Open transpedicular biopsy of the vertebral body

Fidler, Malcolm W.; Niers, B.B.A.M.

doi:10.1302/0301-620x.72b5.2211776

Cited by 15 publications

(7 citation statements)

References 3 publications

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“…Compared to FNAC, a pretreatment CT guided transpedicular core needle biopsy is the preferred method to achieve a histopathologic diagnosis before surgery. An inconclusive preoperative biopsy makes an intraoperative frozen section mandatory [ 9 ]. However, the histopathologic grading does not reliably correlate with prognosis [ 6 10 ], and so was not recorded in our study.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Spinal Giant Cell Tumors: A Study of Risk Factors and Recurrence Patterns

et al. 2016

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Study DesignRetrospective study.PurposeTo highlight risk factors, recurrence patterns and multimodal treatment in management of recurrent giant cell tumors (GCTs).Overview of LiteratureGCTs of the spine are rare and challenging entities. Recurrences are very common and warrant complex management to prevent multiple recurrences. Gross total resection is preferred over subtotal procedures to prevent recurrences. However, resection is associated with morbidity and mortality. Proper understanding of risk factors and a high index of suspicion helps to spot recurrences early and aids in subsequent management.MethodsTen patients (six females, four males) with recurrent GCTs underwent 17 interventions. There were six lesions in the thoracic spine, two in the cervical spine and two in the lumbar spine. Recurrences were managed with preoperative digital subtraction embolization, intralesional curettage and postoperative radiotherapy.ResultsThe average age at intervention was 31.3 years. The average duration of recurrence in patients following index surgery in a tertiary care hospital and surgery elsewhere was 7.3 years and was 40 months, respectively. The minimum recurrence-free interval after the last recurrent surgery was 10 years.ConclusionsOur study reports the largest recurrence-free interval for GCTs. Recurrent GCTs are challenging entities. Understanding of risk factors and meticulous planning is required to prevent recurrences. Intralesional surgery could be a safer and effective modality in managing recurrences.

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Section: Discussionmentioning

confidence: 99%

Recurrent Spinal Giant Cell Tumors: A Study of Risk Factors and Recurrence Patterns

et al. 2016

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“…In contrast to the studies in the literature, Fidler and Niers [16] stated that an open transpedicular approach has certain advantages over a percutaneous procedure in enabling the surgeon to perform block resection, and avoiding any damage to the pedicle wall, thus minimizing the possibility of contaminating the epidural space or paravertebral structures.…”

Section: Discussionmentioning

confidence: 99%

A comparison of two techniques: Open and percutaneous biopsies of thoracolumbar vertebral body lesions

Yapıcı

Atıcı

Balioğlu

et al. 2015

J Craniovert Jun Spine

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Aim:The purpose of this article is to compare the similarity of initial radiological diagnosis and pathological diagnosis between thoracal and lumbar vertebral bodies and the adequacy and the reliability of open and percutaneous biopsies performed via transpedicular approach in the lesions located in vertebral bodies.Materials and Methods:Thirty-three patients who had undergone transpedicular biopsy for vertebral body lesions were retrospectively evaluated. Seventeen patients were diagnosed by percutaneous transpedicular biopsy (11 in the lumbar vertebrae, 6 in the thoracal vertebrae). Sixteen patients were diagnosed by open transpedicular biopsy (9 in the lumbar vertebrae, 7 in the thoracal vertebrae).Results:The similarity ratio between the initial radiological diagnosis and the final pathological diagnosis was 71.4% in the open biopsy and was 69.2% in the percutaneous biopsy (P > 0.05). The similarity ratio between the initial radiological diagnosis and the final pathological diagnosis was 66.7% in the lumbar region and was 77.8% in the thoracal region (P > 0.05). For percutaneous biopsy group, the similarity ratio was 72.7% in the lumbar region and was 66.7% in the thoracal region (P > 0.05). For open biopsy group, the similarity ratio was 62.5% in the lumbar region and 83.3% in the thoracal region (P > 0.05). No complication was observed.Conclusion:Specimen adequacy of open biopsy was higher than percutaneous biopsy. Particularly, the open thoracal biopsy has provided the highest similarity ratio between the initial radiological diagnosis and the final pathological diagnosis.

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“…Fidler and Niers 14 recommended an open transpedicular approach over a percutaneous procedure to facilitate block excision and to prevent damage to the pedicular wall with possibility of contamination of the epidural space or paravertebral structures. However, using the percutaneous techniques described in this study, these potential complications can be avoided, and the patient can be spared the morbidity and cost associated with the open procedure.…”

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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Open transpedicular biopsy of the vertebral body

Abstract: We describe a method of obtaining a biopsy from the body of a vertebra by an open transpedicular route. This minimises the danger of contamination of tissue planes and spaces.

Cited by 15 publications

References 3 publications

Recurrent Spinal Giant Cell Tumors: A Study of Risk Factors and Recurrence Patterns

Recurrent Spinal Giant Cell Tumors: A Study of Risk Factors and Recurrence Patterns

A comparison of two techniques: Open and percutaneous biopsies of thoracolumbar vertebral body lesions

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

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