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Clinico-Radio-Histopathological Correlation by C-Arm Image-Guided Biopsy in Spinal Tuberculosis

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Abstract

Background/Purpose of the Study

C-arm-guided biopsy is a safe and effective technique for evaluating TB spine and is useful in planning therapy. The purpose of this study was to find a correlation between clinically and radiologically suspected TB spine and C-arm image-guided biopsy-proven cases and to study the complications encountered.

Methods

After evaluating the clinical, laboratory, X-ray and MRI findings, 92 patients with provisionally diagnosed tubercular spine were subjected to C-arm image-guided biopsy.

Results

Among our 92 cases, histopathology was positive in 55 cases (59.78%). Out of these 55 histologically positive cases, CBNAAT was positive in 42 cases and negative in the rest 13 cases. Overall, among the 92 cases, CBNAAT was positive in 51(55.43%) of cases, and out of these, histopathology turned out to be positive in 42 of cases. Out of 41 cases with negative CBNAAT, histopathology was suggestive of tuberculosis in 13. The strength of agreement between CBNAAT and histopathology was statistically significant (p < 0.0001; kappa = 0.511). No complication such as bleeding, nerve/cord injury, infection, injury to aorta or pneumothorax was encountered during and after the C-arm biopsy in any case.

Conclusion

C-arm image-guided biopsy is reasonably accurate and should be used as a tool for diagnosis of TB spine. We recommend histopathological examination as a key component for the diagnosis of TB spine, as it is precise and consumes relatively shorter time. CBNAAT is more rapid but is not a substitute for histopathology for spine TB diagnosis.

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Authors and Affiliations

  1. Central Institute of Orthopaedics (CIO), VMMC and Safdarjung Hospital, Delhi, 110029, India

    Mayukh Guha, Tankeswar Boruah, Sapan Kumar, Atul Sareen, Mohit Kumar Patralekh & Ramesh Kumar

  2. Sports Injury Center, VMMC and Safdarjung Hospital, Delhi, 110029, India

    Hitesh Lal

  3. CIO Laboratory, VMMC and Safdarjung Hospital, Delhi, 110029, India

    Geetika Khanna

Authors
  1. Mayukh Guha
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  2. Hitesh Lal
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  3. Tankeswar Boruah
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  4. Sapan Kumar
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  5. Atul Sareen
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  6. Mohit Kumar Patralekh
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  7. Ramesh Kumar
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  8. Geetika Khanna
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Correspondence to Sapan Kumar.

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There is no conflict of interest or source of funding to be disclosed.

Ethical Standard

The study was approved by the Ethics Committee of the Department and conformed to the ethical guidelines of the Helsinki Declaration (as revised in Tokyo 2004). No study advertising was made and no remuneration was offered.

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Informed consent was obtained from all individual participants included in the study.

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Guha, M., Lal, H., Boruah, T. et al. Clinico-Radio-Histopathological Correlation by C-Arm Image-Guided Biopsy in Spinal Tuberculosis. JOIO 55, 1028–1036 (2021). https://doi.org/10.1007/s43465-021-00361-1

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  • DOI: https://doi.org/10.1007/s43465-021-00361-1

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