Percutaneous Transpedicular Biops of the Spine

Stringham, Douglas R.; Hadjipavlou, Alexander; Dzioba, Robert B.; Lander, P

doi:10.1097/00007632-199409000-00021

Cited by 71 publications

(36 citation statements)

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“…The anatomic relationship of the pedicle to neural elements underscores the importance of preserving the integrity of the medial and the inferior walls of the pedicle. 10 Brugieres et al 11 found reliability to be better in osteolytic lesions (94%) than in osteosclerotic lesions (75%). Ghelman et al 12 reported that sclerotic lesions are more difficult to biopsy.…”

Section: Discussionmentioning

confidence: 96%

Transpedicular percutaneous biopsy of vertebral body lesions: a series of 71 cases

2008

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Study design: This prospective study evaluates the effectiveness of transpedicular biopsy carried out under local anesthesia in obtaining diagnostic tissue from vertebral body lesions. Objective: To describe the technique of percutaneous transpedicular biopsy carried out under local anesthesia under C-arm fluoroscopy and to report the author 0 s experience. Setting: Spine hospital, Ahmedabad, Gujarat, India. Methods: Seventy-one patients who underwent transpedicular biopsy from T6 to S1 vertebral body lesions were evaluated. Biopsy specimens were obtained by passing a self-designed 5-mm diameter biopsy instrument through the pedicle into the site of the disease using C-arm fluoroscopy. Specimens were sent for histological and bacteriologic analyses. Results: Biopsy was carried out for vertebral lesions of 51 men and 20 women. Sixteen of these lesions were seen in thoracic spine, 53 in lumbar and two in sacrum. The pathologic examinations revealed infections in 25, osteoporotic wedging in 21, metastasis in eight, plasmacytoma in three, multiple myeloma in four, non-Hodgkin 0 s lymphoma in one and round cell tumor in one patient. Diagnosis was established in 63 of 71 patients (88.7%). Remaining eight patients were reported as chronic nonspecific inflammation, and were followed up for more than 6 months. Conclusion: Percutaneous transpedicular vertebral biopsy under local anesthesia is an important tool in the evaluation of vertebral body lesions, especially in older population and can be performed with minimal morbidity and high diagnostic yield as an outpatient procedure.

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Section: Discussionmentioning

confidence: 96%

Transpedicular percutaneous biopsy of vertebral body lesions: a series of 71 cases

2008

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“…The needle should always be towards the lateral and superior wall of the pedicle. The needle is placed with more caudal to cranial angulation than a traditional vertebroplasty approach in an attempt to provide subsequent access to the intervertebral disk the endplate biopsy would also be feasible [15,19].…”

Section: Thoracic (T) and Lumbar (L) Spinementioning

confidence: 99%

Percutaneous Spine Biopsy: A Literature Review

Nourbakhsh¹

2015

Int J Radiol Radiat Oncol

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Percutaneous spine biopsy has widely replaced open biopsy during the last 50 years. Closed biopsy is more cost effective, less invasive, and has fewer complications than open procedures. A literature search was conducted in PubMed for percutaneous spine biopsy. The contributing factors to the success of the biopsy were identified by reviewing the articles and their references. These factors included location and type of lesion, needle system and use of different modalities of imaging as well as the physician's expertise. Potential complications include pneumothorax, hematoma, nerve root injury, transient paresis, transient spinal anesthesia, meningitis, radiculopathy, and paraplegia. Overviews of the pre and post biopsy workup along with comprehensive description of the determinants of the biopsy outcome are discussed. These determinants are: lesion type; location of the lesion in the vertebrae and the level of the spine where the lesion is located; the imaging guidance used to identify the lesion during biopsy; and, the needle or trephine which is used to obtain the specimen. A detailed review of different approaches used to penetrate the lesion by trephine or needle are also provided. The decision on how the surgeon should obtain a percutaneous spine biopsy is dependent on the characteristics of the lesion, availability of imaging guidance and also the expertise of the physician.

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“…6 The first percutaneous spine biopsy was reported in 1935 by Robertson and Ball. 7 The first percutaneous transpedicular vertebral biopsy was done by Stringham et al 8 Complications include active hemorrhage, hematoma, vascular injury, neural injury (spinal cord or nerve), pneumothorax, infection, and meningitis.…”

Section: Introductionmentioning

confidence: 99%

Fluroscopic guided percutaneous transpedicular biopsy of vertebral body lesion: a safe and effective procedure

et al. 2017

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Background: Vertebral biopsy is suitable for patients with intractable back pain and vertebral body lesions that are detected with noninvasive imaging modalities. Histologic confirmation is necessary for correct diagnosis and subsequent clinical management. Percutaneous biopsy is less invasive and cost-effective.Methods: Twenty three patients with history of severe back pain with vertebral body lesion identified by any of computed tomography (CT) or magnetic resonance imaging (MRI) were taken up for percutaneous biopsy. Lesion level was determined under fluoroscopy. Biopsy was taken with trephine needle under local anesthesia. Accuracy and effectiveness analyzed after histologic reports.Results: Among 23 patients, 2 were having malignant primary lesions (8.6%), 8 were having vertebral metastasis (35%), 10 were having infectious etiology (43.4%) and 3 were osteoporotic fractures. There were no complications. One unsuspected secondary malignancy was detected. True positive cases were 19; true negative cases were 3 and one false negative case. Overall accuracy is 95%. Conclusions: This minimal invasive technique is simple, safe and effective in diagnosis of malignancy and infection aiding the treating surgeon in their further management. It is also useful in detecting unsuspected malignancy.

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Percutaneous Transpedicular Biops of the Spine

Cited by 71 publications

References 0 publications

Transpedicular percutaneous biopsy of vertebral body lesions: a series of 71 cases

Transpedicular percutaneous biopsy of vertebral body lesions: a series of 71 cases

Percutaneous Spine Biopsy: A Literature Review

Fluroscopic guided percutaneous transpedicular biopsy of vertebral body lesion: a safe and effective procedure

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