Diagnostic Accuracy of Percutaneous Needle Biopsy of Vertebral Lesions

Cho, Kyu Jung; Oh, In Suk; Ko, Suk Myun; Kim, Won Hong; Kim, Chang Sun; Park, Seung Rim

Abstract

STUDY DESIGN: This retrospective study is to confirm the diagnostic accuracy of percutaneous needle biopsy of vertebral lesions.
OBJECTIVES
To evaluate the diagnostic accuracy of percutaneous needle biopsy and the clinical and pathological correlation of vertebral lesions. SUMMARY OF LITERATURE REVIEW: A review of previous articles showed that the diagnostic accuracy of percutaneous needle biopsy of vertebral lesions was between 77-94%. The greatest accuracy was achieved in diagnosis of metastatic disease or infection.
MATERIALS AND METHODS
We performed 22 percutaneous needle biopsies in twenty vertebral bodies and two posterior elements under the CT guidance. All biopsies were performed with a 16-gauge Osty-cut bone biopsy needle. There were 1 cervical, 8 thoracic and 13 lumbar biopsies. Transpedicular approach was performed on 13 patients and paraspinal approach on 7 patients. There were 8 malignancies, 9 infections, 2 benign tumors, 2 compression fractures and 1 butterfly vertebra.
RESULTS
An accurate diagnosis was made in 18 cases(81.8%) of all cases. Two of the 22 specimens were blood clots and two specimens of tuberculous spondylitis were insufficient for definite diagnosis. Bacteriological studies revealed a causative agent in 43% of pyogenic spondylitis. Histologic diagnosis confirming the clinical suspicion was obtained in 16(80%) of the 20 positive cases. There was no complication.
CONCLUSION
Percutaneous needle biopsy under the CT guidance is a safe and accurate method for obtaining a diagnosis of vertebral lesions such as osteolytic lesion and infection.