Principles and Approaches
  • Paul Park
  • Frank LaMarca
  • Robert F. McLain
Part of the Current Clinical Oncology book series (CCO)


The primary goal of biopsy is to obtain adequate tissue for histopathological diagnosis with minimal amount of trauma (1). In patients with a known primary tumor, biopsy is often used to confirm metastatic disease or to obtain tissue for hormonal evaluation (2) Without a history of malignancy, the appropriately performed biopsy plays a crucial role in the diagnosis and subsequent management process. Conversely, a poorly planned biopsy can result in misdiagnosis, complications, and adversely limit potential treatment options.


Thoracic Spine Percutaneous Biopsy Open Biopsy Primary Bone Tumor Freeze Section Analysis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Mankin H, Mankin CJ, Simon MA. The hazards of the biopsy, revisited. J Bone Joint Surg 1996; 78:656–663.PubMedGoogle Scholar
  2. 2.
    Asdourian P. Metastatic Disease of the Spine. In: Bridwell K, De Wald RL, eds. The Textbook of Spinal Surgery. Philadelphia, PA: Lippincott-Raven; 1997:2007–2050.Google Scholar
  3. 3.
    Peabody T, Gibbs CP, Simon MA. Evaluation and Staging of Musculoskeletal Neoplasms. J Bone Joint Surg 1998; 80:1204–1218.PubMedGoogle Scholar
  4. 4.
    Stoker D, Kissin CM. Percutaneous vertebral biopsy: a review of 135 cases. Clin Radiol 1985; 36:569–577.PubMedCrossRefGoogle Scholar
  5. 5.
    Colman L, Porter BA, Redmond J, et al. Early diagnosis of spinal metastases by CT and MR studies. J Comput Assist Tomogr 1988; 12:423–426.PubMedCrossRefGoogle Scholar
  6. 6.
    Simon M. Biopsy of musculoskeletal tumors. J Bone Joint Surg 1982;64:1253–1257.PubMedGoogle Scholar
  7. 7.
    Mankin H, Lange TA, Spanier SS. The hazards of biopsy in patients with malignant primary bone and soft-tissue tumors. J Bone Joint 1982; 64:1121–1127.Google Scholar
  8. 8.
    Kattapuram S, Khurana JS, Rosenthal DI. Percutaneous needle biopsy of the spine. Spine 1992; 17:561–564.PubMedCrossRefGoogle Scholar
  9. 9.
    Ottolenghi C. Aspiration biopsy of the spine. J Bone Joint Surg 1969; 51:1531–1544.PubMedGoogle Scholar
  10. 10.
    Springfield D, Rosenberg A. Biopsy: complicated and risky. J Bone Joint Surg 1996; 78:639–643.PubMedGoogle Scholar
  11. 11.
    Stringham D, Hadjipavlou A, Dzioba RB, Lander P. Percutaneous transpedicular biopsy of the spine. Spine 1994; 19:1985–1991.PubMedCrossRefGoogle Scholar
  12. 12.
    Bickels J, Jelinek J, Shmookler B, Malawer M. Biopsy of musculoskeletal tumors. In: Malawer M, Sugarbaker PH, eds. Musculoskeletal Cancer Surgery. Dordrecht/Boston/London: Kluwer Academic Publishers; 2001:37–45.Google Scholar
  13. 13.
    Levine A, Crandall DG. Treatment of primary malignant tumors of the spine and sacrum. In: Bridwell K, DeWald RL, eds. The Textbook of Spinal Surgery. Philadelphia, PA: Lippincott-Raven; 1997:1984–1987.Google Scholar
  14. 14.
    Moore T, Meyers MH, Patzakis MJ, Terry R, Harvey PJ. Closed biopsy of musculoskeletal lesions. J Bone Joint Surg 1979; 61:375–380.PubMedGoogle Scholar
  15. 15.
    Fyfe I, Henry APJ, Mulholland RC. Closed vertebral biopsy. J Bone Joint Surg 1983; 65:140–143.Google Scholar
  16. 16.
    Laredo J, Bard M. Thoracic spine: percutaneous trephine biopsy. Radiology 1986; 160:485–489.PubMedGoogle Scholar
  17. 17.
    Ghelman B, Lospinuso MF, Levine DB, O’Leary PF, Burke SW. Percutaneous computed-tomography-guided biopsy of the thoracic and lumbar spine. Spine 1990; 16:736–739.CrossRefGoogle Scholar
  18. 18.
    Ackermann W. Application of the trephine for bone biopsy. JAMA 1963; 184:11–17.PubMedGoogle Scholar
  19. 19.
    Jamshidi K, Swaim WR. Bone marrow biopsy with unaltered architecture: a new biopsy device. J Lab Clin Med 1971; 77:335–342.PubMedGoogle Scholar
  20. 20.
    Craig F. Vertebral body biopsy. J Bone Joint Surg 1956; 38:93–102.PubMedGoogle Scholar
  21. 21.
    DeSantos L, Murray JA, Ayala AG. The value of percutaneous needle biopsy in the management of primary bone tumors. Cancer 1979; 43:735–744.PubMedCrossRefGoogle Scholar
  22. 22.
    Babu N, Titus VTK, Chittaranjan S, Abraham G, Prem H, Korula RJ. Computed tomographically guided biopsy of the spine. Spine 1994; 19:2436–2442.PubMedCrossRefGoogle Scholar
  23. 23.
    Tampieri D, Weill A, Melanson D, Ethier R. Percutaneous aspiration biopsy in cervical spine lytic lesions. Neuroradiology 1991; 33:43–47.PubMedCrossRefGoogle Scholar
  24. 24.
    Brugieres P, Gaston A, Voisin MC, Ricolfi F, Chakir N. CT-guided percutaneous biopsy of the cervical spine: a series of 12 cases. Neuroradiology 1992; 34:358–360.PubMedCrossRefGoogle Scholar
  25. 25.
    Renfrew D, Whitten CG, Wiese JA, El-Khoury GY, Harris KG. CTguided percutaneous transpedicular biopsy of the spine. Radiology 1991; 180:574–576.PubMedGoogle Scholar
  26. 26.
    Jelinek J, Kransdorf MJ, Gray R, Aboulafia AJ, Malawer MM. Percutaneous transpedicular biopsy of vertebral body lesions. Spine 1996; 21:2035–2040.PubMedCrossRefGoogle Scholar
  27. 27.
    Hadjipavlou A, Kontakis GM, Gaitanis JN, Katonis PG, Lander P, Crow WN. Effectiveness and pitfalls of percutaneous transpedicle biopsy of the spine. Clin Orthop and Relat Res 2003; 411:54–60.CrossRefGoogle Scholar
  28. 28.
    Fazzi U, Waddell G. Semi-open needle biopsy of the upper thoracic spine. Spine 1994; 19:1395–1396.PubMedCrossRefGoogle Scholar
  29. 29.
    Metzger C, Johnson DW, Donaldson WF. Percutaneous biopsy in the anterior thoracic spine. Spine 1993; 18:374–378.PubMedGoogle Scholar
  30. 30.
    Bender C, Berquist TH, Wold LE. Imaging-assisted percutaneous biopsy of the thoracic spine. Mayo Clin Proc 1986; 61:942–950.PubMedGoogle Scholar
  31. 31.
    Kornblum M, Wesolowski DP, Fischgrund JS, Herkowitz HN. Computed tomography-guided biopsy of the spine. Spine 1998; 23:81–85.PubMedCrossRefGoogle Scholar
  32. 32.
    Pierot L, Boulin A. Percutaneous biopsy of the thoracic and lumbar spine: transpedicular approach under fluoroscopic guidance. AJNR Am J Neuroradiol 1999; 20:23–25.PubMedGoogle Scholar
  33. 33.
    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. AJNR Am J Neuroradiol 2003; 24:21112113.Google Scholar
  34. 34.
    Donaldson W, Johnson DW. Percutaneous biopsy of the thoracic spine. Neurosurg Clin N Am 1996; 7:135–144.PubMedGoogle Scholar

Copyright information

© Humana Press, Inc., Totowa, NJ 2006

Authors and Affiliations

  • Paul Park
    • 1
  • Frank LaMarca
    • 1
  • Robert F. McLain
    • 2
  1. 1.Department of NeurosurgeryUniversity of Michigan School of MedicineAnn Arbor
  2. 2.Lerner College of Medicine and The Cleveland Clinic Spine Institute, Department of Orthopaedic SurgeryThe Cleveland Clinic FoundationCleveland

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