have been reported for CT-guided needle biopsies at the thoracic spine [9]. In our study however, accuracy rates were higher in the thoracic, lumbar and sacral tracts, and whereas the cervical tract has the lowest.…”

Section: Discussioncontrasting

confidence: 73%

“…In case of deep lesions, for example in the pelvis or spine, needle biopsies are challenging procedures [16]. In these cases, the aid of computed tomography (CT)-guidance has further increased accuracy, reduced complications and therefore has now become the procedure of choice [5,8,9,11,[17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous CT-guided biopsy of the spine: results of 430 biopsies

et al. 2008

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Biopsies of lesions in the spine are often challenging procedures with significant risk of complications. CT-guided needle biopsies could lower these risks but uncertainties still exist about the diagnostic accuracy. Aim of this retrospective study was to evaluate the diagnostic accuracy of CT-guided needle biopsies for bone lesions of the spine. We retrieved the results of 430 core needle biopsies carried out over the past fifteen years at the authors' institute and examined the results obtained. Of the 430 biopsies performed, in 401 cases the right diagnosis was made with the first CT-guided needle biopsy (93.3% accuracy rate). Highest accuracy rates were obtained in primary and secondary malignant lesions. Most false negative results were found in cervical lesions and in benign, pseudotumoral, inflammatory, and systemic pathologies. There were only 9 complications (5 transient paresis, 4 haematomas that resolved spontaneously) that had no influence on the treatment strategy, nor on the patient's outcome. In conclusion we can assert that this technique is reliable and safe and should be considered the gold standard in biopsies of the spine.

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“…In the study conducted by Kornblum et al 9 in 1998, it was reported that with computed tomography (CT)-guided biopsy adequate specimens were obtained in 87% of cases. On the other hand, adequate sample were obtained in all the cases of this study.…”

Section: Discussionmentioning

confidence: 99%

Transpedicular percutaneous biopsy of vertebral body lesions: a series of 71 cases

2008

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Study design: This prospective study evaluates the effectiveness of transpedicular biopsy carried out under local anesthesia in obtaining diagnostic tissue from vertebral body lesions. Objective: To describe the technique of percutaneous transpedicular biopsy carried out under local anesthesia under C-arm fluoroscopy and to report the author 0 s experience. Setting: Spine hospital, Ahmedabad, Gujarat, India. Methods: Seventy-one patients who underwent transpedicular biopsy from T6 to S1 vertebral body lesions were evaluated. Biopsy specimens were obtained by passing a self-designed 5-mm diameter biopsy instrument through the pedicle into the site of the disease using C-arm fluoroscopy. Specimens were sent for histological and bacteriologic analyses. Results: Biopsy was carried out for vertebral lesions of 51 men and 20 women. Sixteen of these lesions were seen in thoracic spine, 53 in lumbar and two in sacrum. The pathologic examinations revealed infections in 25, osteoporotic wedging in 21, metastasis in eight, plasmacytoma in three, multiple myeloma in four, non-Hodgkin 0 s lymphoma in one and round cell tumor in one patient. Diagnosis was established in 63 of 71 patients (88.7%). Remaining eight patients were reported as chronic nonspecific inflammation, and were followed up for more than 6 months. Conclusion: Percutaneous transpedicular vertebral biopsy under local anesthesia is an important tool in the evaluation of vertebral body lesions, especially in older population and can be performed with minimal morbidity and high diagnostic yield as an outpatient procedure.

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Computed Tomography-Guided Biopsy of the Spine

Cited by 121 publications

References 15 publications

Osteosarcoma of the spine

Osteosarcoma of the spine

Percutaneous CT-guided biopsy of the spine: results of 430 biopsies

Transpedicular percutaneous biopsy of vertebral body lesions: a series of 71 cases

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