Therapeutic impact of percutaneous spinal biopsy in spinal infection

Abstract

Objective: To investigate the therapeutic impact of percutaneous spinal biopsy in patients with suspected spinal infection. Design and patients: A review of the case notes and imaging features of 36 patients who underwent percutaneous spinal biopsy was performed. From this group 20 patients with a prebiopsy diagnosis of spinal osteomyelitis were identified. Management before biopsy was noted including the use of antimicrobial therapy. The results of the histology and microbiology were noted along with the subsequent diagnosis and management.

Identifying Pathogens of Spondylodiscitis: Percutaneous Endoscopy or CT-guided Biopsy

“…They found CT-guided biopsy is an accurate method for identifying pathogens in active bacterial disc space infections, but is less reliable for identifying fungal infections. Rankine et al analyzed 20 patients undergoing percutaneous spinal biopsies for spinal infections [18]. They isolated organisms in six of 12 patients not taking antibiotics, whereas an organism was isolated in only two of eight patients taking antibiotics.…”

“…The reported accuracy of spinal biopsy varies from 36% to 91% according to the organism isolated [5,8,17,18,20,21]. In a retrospective study of postoperative spondylodiscitis, Fouquet et al obtained positive bacteriologic diagnoses in nine (36%) of 25 patients who had biopsies [8].…”

“…Computed tomographic-guided biopsy for bacteriologic diagnosis has a variable rate of 36% to 91% reported accuracy in patients with spinal infections [5,8,17,18,20,21]. Percutaneous endoscopic discectomy and drainage (PEDD), a relatively new technique, is emerging because of its simplicity and apparent diagnostic accuracy from 45% to 87% according to the organism isolated [10,13,22].…”

Percutaneous endoscopic discectomy and drainage for infectious spondylitis

“…In cases of spinal infection the reported accuracy of spinal biopsy varies from 36-76%, according to the organism isolated [5,8,19,23,24]. Fouquet et al obtained 2 97 5 38 9 3 15 2 60 6 4 6 0 7 7 5 182 129 6 239 125 7 147 4 57 7 8 18 2 57 6 9 49 3 95 6 10 65 4 85 8 11 11 1 35 3 12 127 3 116 5 13 20 1 52 3 14 31 2 33 4 15 96 3 69 5 bacteriological diagnosis in nine (36%) of 25 patients biopsied, using a Mazabraud trocar [5].…”

“…However, spinal biopsy for bacteriologic diagnosis has a variable rate of reported success in patients with spondylitis [5,8,19,23,24]. In addition to inadequate amount of biopsy tissue, a high degree of radiation exposure is another concern [15,17].…”