Effectiveness of Fluoroscopy-Guided Percutaneous Vertebral Biopsy<sup/>

Prospective study of patients with vertebral destruction syndrome at one institution. Percutaneous transpedicular vertebral biopsies guided by fluoroscopy were performed, and bony tissue and intervertebral disc tissue were extracted; histopathology and microbiology studies were also performed. Age, sex, vertebral segment, neurologic status, and biopsy and culture results were analyzed.

Results

The average age of the patients was 53.8 years (range: 2 to 83 years), and the main spine segment was the lumbar segment in 62% of the cases. According to the impairment scale of the American Spinal Injury Association (ASIA), preoperatively, 49% of the patients were classified as Asia E, and 100% had pain. Definitive etiology was identified in 83% of the sample. The etiology was grouped into three categories: infectious, neoplasia, and degenerative (osteoporotic). The infectious group was composed of 36% of the patients, in whom Staphylococcus aureus was the most common agent identified; in 34.9% the sample, the etiology was neoplastic, most commonly multiple myeloma and metastatic disease due to prostate cancer; 21.7% of the patients had osteoporosis. The average surgical time was of 47.5 minutes, the average blood loss was of 10 mL. No complications were reported.

Conclusion

Transpedicular percutaneous biopsy guided by fluoroscopy had an effectiveness of 83% for the etiological diagnosis of vertebral destruction syndrome in the present series. It should be considered a useful minimally-invasive procedure, which is easy, economical, and reproducible, with low risk of short- and long-term complications.

Keywords:
spine; lumbar vertebrae; biopsy; spinal neoplasms

CASE	SEX	AGE	SEGMENT	ASIA	FEVER	REPORT	ETIOLOGY	CASE	SEX	AGE	SEGMENT	ASIA	FEVER	REPORT	ETIOLOGY
1	F	64	L	C	YES	NSI	I	51	F	63	L	C	NONE	NSI	I
2	F	51	L	E	NONE	OT	M	52	M	56	L	E	NONE	NM	I
3	M	48	T	A	NONE	M	N	53	M	65	T	L	YES	NSI	I
4	F	42	T	E	NONE	M	N	54	F	75	L	E	NONE	NSI	–
5	M	69	T	D	NONE	PN	N	55	F	69	T	C	NONE	PN	N
6	M	45	L	D	YES	M	N	56	M	65	L	C	NONE	PN	N
7	M	58	T	D	NONE	NSI	–	57	F	53	T	A	NONE	PN	N
8	F	58	L	D	NONE	OT	M	58	M	56	T	A	NONE	NSI	I
9	M	59	T	C	NONE	NSI	–	59	M	2	T	E	NONE	GR	I
10	M	63	L	D	NONE	TB	I	60	M	49	T	D	NONE	NSI	–
11	M	37	L	D	YES	NSI	–	61	F	64	L	E	NONE	OT	M
12	F	57	L	E	NONE	OT	M	62	F	59	LS	D	NONE	NSI	I
13	M	67	T	E	NONE	OT	M	63	M	46	L	E	NONE	NSI	I
14	F	51	C	E	NONE	M	N	64	M	46	L	E	NONE	NSI	I
15	M	71	L	E	NONE	NSI	–	65	M	75	L	D	NONE	NSI	I
16	M	55	L	E	YES	NSI	I	66	M	74	T	E	NONE	OT	M
17	F	34	T	E	NONE	GR	I	67	M	74	T	A	NONE	NSI	–
18	M	60	T	E	NONE	M	N	68	F	16	L	E	NONE	NSI	I
19	F	40	T	B	NONE	M	N	69	M	18	T	E	NONE	TB	I
20	M	15	L	A	NONE	PN	N	70	M	28	L	E	NONE	NSI	I
21	F	44	C	D	NONE	M	N	71	M	65	L	E	NONE	NSI	I
22	M	58	L	D	YES	NSI	I	72	M	59	L	D	NONE	NSI	I
23	M	16	T	E	NONE	NSI	I	73	M	68	L	C	NONE	NSI	I
24	M	18	T	E	NONE	GR	I	74	F	62	S	E	NONE	NSI	–
25	F	58	T	B	NONE	NSI	–	75	M	49	T	A	NONE	PN	N
26	M	64	L	D	YES	NSI	I	76	M	64	L	E	NONE	PN	N
27	M	64	T	E	NONE	M	N	77	F	23	LS	E	YES	NSI	I
28	F	31	TL	D	NONE	NSI	–	78	F	71	LS	E	YES	NSI	I
29	M	18	L	D	YES	GR	I	79	F	67	L	E	NONE	OT	M
30	M	67	L	D	YES	NSI	I	80	M	24	L	D	NONE	NSI	I
31	M	59	T	A	NONE	GR	I	81	F	65	T	A	NONE	NSI	I
32	F	63	L	E	NONE	GR	I	82	M	54	L	E	NONE	NSI	–
33	M	83	T	D	NONE	PN	N	83	F	67	L	E	NONE	NSI	–
34	M	54	L	D	NONE	PN	N	84	F	67	L	E	NONE	OT	M
35	F	13	L	D	NONE	PN	N	85	F	61	L	E	NONE	OT	M
36	M	57	L	C	NONE	NSI	I	86	M	56	L	D	NONE	PN	N
37	M	57	T	A	NONE	M	N	87	F	71	L	E	NONE	OT	M
38	M	10	L	A	NONE	PN	N	88	M	41	L	E	NONE	M	N
39	F	79	L	E	NONE	OT	M	89	F	71	L	E	NONE	OT	M
40	F	40	T	A	NONE	NSI	–	90	F	64	L	E	NONE	NSI	I
41	F	70	L	E	NONE	OT	M	91	F	54	L	E	NONE	NSI	–
42	M	53	L	D	NONE	OT	M	92	M	44	LS	E	NONE	NSI	–
43	M	55	L	D	NONE	OT	M	93	F	59	L	C	NONE	NSI	I
44	F	47	L	D	NONE	NSI	I	94	F	78	L	E	NONE	OT	M
45	F	51	T	E	NONE	M	N	95	M	71	T	A	NONE	M	N
46	M	54	T	D	NONE	PN	N	96	M	69	T	D	NONE	PN	N
47	M	70	L	E	NONE	NSI	–	97	F	67	L	E	NONE	PN	N
48	M	25	TL	E	NONE	GR	I	98	F	67	L	D	NONE	PN	N
49	M	54	T	C	NONE	GR	I	99	F	57	T	E	NONE	OT	M
50	M	43	T	C	NONE	M	N	100	F	78	L	E	NONE	OT	M

ETIOLOGIC GROUP	CASES	N
INFECTIOUS	43.37%	36
Staphylococcus aureus	38.63%	17
Brucella abortus	22.72%	10
Mycobacterium tuberculosis	20.45%	9
Escherichia coli	2.27%	1
NEOPLASTIC	34.94%	29
PRIMARY TUMOR	55.1%	16
MULTIPLE MYELOMA	31.03%	9
PLASMACYTOMA	6.89%	2
EWING TUMOR	6.89%	2
NEUROBLASTOMA	3.44%	1
GIANT-CELL TUMOR	3.44%	1
CHONDROMA	3.44%	1
METASTASIS	44.82%	13
PROSTATE	13.79%	4
LUNG	10.34%	3
ESOPHAGUS	6.89%	2
BREAST	3.44%	1
OVARY	3.44%	1
BILLIARY TRACT	3.44%	1
SKIN (BASOCELLULAR CANCER)	3.44%	1
METABOLIC	21.69%	18
OSTEOPOROSIS	100%	18

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E-mail: rbo@sbot.org.br

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[1] Address for correspondence José Nicolás Mireles Cano, Apolo XI, 418, Col. Futurama Monterrey, León, Guanajuato, 37180, México (e-mail: drmirelescano@hotmail.com).

Brasil

Brasil

Effectiveness of Fluoroscopy-Guided Percutaneous Vertebral Biopsy* * Work developed at Hospital Regional de Alta Especialidad del Bajío, Universidad de Guanajuato, Guanajuato, Mexico.

Abstract

Objective

Methods

Results

Conclusion

Effectiveness of Fluoroscopy-Guided Percutaneous Vertebral Biopsy^* * Work developed at Hospital Regional de Alta Especialidad del Bajío, Universidad de Guanajuato, Guanajuato, Mexico.