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Effectiveness of Fluoroscopy-Guided Percutaneous Vertebral Biopsy[*]Article in several languages: português | English
Objective To define the effectiveness of fluoroscopy-guided percutaneous vertebral biopsy.
Methods Prospective study of patients with vertebral destruction syndrome at one institution. Percutaneous transpedicular vertebral biopsies guided by fluoroscopy were performed, and bony tissue and intervertebral disc tissue were extracted; histopathology and microbiology studies were also performed. Age, sex, vertebral segment, neurologic status, and biopsy and culture results were analyzed.
Results The average age of the patients was 53.8 years (range: 2 to 83 years), and the main spine segment was the lumbar segment in 62% of the cases. According to the impairment scale of the American Spinal Injury Association (ASIA), preoperatively, 49% of the patients were classified as Asia E, and 100% had pain. Definitive etiology was identified in 83% of the sample. The etiology was grouped into three categories: infectious, neoplasia, and degenerative (osteoporotic). The infectious group was composed of 36% of the patients, in whom Staphylococcus aureus was the most common agent identified; in 34.9% the sample, the etiology was neoplastic, most commonly multiple myeloma and metastatic disease due to prostate cancer; 21.7% of the patients had osteoporosis. The average surgical time was of 47.5 minutes, the average blood loss was of 10 mL. No complications were reported.
Conclusion Transpedicular percutaneous biopsy guided by fluoroscopy had an effectiveness of 83% for the etiological diagnosis of vertebral destruction syndrome in the present series. It should be considered a useful minimally-invasive procedure, which is easy, economical, and reproducible, with low risk of short- and long-term complications.
* Work developed at Hospital Regional de Alta Especialidad del Bajío, Universidad de Guanajuato, Guanajuato, Mexico.
There was no financial support from public, commercial, or non-profit sources.
Received: 19 March 2020
Accepted: 06 July 2020
30 August 2021 (online)
© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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- 1 Alpízar-Aguirre A, Elías-Escobedo A, Rosales-Olivares LM, Miramontes-Martínez V, Reyes-Sánchez A. Síndrome de destrucción vertebral. Sistemas de evaluación en su diagnóstico. Cir Cir 2008; 76 (03) 205-211
- 2 Metzger CS, Johnson DW, Donaldson III WF. Percutaneous biopsy in the anterior thoracic spine. Spine 1993; 18 (03) 374-378
- 3 Robertson RC, Ball RP. Destructive spinal lesions: diagnosis by needle biopsy. J Bone Joint Surg 1935; 17: 749-758
- 4 Ottolenghi CE. Aspiration biopsy of the spine. Technique for the thoracic spine and results of twenty-eight biopsies in this region and over-all results of 1050 biopsies of other spinal segments. J Bone Joint Surg Am 1969; 51 (08) 1531-1544
- 5 Valls J, Ottolenghi CE, Schajowicz F. Aspiration biopsy in diagnosis of lesions of vertebral bodies. J Am Med Assoc 1948; 136 (06) 376-382
- 6 Craig FS. Vertebral-body biopsy. J Bone Joint Surg Am 1956; 38-A (01) 93-102
- 7 Rosales-Olivares LM, Valle-Cerna I, Alpízar-Aguirre A, Miramontes-Martínez V, Arenas-Sordo MdeL, Reyes-Sánchez A. Evaluación de la biopsia percutánea en el diagnóstico del síndrome de destrucción vertebral tóracico y lumbar. Cir Cir 2007; 75 (06) 459-463
- 8 Misenhimer GR, Peek RD, Wiltse LL, Rothman SL, Widell Jr EH. Anatomic analysis of pedicle cortical and cancellous diameter as related to screw size. Spine (Phila Pa 1976) 1989; 14 (04) 367-372
- 9 Rosales Olivarez LM, Nieto Sandoval HR, Alpízar Aguirre A, Zárate Kalfopulos B, Sánchez Bringas MG, Reyes Sánchez AA. Evaluacion de la biopsia transpedicular guiada por TAC. Coluna/Columna 2012; 11 (03) 209-213
- 10 Rehm J, Veith S, Akbar M, Kauczor HU, Weber MA. CT-Guided Percutaneous Spine Biopsy in Suspected Infection or Malignancy: A Study of 214 Patients. Rofo 2016; 188 (12) 1156-1162