Percutaneous C-arm-guided Wide Bore Needle Biopsy for Intraosseous Spinal Lesions

Abstract

Study design Retrospective analysis of data of those patients who underwent a percutaneous transpedicular biopsy at our hospital was done. All patients had a bony lesion in a vertebra (thoracic, lumbar, sacrum) without a soft tissue component around the bone and neurodeficit. Objective To analyze the role of percutaneous wide bore needle biopsy in vertebral lesions without any soft tissue component. Summary of background data Adequate treatment of spinal lesions requires formulation of diagnosis-best achieved by a tissue biopsy when all attempts at diagnosis fail by noninvasive methods. Percutaneous CT guided fine needle biopsy is technically difficult in intraosseous lesions leading to frequent inconclusive results and hence the necessity of wide bore needle biopsy. Materials and methods Retrospective analysis of data of 26 patients with mean age of 58.8 years who underwent a percutaneous transpedicular biopsy at our hospital was done. All patients had a bony lesion in a vertebra (thoracic, lumbar, saccrum) without a soft tissue component around the bone and neurodeficit. The procedure was done under local anesthesia with sedation. Results Positive diagnosis was achieved in 23 out of 26, i.e. 88.4% of cases (adequacy). Out of 26, there were 13 cases of malignancy (50%), 8 cases of tuberculosis (30.7%), 2 cases of osteoporosis (7.6%) and biopsy was inconclusive in 3 (11.5%) cases. Of the 13 malignancies, 7 cases were of metastasis (53.8%), 5 cases of plasmocytoma (38.4%) and 1 case of lymphoma (7.6%). Conclusion Percutaneous biopsy under fluoroscopic guidance by transpedicular approach is quite safe and gives high adequacy (88.4%) without significant complications that are associated with open and paraspinal techniques. How to cite this article Basu S, Tikoo A, Malik FH, Ghosh JD, Jain M, Sarangi T. Percutaneous C-arm-guided Wide Bore Needle Biopsy for Intraosseous Spinal Lesions. J Postgrad Med Edu Res 2015;49(1):5-9.

Transpedicular vertebral biopsy under O-arm navigation: a technical note

“…There were similar findings reported in a study by Tanaka et al in 2021 [16]. However, the same method can be applied using 2D fluoroscopy without navigation [17,18]. Oblique "scotty dog" view can be used by novice surgeons and routine AP can be also used by experienced surgeons.…”