PERCUTANEOUS TRANSPEDICULAR BIOPSY OF THE SPINE

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.