title: Percutaneous transpedicular biopsy of vertebral body lesions.
abstract: METHODS
  This prospective study evaluates the use of transpedicular biopsy in obtaining diagnostic tissue from vertebral body lesions.
  
  
  OBJECTIVE
  To report the authors' experience of all (N = 32) percutaneous transpedicular biopsies performed between 1990-1994.
  
  
  BACKGROUND
  Previous articles have discussed the value of open biopsy of the vertebral body using a Craig needle. A large series of closed percutaneous transpedicular biopsies have not been reported.
  
  
  METHODS
  The authors evaluated 32 patients (26 outpatients, six inpatients) who underwent transpedicular biopsy for T1-L4 lesions of the vertebral bodies. None of the tumors had an extraosseous component. Biopsy specimens were obtained from 25 lesions using C-arm fluoroscopy; seven were guided by computed tomography. All biopsies were performed with a 14- to 17-gauge bone biopsy needle.
  
  
  RESULTS
  The needle passed through the pedicle into the site of disease in all patients, as confirmed by C-arm fluoroscopy or computed tomography. There were 22 malignancies; four isolated compression fractures, two at T6, one at T7, one at T8; four cases of infection or inflammation; and one case each of Paget's disease and myelofibrosis. Two patients required a second biopsy because the tissue sample was suspicious for lymphoma but not diagnostic. All 26 outpatients were discharged after a 2-hour observation period. There were no complications.
  
  
  CONCLUSIONS
  Transpedicular biopsy of deep vertebral body lesions using a bone biopsy needle under computed tomography or fluoroscopy guidance can be performed safely and efficaciously as an outpatient procedure.
authors.affiliation: Department of Radiology, Washington Cancer Institute, Washington Hospital Center, Washington, DC, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Jelinek
authors.forename: M J
authors.initials: MJ
authors.lastname: Kransdorf
authors.forename: R
authors.initials: R
authors.lastname: Gray
authors.forename: A J
authors.initials: AJ
authors.lastname: Aboulafia
authors.forename: M M
authors.initials: MM
authors.lastname: Malawer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013122:Spinal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*