title: The value of routine biopsy during percutaneous kyphoplasty for vertebral compression fractures.
abstract: OBJECTIVE
  Percutaneous kyphoplasty (PKP) is now widely performed to treat VCF, which is usually caused by osteoporosis. Previous researches have reported unsuspected malignancies found by biopsy. However, the safety and cost-effective profiles of routine biopsy during PKP are unclear. The purpose of this study was to evaluate the feasibility of routine biopsy during PKP in treatment of VCF.
  
  
  METHODS
  Ninety-three patients (September 2007-November 2010) undergoing PKP without biopsy were reviewed as the control group. One hundred and three consecutive patients (November 2010-September 2013) undergoing PKP with biopsy of every operated vertebral level were prospectively enrolled as the biopsy group. The rate of unsuspected lesions was reported, and the severe adverse events, surgical duration, cement leakage rate and pain control were compared between the two groups.
  
  
  RESULTS
  No statistically significant differences were found between the two groups, regarding the severe adverse events, surgical duration, cement leakage rate and pain control. Four unsuspected lesions were found in the biopsy group, three of which were malignancies with a 2.9% (3/103) unsuspected malignancy rate. The economic analysis showed that routine biopsy was cost-effective in finding new malignancies comparing with a routine cancer screening campaign.
  
  
  CONCLUSIONS
  Routine biopsy during PKP was safe and cost-effective in finding unsuspected malignancies. We advocate routine biopsy in every operated vertebral level during PKP for VCF patients.
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Surgery, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Surong
authors.initials: S
authors.lastname: Hua
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Chu
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Siyi
authors.initials: S
authors.lastname: Cai
authors.affiliation: Department of Orthopedics, Peking Union Medical College Hospital, Beijing, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000368:Aged; D001706:Biopsy / Q000009:adverse effects; D016022:Case-Control Studies; D003362:Cost-Benefit Analysis; D003955:Diagnostic Tests, Routine / Q000009:adverse effects* / Q000191:economics; D055088:Early Detection of Cancer / Q000009:adverse effects / Q000191:economics; D005240:Feasibility Studies; D005260:Female; D050815:Fractures, Compression / Q000473:pathology* / Q000601:surgery; D006801:Humans; D058498:Kyphoplasty / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016103:Spinal Fractures / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome