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Computed tomography–guided spine biopsy is a routine procedure in diagnosing vertebral infection or tumor. Following a thoracic intervertebral disc biopsy for presumed osteodiscitis, a patient immediately presented with flaccid paralysis and loss of temperature and pinprick sensation below biopsy level, followed rapidly by complete sensation loss. There was no evidence of direct injury during the biopsy, and emergent post-biopsy magnetic resonance imaging revealed no cord signal abnormality or compression. Later magnetic resonance imaging demonstrated corresponding-level cord edema, presumed secondary to transient cord ischemia during the procedures. Despite frequent utility, authors recommend caution in utilization of computed tomography–guided spine biopsy.

Although the literature indicates that the anteriorly instrumented spine may restore the overall spinal structure to near-normal resistance to rotation and flexion forces, the current study demonstrates that a significant amount of compression through the graft is lost by its application. This decreased axial loading further supports the concept of device-related osteopenia observed clinically with such devices.