[Percutaneous biopsy evaluation in the diagnosis of thoracic and lumbar vertebral destruction syndrome].
BACKGROUND
The vertebral destruction syndrome is defined as those pathologies affecting the integrity of the vertebral structure, modifying its normal architecture and resulting in neurological deficit. Correct diagnosis is essential to define appropriate treatment. Biopsy, in addition to histopathological study, is a vital element for definitive diagnosis.


METHODS
We carried out a descriptive, deliberate interventional study in 20 patients with a diagnosis of vertebral destruction in whom a percutaneous transpendicular biopsy was done between January 2005 and July 2006. Variables analyzed were age, sex, affected segment, neurological condition, neurological deficit type, results of the biopsy and specific diagnosis.


RESULTS
There was a predominance of males (55%). The lumbar spine was the most affected region in 80% of patients. Of the biopsies performed, 10% were reported as normal tissue, 20% with degenerative changes, 15% with inflammatory changes, 15% with primary tumoral lesion, 5% with chronic osteomyelitis, 10% with tuberculosis, 15% with tumoral metastasis and 10% necrotic devitalized bone tissue. Of these patients, 55% were treated nonsurgically, and the remaining 45% were treated surgically. No complications were reported.


CONCLUSIONS
Percutaneous transpedicular biopsy has only 55% specificity in diagnosis and for that reason is a less useful diagnostic method in our setting for destructive lesion diagnosis from the vertebral body.
Rosales-Olivares
Luis Miguel
LM
Servicio Cirugía de Columna Vertebral, Instituto Nacional de Rehabilitación, Secretaría de Salud, México, D.F., Mexico.
Valle-Cerna
Iván
I
Alpizar-Aguirre
Armando
A
Miramontes-Martínez
Victor
V
Arenas-Sordo
María de la Luz
Mde L
Reyes-Sánchez
Alejandro
A
D000328:Adult; D001706:Biopsy / Q000379:methods; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013122:Spinal Diseases / Q000473:pathology*; D013577:Syndrome; D013904:Thoracic Vertebrae / Q000473:pathology*