Vertebral Fractures of Unknown Origin: Role of Computed Tomography-Guided Biopsy

Spinnato, Paolo; Bazzocchi, Alberto; Facchini, Giancarlo; Filonzi, Giacomo; Nanni, Cristina; Rambaldi, Ilaria; Rimondi, Eugenio; Fanti, Stefano; Albisinni, Ugo

doi:10.14444/5084

Cited by 11 publications

(3 citation statements)

References 12 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, considering the whole series of osteoporotic patients with serum tryptase assessment, the prevalence of SM was 1.3%, and, including the MC alterations, it increased to 3.0%. These frequencies are similar to those previously reported in a series of iliac crest bone biopsies from osteoporotic patients (1.3%) [ 20 ] and in a series of diagnostic biopsies in fractured vertebrae (3.1%) [ 21 ].…”

Section: Discussionsupporting

confidence: 90%

Hypertryptasemia and Mast Cell-Related Disorders in Severe Osteoporotic Patients

Carosi

Guabello

Longhi

et al. 2020

Mediators of Inflammation

View full text Add to dashboard Cite

Purpose. Systemic mastocytosis (SM) is characterized by a clonal proliferation of neoplastic mast cells (MCs) in one or more extracutaneous organs including the bone marrow (BM). SM is often associated with osteoporosis (OP) and fractures. Hypertryptasemia usually occurs in SM. We investigated the prevalence of hypertryptasemia in a series of severe osteoporotic patients, the performance of the tryptase test in diagnosing SM in these patients, and their bone features. Methods. The medical records of 232 patients (168 females and 64 males) with a diagnosis of OP (50.4% with fractures) and a serum tryptase assessment were reviewed. BM assessment was performed in a subset of hypertryptasemic patients; clinical, biochemical, and radiographic data were collected. Results. Hypertryptasemia was detected in 33 patients. BM assessment ( n = 16 ) was normal in 8 hypertryptasemic patients, while BM criteria for the diagnosis of SM were met in 3 patients, MC alterations were detected in 4 patients, and one patient presented a polycythemia vera. Serum tryptase levels were higher than 11.4 ng/ml in all patients with BM alterations. The best cut-off of tryptase level related to BM alterations was 17.9 ng/ml, with a sensibility and sensitivity of 75% ( AUC = 0.797 and P = 0.015 by ROC analysis). All osteoporotic patients with hypertryptasemia experienced at least one vertebral fracture associated with a severe reduction of the lumbar bone mineral density. Conclusions. The prevalence of MC-related disorders in severe OP was 3.0%, accounting for the 7.4% of the secondary causes of OP. MC-related disorders may be involved in bone fragility and assessment of serum tryptase is useful to detect MC-related disorders.

show abstract

Section: Discussionsupporting

confidence: 90%

Hypertryptasemia and Mast Cell-Related Disorders in Severe Osteoporotic Patients

Carosi

Guabello

Longhi

et al. 2020

Mediators of Inflammation

View full text Add to dashboard Cite

show abstract

“…Computed tomography (CT)-guided biopsy is proved to be an effective and safe tool for the diagnosis of spinal bone lesions [ 2 , 3 , 4 , 5 ]. Moreover, CT-guided biopsy showed a higher success rate than fluoroscopic-guided biopsy of the spine, and it is by far less invasive than open surgical biopsy.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous CT-Guided Biopsy of the Craniovertebral Junction: Safety, Diagnostic Yield, and Technical Notes

2022

Self Cite

View full text Add to dashboard Cite

The craniovertebral junction defined as the occiput, the atlas, and the axis is a complex bony region that contains vital neural and vascular structures. We report the experience of a single academic institution regarding CT-guided biopsy of this skeletal region. We reviewed all of the CT-guided biopsies performed in our department, completed in the craniovertebral junction. We collected data in regard to biopsy procedures, patients’ vital statistics, and histopathological diagnosis. In total, 16 patients (8M and 8F; mean age 52; range 16–86 years old) were included in this series. In eight patients, the lesions were located in the atlas vertebra (8/16—50%), in six patients in the axis (37.5%), and in two patients in the occiput (12.5%). No complications were observed during or after the procedures. All of the procedures were technically successful. The biopsy was diagnostic in 13/16 patients (81.3%): four metastatic lesions (25%—three breast and one prostate cancers), four multiple myeloma bone lesions (25%), three aneurismal bone cysts (18.8%), one aggressive hemangioma (6.3%), and one pseudogout (6.3%). Moreover, in two-thirds (66.6%) of non-diagnostic histological reports, malignancies were excluded. CT-guided percutaneous biopsy is a safe tool and allows obtaining a histological diagnosis, in most cases, even in the most delicate site of the human skeleton—the craniovertebral junction.

show abstract

“…Забор материала путем чрес кожной трепанобиопсии рассматривают как основ ной метод для определения лечебной тактики. Его информативность достигает 75 % у взрослых и 85 % у детей [9], при этом КТ-навигация позволяет повысить эффективность процедуры [10].…”

unclassified

Pathological fractures of the spine in children (review of the literature and clinical and morphological monocenter cohort analysis)

Зорин

Иванович²,

Mushkin

et al. 2020

Pediatr Traum Orthop Reconstr Surg

View full text Add to dashboard Cite

Background. Pathological vertebral fractures are rare and occur in inflammatory, tumor, and dystrophic lesions. Aim. This study aimed to analyze clinical features and morphological structure of pathological fractures of the spine in children. Materials and methods. The authors examined and operated 62 children aged 217 years for pathological vertebral fractures. We investigated the clinical, radiological, and morphological features. Results. The average age of children at the time of hospitalization was 10 years. Lesions of thoracic vertebrae prevailed (78%) with the maximum frequency of occurrence at the apex of physiological kyphosis Th78. In 10 cases, multiple lesions were noted, including the pathology of other parts of the skeleton. In 69% of observations, clinical symptoms were not dominated by mechanical back pain. Palpation pain (34%) and local spinal deformation (27%) were noted. On average, local kyphosis was 24. Eleven patients (18%) manifested a neurological deficiency, of which nine fractures were a consequence of the tumor process. In 16% of observations, the fracture of the vertebra was detected to be an accidental Х-ray finding. Among the radiation manifestations, all cases (12 patients) registered the decrease in the height of the vertebral body in the form of collapse. Destruction was manifested by various options other than blastic. Therapeutic and diagnostic interventions were performed in 56 patients, and in six children, manipulation was limited to trepan biopsy. The pathological fracture was caused by an inflammatory process in 50% of observations and tumors in 42%, of which 31% is malignant. Conclusions. Pathological spinal fracture in children should be considered as a syndrome, which in most cases is based on an inflammatory or tumor process. The high frequency of neoplastic, including malignant processes, requires active invasive diagnosis. Therapeutic tactics are determined by the clinical, radiation, and morphological characteristics of pathology.

show abstract

Vertebral Fractures of Unknown Origin: Role of Computed Tomography-Guided Biopsy

Cited by 11 publications

References 12 publications

Hypertryptasemia and Mast Cell-Related Disorders in Severe Osteoporotic Patients

Hypertryptasemia and Mast Cell-Related Disorders in Severe Osteoporotic Patients

Percutaneous CT-Guided Biopsy of the Craniovertebral Junction: Safety, Diagnostic Yield, and Technical Notes

Pathological fractures of the spine in children (review of the literature and clinical and morphological monocenter cohort analysis)

Contact Info

Product

Resources

About