Approach-based techniques of CT-guided percutaneous vertebral biopsy
Dharmendra Kumar Singh, Nishith Kumar, Bibhu Kalyan Nayak, Binita Jaiswal, Sagar Tomar, Mahesh Kumar Mittal, Sunil Bajaj
Abstract
istopathological confirmation of a vertebral lesion can be done either by open surgical method or by a minimally invasive (percutaneous imaging-guided) method. Open surgical biopsy in a vertebral lesion carries a significant risk of morbidity, the possibility of spillage or contamination of adjacent tissue planes and postoperative complications (1, 2). Percutaneous imaging-guided biopsy of a vertebral lesion can be performed under the guidance of computed tomography (CT). Percutaneous CT-guided biopsy of the vertebral lesion is a safe, effective and accurate diagnostic tool and is favored over open techniques when feasible (3). The common indications for vertebral biopsy are histological characterization of focal vertebral lesion; characterization of suspected as well as known spinal metastasis, receptor/immunohistochemical analyses; diagnosis of a suspect spondylodiscitis, histopathology and microbiological test; diagnosis of atraumatic vertebral fractures of unknown origin with differentiation between osteoporotic, neoplastic, and inflammatory fractures (4-6). This technical note will highlight the approach-based techniques of CT-guided percutaneous vertebral biopsy.