Study Design. Despite increasing information regarding pedicular instr
umentation, the transpedicular biopsy of the vertebral body has not be
en popularized. The precise technique for percutaneous transpedicular
biopsy and the volume of the vertebral body accessible through the ped
icle has not been reported. Objective. To describe the percutaneous tr
anspedicular biopsy, its diagnostic yield, to determine the amount of
bone retrievable through the pedicle. Summary of Background Data. Expe
rience gained from open biopsy facilitates the development of the perc
utaneous technique. There were no complications with the open or close
d procedures. Methods. Transpedicular biopsy was performed on 18 patie
nts (nine open and nine percutaneous). Unilateral transpedicular curet
ments were performed on the cadaveric lumbar spines. The volume of the
vertebral body accessible through the pedicle was determined using ro
entgenograms, computed tomography, and image analysis. Results. Adequa
te specimens for a correct diagnosis were obtained in all biopsies. La
boratory volumetric analysis demonstrated that more than 50% of the vo
lume of a lumbar vertebral body is accessible through a unilateral tra
nspedicular approach, without compromising the anatomic structure of t
he pedicle. Conclusions. The vertebral pedicle provides a safe conduit
for biopsy of most vertebral body lesions. Percutaneous transpedicula
r biopsy can be performed with minimal morbidity and high diagnostic y
ield.