The application of thick trocar puncture biopsy in thoracic and lumbar vertebral lesions

English Keywords:Vertebral  Puncture  Biopsy

English Abstract:

  【Abstract】　Objectives: To evaluate the use of thick trocar puncture biopsy in thoracic and lumbar vertebral lesions. Methods: 54 cases(30 males and 24 females) with thoracic and lumbar vertebral lesions undergoing CT-guided percutaneous biopsy before operation between February 2004 and August 2009 were reviewed retrospectively. All cases had a mean age of 50.6 years(range, 15 to 78 years). Local pain was the main complaint. 12 cases presented with different degrees of radiating pain in lower extremities, 43 cases presented with local pain and different degrees of paresthesia in lower extremities. Each case underwent X-ray and CT scanning before operation, and all presented with single level lesion in thoracic or lumbar spine with different degrees of vertebral body defect. 30 cases had defect in thorac(7 in T4, 2 in T5 7 in T6, 8 in T7, 5 in T8, 1 in T11), and 24 cases had defect in lumbar(1 in L1, 8 in L2, 4 in L3, 5 in L4, 6 in L5). All cases underwent CT-guided puncture biopsy. And the pathological results after operation were compared with the preoperative biopsy. Results: No complication was noted. After biopsy, malignant tumor was verified in 28 cases, benign neoplastic lesion 1 case, suspection of malignant tumor in 1 case, normal tissue in 1 case, inflammatory lesion 23 cases. 52 cases had definite pathologic diagnosis, with the positive rate of 96.3％; moreover, after operation, 51 cases had the final pathological results as same as the preoperative biopsy, with the consistent rate of 98.1％. 1 suspection of malignant tumor after biopsy was verified as adenocarcinoma after general pathological test; 1 normal tissue after biopsy was verified as non-specificity inflammation; 1 pyogenic infection was verified as tuberculosis. Conclusions:　Thick trocar percutaneous biopsy can ensure abundant specimens in thoracic and lumbar lesions, and the positive diagnostic value is high, which is consistence with general pathological tests.