Percutaneous CT-Guided Biopsies of the Cervical Spine: Technique, Histopathologic and Microbiologic Yield, and Safety at a Single Academic Institution

Abstract

Percutaneous CT-guided biopsy of the cervical spine is an effective and safe procedure with high diagnostic yield and can obviate open procedures for histopathologic and microbiologic analyses of patients with clinical and imaging findings concerning for infection or primary and metastatic osseous lesions.

Reduction of Radiation Dose and Scanning Time While Preserving Diagnostic Yield: A Comparison of Battery-Powered and Manual Bone Biopsy Systems

“…[8][9][10] However, there is scarcity of data when it comes to assessing the comparative efficacy of these drill systems in lytic and suspected infectious lesions. In lytic lesions, prior studies have shown the diagnostic yield ranging from 70% to 96%; 3,11,12 however, these studies have predominantly assessed the manual drill systems. One prior study 13 reported the diagnostic yield and radiation dose for battery-powered drill systems, however, without comparison with manual systems.…”

Best Practices: CT-Guided Percutaneous Sampling of Vertebral Discitis-Osteomyelitis and Technical Factors Maximizing Biopsy Yield

“…Complication rates are based on retrospective studies of CT-guided spine biopsies for infectious and noninfectious processes. These report major complication rates of less than 2%, with the most common major complications being retroperitoneal or paraspinal hematomas that are usually (47,50,(52)(53)(54)(55)(56)(57). Cases of transient and permanent neurologic deficits have been reported (52,58).…”

“…Cases of transient and permanent neurologic deficits have been reported (52,58). Although critical structures such as nerves, blood vessels, and the airway are in particularly close proximity to the needle path for cervical spine biopsies, case studies report that major and minor complications are rare and do not occur at a higher rate than in biopsies of the thoracic or lumbar spine (54,58,59). (Figure 2A) (54).…”

“…Although critical structures such as nerves, blood vessels, and the airway are in particularly close proximity to the needle path for cervical spine biopsies, case studies report that major and minor complications are rare and do not occur at a higher rate than in biopsies of the thoracic or lumbar spine (54,58,59). (Figure 2A) (54). Percutaneous access to the disc space most commonly requires a lateral or posterolateral approach (54).…”

“…(Figure 2A) (54). Percutaneous access to the disc space most commonly requires a lateral or posterolateral approach (54). In the lateral approach, the needle is introduced into the disc space posterior to the carotid sheath structures and anterior to the vertebral artery.…”