Study Design. Efficacy of the percutaneous biopsy of the spine under c
omputed tomographic guidance was investigated. Seventy-five patients,
ranging in age from 7 to 72 years, underwent this procedure. Objective
s. To determine the usefulness of computed tomographically guided biop
sies in the treatment of patients with spinal disorders. Summary of Ba
ckground Data. The results of 68 biopsies (90.6%) were judged to be ac
curate insofar as the samples of tissue obtained could be diagnosed as
specific types of neoplasm, infective lesions, reactive lesions of no
nspecific type, or normal bone. Methods. Biopsies that yielded a speci
fic abnormality were categorized as true positives. The ''normal'' bio
psies were followed for 6-18 months and were then deemed true negative
s. Nondiagnostic ones were considered false negatives. Results. The re
sults are acceptable with an accuracy rate of 90.6%. It is a safe and
simple procedure with a short learning curve. Conclusions. Computed to
mographically guided biopsy of the spine is recommended as a procedure
of choice, especially in cervical and thoracic lesions. Computed tomo
graphy is superior to fluoroscopy when dealing with small, deep-seated
lesions especially in the cervical and thoracic regions and with lesi
ons picked up on bone scan only, radiographs being negative. Needle bi
opsy under computed tomographic guidance is safe and precise.