CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2021; 56(04): 453-458
DOI: 10.1055/s-0040-1718950
Artigo Original
Coluna

Effectiveness of Fluoroscopy-Guided Percutaneous Vertebral Biopsy[*]

Article in several languages: português | English
1  Cirurgia de Coluna, Departamento de Neurocirurgia, Hospital Regional de Alta Especialidad del Bajío, Universidad de Guanajuato, León, Guanajuato, México
,
2  Departamento de Neurocirurgia, Hospital Regional de Alta Especialidad del Bajío, Universidad de Guanajuato, León, Guanajuato, México
,
3  Neurocirurgia Pediátrica, Departamento de Neurocirurgia, Hospital Regional de Alta Especialidad del Bajío, Universidad de Guanajuato, León, Guanajuato, México
,
4  Cirurgia Ortopédica, Departamento de Cirurgia Ortopédica e Traumatologia, Centenario Hospital Miguel Hidalgo, Aguascalientes, Aguascalientes, México
› Author Affiliations

Abstract

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.


Financial Support

There was no financial support from public, commercial, or non-profit sources.




Publication History

Received: 19 March 2020

Accepted: 06 July 2020

Publication Date:
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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