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Research ArticleSPINE

Percutaneous CT-Guided Biopsies of the Cervical Spine: Technique, Histopathologic and Microbiologic Yield, and Safety at a Single Academic Institution

E.L. Wiesner, T.J. Hillen, J. Long and J.W. Jennings
American Journal of Neuroradiology April 2018, DOI: https://doi.org/10.3174/ajnr.A5603
E.L. Wiesner
aFrom the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri.
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T.J. Hillen
aFrom the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri.
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J. Long
aFrom the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri.
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J.W. Jennings
aFrom the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri.
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Abstract

BACKGROUND AND PURPOSE: Cervical spine biopsies can be challenging due to the anatomy and the adjacent critical structures. Percutaneous image-guided biopsies can obviate the need for an open biopsy, however there have been few studies looking at the approaches, safety, and efficacy of percutaneous cervical spine biopsies. This retrospective study evaluated technical considerations, histopathologic and microbiologic yield, and safety in CT-guided cervical bone biopsies.

MATERIALS AND METHODS: A retrospective review of cervical bone and/or bone/disc biopsies performed from January 2010 to January 2017 was included in this study. Clinical diagnosis and indication, patient demographics, biopsy location, biopsy needle type, technical approach, lesion size, dose-length product, conscious sedation details, complications, and diagnostic histopathologic and/or microbiologic yield were recorded for each case and summarized.

RESULTS: A total of 73 patients underwent CT-guided cervical bone biopsies. Fifty-three percent (39/73) were for clinical/imaging concern for infection and 47% (34/73) were for primary tumors or metastatic disease. Thirty-four percent (25/73) were of the inferior cervical spine (ie, C6 and C7). A sufficient sample was obtained for histopathologic and microbiologic analyses in 96% (70/73) of the biopsies. Forty-six percent (18/39) of those samples taken for infection had positive cultures. Two intraprocedural complications occurred in which the patients became hypotensive during the procedure without long-term complications.

CONCLUSIONS: Percutaneous CT-guided biopsy of the cervical spine is an effective and safe procedure with high diagnostic yield and can obviate open procedures for histopathologic and microbiologic analyses of patients with clinical and imaging findings concerning for infection or primary and metastatic osseous lesions.

ABBREVIATION:

DLP
dose-length product

Footnotes

  • Disclosures: Travis J. Hillen—UNRELATED: Consultancy: Medtronic, Merit Medical Systems, Comments: consultant (Medtronic) and proctor training labs (Merit Medical Systems). Jack W. Jennings—UNRELATED: Consultancy: Merit, Medtronic, Bard, Comments: consultant (Merit, Medtronic, Bard) and advisory board (Merit, Medtronic).

  • © 2018 by American Journal of Neuroradiology
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Percutaneous CT-Guided Biopsies of the Cervical Spine: Technique, Histopathologic and Microbiologic Yield, and Safety at a Single Academic Institution
E.L. Wiesner, T.J. Hillen, J. Long, J.W. Jennings
American Journal of Neuroradiology Apr 2018, DOI: 10.3174/ajnr.A5603

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Percutaneous CT-Guided Biopsies of the Cervical Spine: Technique, Histopathologic and Microbiologic Yield, and Safety at a Single Academic Institution
E.L. Wiesner, T.J. Hillen, J. Long, J.W. Jennings
American Journal of Neuroradiology Apr 2018, DOI: 10.3174/ajnr.A5603
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