Study Design. This prospective study evaluates the use of transpedicul
ar biopsy in obtaining diagnostic tissue from vertebral body lesions.
Objective. To report the authors' experience of all (N = 32) percutane
ous transpedicular biopsies performed between 1990-1994. Summary of Ba
ckground Data. Previous articles have discussed the value of open biop
sy of the vertebral body using a Craig needle. A large series of close
d percutaneous transpedicular biopsies have not been reported. Methods
. The authors evaluated 32 patients (26 outpatients, six inpatients) w
ho underwent transpedicular biopsy for T1-L4 lesions of the vertebral
bodies. None of the tumors had an extraosseous component. Biopsy speci
mens 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 th
e pedicle into the site of disease in all patients, as confirmed by C-
arm fluoroscopy or computed tomography. There were 22 malignancies; fo
ur isolated compression fractures, two at T6, one at T7, one at T8; fo
ur cases of infection or inflammation; and one case each of Paget's di
sease 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. The
re were no complications. Conclusions. Transpedicular biopsy of deep v
ertebral body lesions using a bone biopsy needle under computed tomogr
aphy or fluoroscopy guidance can be performed safely and efficaciously
as an outpatient procedure.