Skip to main content
SpringerLink
Log in

Percutaneous wide bore needle biopsy for spinal lesions using the kyphoplasty cannula—a technical note

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

Management of vertebral and discovertebral lesions depends on highly specific modalities like biopsy and histopathology. The transpedicular and transforaminal routes have gained popularity for obtaining samples for diagnosing these lesions. Sample inadequacy plays an important part in lowering the diagnostic accuracy. Present study introduces a technical modification by using a kyphoplasty cannula and pituitary forceps through it thus improving sample adequacy and diagnostic accuracy.

Methods

Seventy-one patients with radiological evidence of spinal lesions from T1 to S1 were included. After obtaining samples via the transpedicular route they were sent for aerobic, anaerobic, acid fast bacilli & fungal cultures, Mycobacterium Tuberculosis/Radio Immuno Frequency (MTB/RIF) Assay and histopathological examination. In lesions with minimal vertebral erosions the transforaminal route was used to obtain samples from the disc space.

Results

Sixty-eight patients (95.8%) had a definite diagnosis of which 37 patients (54.4%) tested positive for vertebral osteomyelitis/discitis. All the samples were found to be adequate on histopathological examination. The remaining 3 patients showed chronic inflammation and responded to oral and intravenous antibiotics. None of the patients underwent repeat biopsy. There were no perioperative complications.

Conclusions

Percutaneous transpedicular biopsy has evolved as the intervention of choice in diagnosing radiologically proven vertebral body lesions. Our technique of using a pituitary forceps through a cannula is highly effective in getting an adequate representative sample with excellent accuracy in diagnosis. This procedure is beneficial for soft tissue lesions and for infective pathology especially discitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Dave BR, Nanda A, Anandjiwala JV (2009) Transpedicular percutaneous biopsy of vertebral body lesions: a series of 71 cases. Spinal Cord 47:384–389

    Article  CAS  Google Scholar 

  2. Stringham DR, Hadjipavlou A, Dzioba RB et al (1994) Percutaneous transpedicular biopsy of the spine. Spine (Phila Pa 1976) 19:1985–1991

    Article  CAS  Google Scholar 

  3. Fraser-Hill MA, Renfrew DL, Hilsenrath PE (1992) Percutaneous needle biopsy of musculoskeletal lesions. 2. Cost-effectiveness. AJR Am J Roentgenol 158:813–818

    Article  CAS  Google Scholar 

  4. Shidham VB, Dravid NV, Kher AV (1984) Role of scrape cytology in intraoperative diagnosis values and limitations. Acta Cytol 28:477–482

    CAS  PubMed  Google Scholar 

  5. Dupuy DE, Rosenberg AE, Punyaratabandhu T (1998) Accuracy of CT-guided needle biopsy of musculoskeletal neoplasms. Am J Roentgenol 171:759–762

    Article  CAS  Google Scholar 

  6. Mankin HJ, Lange TA, Spanier SS (1982) The hazards of biopsy in patients with malignant primary bone and soft-tissue tumors. J Bone Joint Surg Am 64:1121–1127

    Article  CAS  Google Scholar 

  7. Yang YJ, Damron TA (2004) Comparison of needle core biopsy and fine needle aspiration for diagnostic accuracy in musculoskeletal lesions. Arch of Pathol Lab Med 128(7):759–764

    Article  Google Scholar 

  8. Brugieres P, Revel MP, Dumas JL et al (1991) CT-guided vertebral biopsy: a report of 89 cases. J Neuroradiol 18:351–359

    CAS  PubMed  Google Scholar 

  9. Nourbakhsh A, Grady JJ, Garges KJ (2008) Percutaneous spine biopsy: a meta-analysis. J Bone Joint Surg Am 90:1722–1725

    Article  Google Scholar 

  10. Kornblum MB, Wesolowski DP, Fischgrund JS et al (1998) Computed tomography guided biopsy of the spine. Spine 23:81–85

    Article  CAS  Google Scholar 

  11. Rimondi E, Staals EL, Errani C (2008) Percutaneous CT-guided biopsy of the spine: results of 430 biopsies. Eur Spine J 17(7):975–981

    Article  Google Scholar 

  12. Basu S, Tikoo A, Malik FH et al (2015) Percutaneous C-arm-guided wide bore needle biopsy for intraosseous spinal lesions. J Postgrad Med Edu Res 49(1):5–9

    Article  Google Scholar 

  13. Naresh-Babu J, Neelima G, Reshma-Begum SK (2014) Increasing the specimen adequacy of transpedicular vertebral body biopsies. Role of intraoperative scrape cytology. Spine J 14:2320–2325

    Article  CAS  Google Scholar 

  14. Basu S, Ghosh JD, Malik FH et al (2012) Postoperative discitis following single-level lumbar discectomy: Our experience of 17 cases. Indian J Orthop 46(4):427–433

    Article  Google Scholar 

  15. Krishnan A, Barot MP, Dave BR et al (2018) Percutaneous transforaminal endoscopic discectomy and drainage for spondylodiscitis: A technical note and review of literature. J Orthop Allied Sci 6(S1):16–20

    Article  Google Scholar 

Download references

Funding

Not Applicable.

Author information

Authors and Affiliations

  1. Park clinic, 4, Gorky Terrace, Minto Park, Kolkata, 700017, India

    Saumyajit Basu, Rohan B. Gala & Anil M. Solanki

Authors
  1. Saumyajit Basu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rohan B. Gala
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anil M. Solanki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rohan B. Gala.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Basu, S., Gala, R.B. & Solanki, A.M. Percutaneous wide bore needle biopsy for spinal lesions using the kyphoplasty cannula—a technical note. Eur Spine J 30, 2852–2856 (2021). https://doi.org/10.1007/s00586-021-06819-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-021-06819-y

Keywords

Search

Navigation