Percutaneous CT Guided Vertebral Biopsy: Anatomy and Technical Considerations

Abstract

In this review article, the authors discuss the anatomy and technical aspects of CT-guided biopsy of vertebral lesions. CT guidance is highly useful for vertebral biopsies, as the anatomy of the spine is complex and varies widely across the levels. Prebiopsy imaging should be reviewed and later correlated with the final histopathological diagnosis. The majority of the spine biopsies are performed under local anesthesia, except those in critical locations and pediatric age groups. The biopsy sample is sent for histopathological analysis and/or microbiological analysis depending on the indications. It is preferable to use a coaxial system for biopsies, so multiple cores can be obtained with a single needle puncture, thus minimizing the negative yield and complications. Complications after image-guided percutaneous biopsy are rare and can be managed easily.

Computed Tomography-Guided Fine Needle Biopsies of Vertebral and Paravertebral Lesions in Small Animals

“…It is not clear whether these complications were due to the severe osteolysis and the expected progression of the infection after diagnosis, or to the FNB and TCB procedure. The low rate of complications (9%) agrees with the human literature, where complications after spinal CT-guided percutaneous sampling are in the range of 0-10% and less frequent than after surgical procedures [15,27].…”

“…In the present study, the size of the needle used was 22 G. Small needle sizes (22 G and 20 G) have been used in other studies in small animals and people because it prevents contamination of the sample with blood [7,22,[25][26][27][28]. The nature of the lesions (size, shape and location) prevented from taking complementary TCBs in most cases.…”

Cervical Vertebral Bone Biopsy: Challenges and Tricks

“…Gala et al 16 found CT-guided percutaneous biopsy is safer than open surgical biopsy with lower rates of complications and shorter hospital stays.…”