Spine biopsy

A bone biopsy is a test in which a small sample of bone is removed from the body and examined under a microscope for cancer, infection, or other bone disorders.

It is of 2 type-

• Open biopsy
• closed CT guided spine biopsy

• Confirm the diagnosis of a bone disorder (such as Pagets disease, a disease that may look like bone cancer, or bone cancer) that was found by another test, such as an X-ray, CT scan, or MRI
• Tell the difference between a noncancerous (benign) bone mass, such as a bone cyst, and bone cancer, such as multiple myeloma.
• See what is causing a bone infection (osteomyelitis) or if an infection is present.
• Find the cause of ongoing bone pain.
• Check bone problems seen on an X-ray.

The procedure is done with the patient lying on his or her abdomen. Using fluoroscopy via CT scan, the sample of bone is removed by inserting a needle through the skin and directly into the bone. A numbing medication (local anesthetic) is used to prevent pain during this procedure. Intravenous (IV) pain and sedative medication also may be given. Following the procedure the patient is taken to a recovery area for approximately one hour then discharged home to rest.

Over open spine biopsy method

• Early return to normal activity with in one day.
• Less bleeding
• Less chances of infection
• Can be done under local or in sedation
• Less post op pain

As compare to open biopsy

• Relatively more expensive
• Obtaining less tissue(bone) so chances of false negative result is more.
• Radiation exposure to patient.

Complication –
• Pain
• Bleeding
• Infection.

Prior to scheduling the procedure, we will need to evaluate an MRI, bone scan, or CT scan of your spine showing the area in which the biopsy is necessary. Once scheduled for the procedure, you will be contacted by one of the spine nurses. You will be asked to provide information regarding your current problem, past medical history, and medications. She will provide you with detailed instructions on how to prepare for the upcoming procedure. You will be asked to hold any NSAIDS, Aspirin, or blood thinners such as Coumadin. Any insurance questions can be answered by your referring physician Prior to arrival we ask that you refrain from eating or drinking after midnight the night before. You will need someone to drive you home. Patients without a driver will be rescheduled for another day.

You can return to your normal activities 24 hours after the procedure.

Same procedure but can be done by surgically open the spine and under visualization take a piece of bone for biopsy.

• More time taken to return to normal activity
• Can be done only under GA
• More morbidity in term of post op pain ,infection,bleeding.
• It is like mini surgical procedure

• More chances of getting positive result as compare to close method as tissue obtained is more and taken under direct visualization.
• Less expensive

With the patient prone, the spinal level was confirmed by image intensifer and a longitudinal incison made just to the right of the midline. To minimise the chance of making a false passage, the entry site into the pedicle was checked with biplanar image intensification and the pedicle broached as for the insertion of a pedicle screw. The diametre and direction of the pedicle were positioned the pt prone,level is marked under image than midline vertical incision was given,spinus process was made free from its attachments,under direct visualization of lesion bone fragment was taken out and collected in saline and was sent for histopathology lab. out and closed.

Return to normal activity- wks after the procedure