CT-guided Percutaneous Biopsy of the Spine: Transpedicular approach

ABSTRACT

PURPOSE: To evaluate the efficiency of CT-guided transpedicular biopsy in obtaining diagnostic tissue fromvertebral body lesion. MATERIALS AND METHODS: The authors evaluated 25 patients(27 cases) who underwent CT-guidedtranspedicular biopsy for thoracic and lumbar vertebral lesions. Specimens were obtained from 27 lesions, sevenfrom thoracic spine and others from lumbar spine. Nine patients were men and 16 were women ; their ages rangedfrom 20 to 80 years. A 17-gauge "Osty-Cut" bone biopsy needle(Angiomed) with a hand-grip was used, and the patientwas placed in the prone position. For the analysis of results, pathologic reports were reviewed and follow-upstudies were checked. RESULTS: In all patients, the biopsy needle could be passed under CT guidance through thepedicle to the site of the disease. Pathologic reports indicated 11 malignancies, 11 normal trabecular bones andtwo cases of infectious spondylitis. Three cases were not diagnosed because of insufficient biopsy specimen. Eightcases of normal trabecular bone described in pathologic reports were confirmed by follow-up study. There were nocomplications during and after biopsy, and for pathologic diagnosis this was successful in 24 of 27 cases(88.9%). CONCLUSION: CT-guided transpedicular biopsy of vertebral lesion was safe and efficacious, especially in cases inwhich the posterolateral approach was difficult.