Image-Guided Percutaneous Spine Biopsy

  • A. Orlando Ortiz
  • Gregg H. Zoarski
  • Allan L. Brook


Prior to the development of image-guided percutaneous spine biopsy techniques, an open biopsy procedure was required for definitive diagnosis. The advantage of the open biopsy procedure is twofold. First, under direct visualization, multiple and larger tissue samples can be obtained and made available for frozen histopathological analysis. Second, the open biopsy can be performed as part of a surgical decompression and/or stabilization procedure of the spine. The first report of percutaneous spine biopsy was in 1935 by Robertson and Ball.1 Their procedures, however, did not utilize imaging guidance. Siffert and Arkin utilized a posterolateral approach for spine biopsy using radiographic guidance.2 Fluoroscopy-guided spine biopsy was subsequently reported in 1969, and CT-guided spine biopsy was reported in 1981.3,4


Biopsy Needle Biopsy Procedure Compute Tomography Guidance Coaxial Technique Transpedicular Approach 
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  1. 1.
    Robertson RC, Ball RP. Destructive spine lesions: diagnosis by needle biopsy. J Bone Joint Surg 1935;57:749-758.Google Scholar
  2. 2.
    Siffert RS, Arkin AM. Trephine bone biopsy with special reference to the lumbar vertebral bodies. Am J Bone Joint Surg 1949;31:146-149.Google Scholar
  3. 3.
    Adapon BD, Legada BD, Lim EVA, Silao JV Jr, Dalmacio-Cruz A. CT-guided closed biopsy of the spine. J Comput Assist Tomogr 1981;5:73-78.CrossRefPubMedGoogle Scholar
  4. 4.
    Ottolenghi CE. Aspiration biopsy of the spine. Am J Bone Joint Surg 1969;51:1531-1544.Google Scholar
  5. 5.
    Murphy WA, Destouet JM, Gilula LA. Percutaneous skeletal biopsy 1981: a procedure for radiologists - results, review, and recommendations. Radiology 1981;139:545-549.PubMedGoogle Scholar
  6. 6.
    DeSantos LA, Lukeman JM, Wallace S, Murray JA, Ayala AG. Percutaneous needle biopsy of bone in the cancer patient. Am J Roentgenol 1978;130:641-649.Google Scholar
  7. 7.
    Kattapuram SV, Rosenthal DI. Percutaneous biopsy of skeletal lesions. Am J Roentgenol 1991;157:935-942.Google Scholar
  8. 8.
    Froelich JJ, Saar B, Hoppe M, Ishaque N, Walthers EM, Regn J, Klose KJ. Real-time CT-fluoroscopy for guidance of percutaneous drainage procedures. J Vasc Int Rad 1998;9:735-740.CrossRefGoogle Scholar
  9. 9.
    Onik G, Cosman ER, Wells TH, Goldberg HI, Moss AA, Costello P, Kane RA, Hoddick WI, Demas B. CT-guided aspirations for the body: comparison of hand guidance with stereotaxis. Radiology 1988;166:389-394.PubMedGoogle Scholar
  10. 10.
    Palestrant AM. Comprehensive approach to CT-guided procedures with a hand-held guidance device. Radiology 1990;174:270-272.PubMedGoogle Scholar
  11. 11.
    Rice KM, Cronan JJ. Practical CT stereotactic biopsy techniques. Appl Radiol 1995;24:35-38.Google Scholar
  12. 12.
    Brugieres P, Gaston A, Heran F, Voisin MC, Marsault C. Percutaneous biopsies of the thoracic spine under CT guidance: transcostovertebral approach. J Comput Assist Tomogr 1990;14:446-448.CrossRefPubMedGoogle Scholar
  13. 13.
    Laredo JD, Bard M. Thoracic spine: percutaneous trephine biopsy. Radiology 1986;160:485-489.PubMedGoogle Scholar
  14. 14.
    Kattapuram SV, Rosenthal SI. Percutaneous biopsy of the cervical spine using CT guidance. Am J Roentgenol 1987;149:539-541.Google Scholar
  15. 15.
    Geremia GK, Charletta DA, Granato DB, Raju S. Biopsy of vertebral and paravertebral structures with a new coaxial needle system. Am J Neuroradiol 1992;13:169-171.PubMedGoogle Scholar
  16. 16.
    Schweitzer ME, Gannon FH, Deely DM, O'Hara BJ, Juneja V. Percutaneous skeletal aspiration and core biopsy: complementary techniques. Am J Roentgenol 1996;166:415-418.Google Scholar
  17. 17.
    Kreula J, Virkkunen P, Bondestam S. Effect of suction on specimen size in fine needle aspiration biopsy. Invest Radiol 1990;25:1175-1181.CrossRefPubMedGoogle Scholar
  18. 18.
    Kreula J. Effect of sampling technique on specimen size in fine needle aspiration biopsy. Invest Radiol 1990;25:1294-1299.CrossRefPubMedGoogle Scholar
  19. 19.
    Renfrew DL, Whitten CG, Wiese JA, el-Khoury GY, Harris KG.CT-guided percutaneous transpedicular biopsy of the spine. Radiology 1991;180:574-576.PubMedGoogle Scholar
  20. 20.
    Hewes RC, Vigorita VJ, Freiberger RH. Percutaneous bone biopsy: the importance of aspirated osseous blood. Radiology 1983;148:69-72.PubMedGoogle Scholar
  21. 21.
    Puri A, Shingade VU, Agarwal MG, Anchan C, Juvekar S, Desai S, Jambhekar NA. CT-guided percutaneous core needle biopsy in deep seated musculoskeletal lesions: a prospective study of 128 cases. Skeletal Radiol 2006:35(3):138-43.CrossRefPubMedGoogle Scholar
  22. 22.
    Yaffe D, Greenberg G, Leitner J, Gipstein R, Shapiro M, Bachar GN. CT-guided percutaneous biopsy of thoracic and lumbar spine: A new coaxial technique. Am J Neuroradiol 2003:24(10):2111-3.PubMedGoogle Scholar
  23. 23.
    Michel SC, Pfirrmann CW, Boos N, Hodler J. CT-guided core biopsy of subchondral bone and intervertebral space in suspected spondylodiskitis. Am J Roentgenol 2006;186(4):977-80.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • A. Orlando Ortiz
    • 1
  • Gregg H. Zoarski
    • 2
  • Allan L. Brook
    • 3
  1. 1.Department of RadiologyWinthrop-University HospitalMineolaUSA
  2. 2.Department of Diagnostic ImagingUniversity of MarylandBaltimoreUSA
  3. 3.Department of RadiologyAlbert Einstein College of Medicine, Director, Interventional Neuroradiology, Montefiore Medical CenterBronxUSA

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