Percutaneous biopsy in the anterior thoracic spine

Over a 24-month period, seven patients have undergone nine diagnostic closed percutaneous biopsies of thoracic vertebral body lesions. Seven of the nine biopsies were performed using the Craig trephine biopsy set. All seven biopsies provided diagnostic material. Two biopsies were performed with 22-gauge needles and aspiration technique. One provided diagnostic material. The only complication was a small pneumothorax that spontaneously resolved. Current editions of orthopedic texts give mixed recommendations as to the route of vertebral body biopsy in the thoracic spine. Most recommend open rather than percutaneous biopsy, particularly above T10. Review of current orthopedic literature, however, reveals overwhelming support for the use of closed biopsy techniques as the procedure of choice for tissue diagnosis of thoracic vertebral body lesions. As in this limited series, the reported positive biopsy ratio is high and the complication rate acceptably low.