title: Rate of Unsuspected Malignancy in Patients With Vertebral Compression Fracture Undergoing Percutaneous Vertebroplasty.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To determine the malignancy rate and histology in bone biopsies obtained during PVP for VCF.
  
  
  BACKGROUND
  Osteoporotic vertebral compression fractures (VCF) affect approximately 20% of postmenopausal women and can lead to long-term disability. Percutaneous vertebroplasty (PVP) is a minimally invasive procedure, primarily used in patients with severe pain after VCF. Even with a thorough clinical examination, magnetic resonance imaging (MRI) scans, and blood samples, some fractures maybe caused by an underlying malignant disease.
  
  
  METHODS
  144 consecutive patients underwent PVP for painful VCF, at the Center for Spine Surgery and Research, Middelfart Hospital. All patients had bone biopsies obtained during the PVP, and these biopsies were sent to the Department for Pathology at Vejle Sygehus for histologic diagnosis.
  
  
  RESULTS
  About 144 patients were included in this study. The majority of the biopsy specimens (137, 95.1%) were acceptable for histological diagnosis. One hundred and twenty nine (89.6%) biopsies showed no signs of malignancy. Seven (4.9 %) were positive for malignancy. One biopsy was positive for MGUS. Seven (4.9 %) of the biopsies were unsuitable for histologic diagnosis.
  
  
  CONCLUSIONS
  Our study shows an incidence of unsuspected malignancy in biopsies during PVP of 4.9%. Conservative treatment with analgesics and brace can potentially delay diagnosis and treatment of underlying malignant disease. We recommend biopsy during PVP as a standard procedure, to insure not to overlook any underlying malignancy despite the MRI-scan, blood analysis, and clinical examination being inconspicuous.
authors.affiliation: Center for Spine Surgery and Research, Middelfart Hospital, Ostre Hougvej Middelfart, Denmark.
authors.forename: Emil Jesper
authors.initials: EJ
authors.lastname: Hansen
authors.forename: Ane
authors.initials: A
authors.lastname: Simony
authors.forename: Leah
authors.initials: L
authors.lastname: Carreon
authors.forename: Mikkel Osterheden
authors.initials: MO
authors.lastname: Andersen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001859:Bone Neoplasms / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D050815:Fractures, Compression / Q000150:complications / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000150:complications / Q000453:epidemiology* / Q000601:surgery*; D054854:Vertebroplasty / Q000379:methods*