Percutaneous transpedicular biopsy of the spine.
METHODS
Despite increasing information regarding pedicular instrumentation, the transpedicular biopsy of the vertebral body has not been popularized. The precise technique for percutaneous transpedicular biopsy and the volume of the vertebral body accessible through the pedicle has not been reported.


OBJECTIVE
To describe the percutaneous transpedicular biopsy, its diagnostic yield, to determine the amount of bone retrievable through the pedicle.


BACKGROUND
Experience gained from open biopsy facilitates the development of the percutaneous technique. There were no complications with the open or closed procedures.


METHODS
Transpedicular biopsy was performed on 18 patients (nine open and nine percutaneous). Unilateral transpedicular curetments were performed on the cadaveric lumbar spines. The volume of the vertebral body accessible through the pedicle was determined using roentgenograms, computed tomography, and image analysis.


RESULTS
Adequate specimens for a correct diagnosis were obtained in all biopsies. Laboratory volumetric analysis demonstrated that more than 50% of the volume of a lumbar vertebral body is accessible through a unilateral transpedicular approach, without compromising the anatomic structure of the pedicle.


CONCLUSIONS
The vertebral pedicle provides a safe conduit for biopsy of most vertebral body lesions. Percutaneous transpedicular biopsy can be performed with minimal morbidity and high diagnostic yield.
Stringham
D R
DR
Division of Orthopedic Surgery, University of Arizona Health Sciences Center, Tucson.
Hadjipavlou
A
A
Dzioba
R B
RB
Lander
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D002102:Cadaver; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed