Vertebral Biopsy

KEY FACTS

Terminology

• Image-guided percutaneous vertebral biopsy

• Cerebrospinal fluid

Preprocedure

• Indications

  • Suspected tumor (biopsy ± vertebroplasty/kyphoplasty)

  • Osteomyelitis/discitis (identify responsible organism, determine antimicrobial sensitivity)

Procedure

• Biopsy ± fine-needle aspiration (FNA)

  • ± vertebroplasty, kyphoplasty, vertebral augmentation

• Selection of biopsy system to use depends on

  • Lesion size, location

  • Operator experience/preference

Post Procedure

• Ensure proper specimen handling, communication of results to clinician

• Follow-up on biopsy results

  • Operator quality assurance

  • Accountability to patient and referring clinician

Outcomes

• Problems

  • Nondiagnostic specimen

    • –

      May be reduced by pathologist in attendance if FNA to be performed

      • □

        FNA not practical to confirm specimen in cases of bone biopsy

• Complications

  • Most feared: Spinal cord or vascular injury, epidural/subdural hematoma, osteomyelitis, meningitis

  • Others: Local infection, bleeding, nerve injury