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Modified percutaneous biopsy of the spine: improvement of the technique

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Abstract

Purpose

Biopsy of the spine can be performed by open surgery or percutaneous needle sampling. The first has the highest diagnostic yield while the second is a less invasive procedure with lower rate of complications and shorter hospitalization time. We described a modified technique of percutaneous biopsy using semi-rigid grasping forceps that may offer the advantages of both, open and minimally invasive surgery.

Methods

Thirty consecutive patients with spinal lesions requiring biopsy were admitted to Neurosurgical Unit of Belcolle Hospital (Viterbo, Italy) from January 2017 to September 2021. There was a suspicion of spondylodiscitis in 25 cases and of tumor in 5 cases. Percutanous trans-pedicular spine biopsy has been performed using this new semi-rigid grasping forceps. Combining the opening width, jaw length and full 360° rotation, the device allows a wide and precise sampling.

Results

Sampling was sufficient in all cases (100%); tumors was observed in 5 cases (16.7%%) with a percentage of definitive histopathologic diagnosis of 100% (n = 5); among the remaining patients histological examination yielded a diagnosis of spinal infection in 25 cases (100%), and microbiologic culture provided an aetiologic diagnosis in 23 cases (92%). All procedures were well tolerated, and no postoperative complications were observed. Levels involved included: thoracic (T5-T9) in 8 cases, thoracolumbar junction (T10-L2) in 12 cases and lumbar (L3-L5) in 10 cases.

Conclusions:

Percutaneous biopsy with the semi-rigid grasping forceps is a safe and effective procedure that can be used for diagnosis of both infectious and tumor lesions of the spine. It allows to obtain a larger specimen volume and to use a multidirectional trajectory for sampling, resulting in a minimally invasive technique with strong ability to yield etiologic diagnosis.

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Authors and Affiliations

  1. Neurosurgery, Belcolle Hospital, Viterbo, Italy

    Daniele Marruzzo, Vittorio Ricciuti, Francesca Romana Barbieri, Serena Pagano & Riccardo Antonio Ricciuti

  2. Neurosurgery, Azienda Ospedaliera Di Perugia, Perugia, Italy

    Fabrizio Mancini

  3. Infectious Disease, Belcolle Hospital, Viterbo, Italy

    Roberta Preziosi

Authors
  1. Daniele Marruzzo
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  2. Fabrizio Mancini
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  3. Vittorio Ricciuti
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  4. Francesca Romana Barbieri
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  5. Roberta Preziosi
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  6. Serena Pagano
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  7. Riccardo Antonio Ricciuti
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Correspondence to Fabrizio Mancini.

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Marruzzo, D., Mancini, F., Ricciuti, V. et al. Modified percutaneous biopsy of the spine: improvement of the technique. Eur Spine J 32, 221–227 (2023). https://doi.org/10.1007/s00586-022-07384-8

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  • DOI: https://doi.org/10.1007/s00586-022-07384-8

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