title: Role of Transpedicular Percutaneous Vertebral Biopsy for Diagnosis of Pathology in Vertebral Compression Fractures.
abstract: METHODS
  Retrospective observational study.
  
  
  OBJECTIVE
  To identify the role of percutaneous vertebral biopsy in histopathological diagnosis of vertebral compression fractures and to identify the frequency of unexpected malignancy in vertebral compression fractures.
  
  
  BACKGROUND
  Vertebral compression fractures are common in the Indian population. Magnetic resonance imaging and nuclear imaging have some limitations in the diagnosis of definitive pathology of vertebral compression fractures. Therefore, histological confirmation is necessary for definitive diagnosis and to plan appropriate management for patient.
  
  
  METHODS
  A retrospective observational study was conducted involving 84 patients who underwent percutaneous vertebral biopsy between 2010 and 2014. We performed C-arm guided percutaneous transpedicular core vertebral biopsy of vertebral compression fractures under combination of local anesthesia and intravenous conscious sedation.
  
  
  RESULTS
  Sufficient biopsy material was obtained in 79 of the 84 cases. In the other five cases, biopsy material was not sufficient for reporting. Out of the 79 cases, osteoporotic pathology was detected in 69 patients, malignancy was detected in 8 patients and no pathology was found in 2 patients. Two patients with distant metastases to vertebra were identified. Primary spinal malignancy was detected in 6 patients (1 unsuspected plasmacytoma, 5 diagnosed malignancy preoperatively). So, the frequency of unsuspected malignancy of this study was 1.19% (1/84). None of the patients had any complications.
  
  
  CONCLUSIONS
  C-arm guided percutaneous transpedicular vertebral biopsy is useful in obtaining definitive histopathological diagnosis of vertebral compression fractures, especially in differentiating malignant and non-malignant vertebral compression fractures and helping plan appropriate management of patients. The rate of unexpected malignancy in vertebral compression fracture was 1.19%.
authors: Department of Orthopedic Surgery, Hardikar Hospital, Pune, India.
authors: Saurabh Shrinivas
authors: SS
authors: Pagdal
authors: Department of Orthopedic Surgery, Hardikar Hospital, Pune, India.
authors: Sunil
authors: S
authors: Nadkarni
authors: Head of Institutet, Hardikar Hospital, Pune, India.
authors: Sharad Moreshwar
authors: SM
authors: Hardikar
authors: Department of Orthopedic Surgery, Hardikar Hospital, Pune, India.
authors: Madan Sharad
authors: MS
authors: Hardikar
keywords: Compression fracture; Needle biopsies; Osteoporosis; Second malignancies