Percutaneous coaxial transpedicular biopsy of vertebral body lesions during vertebroplasty

We evaluated the safety and histological results of percutaneous transpedic ular biopsy in patients undergoing vertebroplasty for vertebral collapse. O ver a 6 year period, we carried out biopsies in 46 patients who underwent p ercutaneous injection of acrylic surgical cement for 57 collapsed vertebrae , because the diagnosis was not clearly established on clinical or imaging grounds. All procedures were performed under fluoroscopic guidance via a co axial bitranspedicular approach used for vertebroplasty. We performed a cli nical examination and CT after every procedure and approximately 6 months t hereafter. Biopsies contributed to in 55 (96.5%) of the 57 vertebral lesion s. Biopsy material was inadequate in one case (1.7%) and one biopsy was a f alse-negative (1.7%). The accuracy of the histological results was 98.2%, a llowing a correct diagnosis in 55 of the 56 procedures. Of the 37 lesions i n 25 patients with a history of a tumour; the final diagnosis was osteoporo tic collapse in 25 (67.6%), metastasis in nine (24.3%), and myeloma in thre e (8.1%). The final diagnosis in the 19 lesions in 17 patients without a kn own tumour was osteoporotic collapse in 12 (63.2%), metastasis in five (26. 3%), and amyloidosis in two (10.5%), the latter in one patient. No complica tions were observed.