Should We Perform Routine Biopsy During Percutaneous Vertebroplasty in Vertebral Compression Fractures?

Abstract

Objective: Percutaneous vertebroplasty (PVP) is widely used all over the world, especially in elderly patients for osteoporotic, traumatic, and pathological vertebral compression fractures (VCFs). Previous studies have reported incidental tumors in vertebral biopsy. However, whether a routine biopsy should be performed during PVP is controversial. The aim of this study was to evaluate the importance of routine biopsy during PVP in the treatment of VCF. Materials and Methods: The patients who underwent PVP under sedo-analgesia for single or multi-level thoracolumbar vertebrae fracture were reviewed retrospectively between March 2015 and June 2019. The study included 87 patients with VCF. A hundred eleven vertebral levels were treated with PVP. Vertebral bone biopsy was performed in 67 (77.01%) patients. These biopsy specimens were examined pathologically. The mean age of the patients was 74.18±9.08 years (91-48 years), and 12 of them (17.91%) were male and 55 (82.09%) were female. Results: Malignancy was detected in 3 patients (4.48%). Two of them were multiple myeloma and the other one was renal cell carcinoma metastasis. Conclusion: Bone biopsy during PVP procedures does not cause significant time loss or complications. Therefore, revealing the underlying pathology provides a great advantage to the patient and the surgeon. We recommend routine vertebral bone biopsy using a biopsy needle during the PVP procedure.

Clinical Comparison of Low and High Injection Volumes of High-viscosity Bone Cement Used in Percutaneous Vertebroplasty

“…Percutaneous vertebroplasty is widely used throughout the world, particularly in elderly patients, for osteoporotic, traumatic, and pathological VCFs [4]. Bone cement leakage is one of the most common complications of the PVP procedure.…”

Perkütan vertebroplasti uygulanan postmenopozal hastalarda osteoporoza eşlik eden sistemik hastalıklar

“…Sistemik lupus eritematozus, Cooley hastalığı, Paget hastalığı veya uzun süre kortikosteroid kullanımı gibi nedenler de sekonder osteoporoza neden olabilir. Dolayısıyla bu gibi durumlarda da osteoporoza bağlı vertebral kompresyon kırıkları (VKK) ortaya çıkabilir (1) .…”