Percutaneous Biopsy of the Spine: Analysis of 84 Cases

Abstract

Objective: Percutaneous vertebral biopsy can be performed under local anesthesia on an outpatient basis. So then additional therapies such as radiotherapy, chemotherapy and antibiotherapy may be planned without an open surgery after getting histopathological or microbiological results. This study aims to analyse the accuracy and results of a series of patients that we performed percutaneous biopsy of the spine. Methods: The medical records of 84 patients with vertebral pathologic lesions who underwent percutaneous vertebral biopsy at our institution between 1995 and 2007 were reviewed. Results: There were 84 patients (49 male, 35 female). The biopsies were performed in the following regions: cervical (5), thoracic (18), lumbar (49) and sacral (12). The diagnoses were spondylodiscitis in 32, primary tumors in 17, and metastatic tumors in 24 cases. Eleven biopsies were not diagnostic. In patients with spondylodiscitis, the most common isolated microorganism was Staphylococcus aureus (13), followed by Mycobacterium tuberculosis (9). The lumbar spine was the most common location of infection (19 of 32) and also of metastatic tumors (13 of 24). 34 patients underwent a surgical procedure according to the biopsy results. There were no post procedure complications or mortality in our series. 73 of our biopsies (87%) were diagnostic. Conclusions: Fluoroscopic guided percutaneous vertebral biopsy is still an important diagnostic method for the accurate diagnosis and treatment of vertebral pathologic lesions. Its accuracy and low complication rate are similar to that of the CT guided biopsy technique.