COMPUTED TOMOGRAPHICALLY GUIDED BIOPSY OF THE SPINE

Study Design. Efficacy of the percutaneous biopsy of the spine under computed tomographic guidance was investigated. Seventy-five patients, ranging in age from 7 to 72 years, underwent this procedure. Objectives. To determine the usefulness of computed tomographically guided biopsies in the treatment of patients with spinal disorders. Summary of Background Data. The results of 68 biopsies (90.6%) were judged to be accurate insofar as the samples of tissue obtained could be diagnosed as specific types of neoplasm, infective lesions, reactive lesions of nonspecific type, or normal bone. Methods. Biopsies that yielded a specific abnormality were categorized as true positives. The ''normal'' biopsies were followed for 6-18 months and were then deemed true negatives. Nondiagnostic ones were considered false negatives. Results. The results are acceptable with an accuracy rate of 90.6%. It is a safe and simple procedure with a short learning curve. Conclusions. Computed tomographically guided biopsy of the spine is recommended as a procedure of choice, especially in cervical and thoracic lesions. Computed tomography is superior to fluoroscopy when dealing with small, deep-seated lesions especially in the cervical and thoracic regions and with lesions picked up on bone scan only, radiographs being negative. Needle biopsy under computed tomographic guidance is safe and precise.