THE VALUE OF PERCUTANEOUS TRANSPEDICULAR VERTEBRAL BONE BIOPSIES FOR HISTOLOGIC EXAMINATION - RESULTS OF AN EXPERIMENTAL HISTOPATHOLOGIC STUDY COMPARING 2 BIOPSY NEEDLES

Study Design. A 3.5-mm trephine was designed to overcome difficulties encountered in the histologic evaluation of vertebral bone samples obt ained with a 2-mm trephine. Objectives. To compare the 3.5-mm trephine with the 2-mm trephine. Summary of Background Data. A review of resul ts obtained with a 2-mm trephine showed that histologic examination of vertebral bone cores was disturbed by artifacts in 32 of 70 cases (46 %). Although tissue diagnosis was possible from 61 samples, only 36 (5 1%) bone cores yielded a secure diagnosis. Methods. Transpedicular bon e cores were obtained from the bodies of 54 fresh cadaver vertebrae wi th both trephines. In each vertebra, the 2 mm trephine was used on one side, and the 3.5-mm trephine was used on the other side. Longitudina l sections were prepared and examined macroscopically for length and b reak ages and microscopically for trabeculae, marrow, and artifacts. E ach sample was graded for its value for histologic examination. Result s. Significant differences were found between the two trephines for al l criteria evaluated. Of 54 samples taken with the 2-mm trephine. 13 ( 24%) were graded ''good,'' compared with 45 (83%) from the 3.5-mm trep hine. Twelve (22%) ''bad'' samples were taken from the 2-mm trephine c ompared with three (6%) ''bad'' samples taken from the 3.5-mm trephine . Conclusions. The 2-mm trephine does not provide suitable bone cores for histologic examination, whereas samples obtained with the 3.5-mm t rephine are suitable.