Abstract
Study Design: A retrospective case note review.
Objective: To report on the accuracy of the Harlow-Wood bone biopsy trephine used via a percutaneous approach to obtain tissue from vertebral lesions.
Methods: 82 patients undergoing this procedure in either the University Hospital Nottingham or Leicester Royal Infirmary between 1995 and 2003 were included in the study. Data was collected regarding the provisional diagnosis, MRI diagnosis and final diagnosis based on micro-biological and histological reports.
Outcome Measures: Microbiological and histological reports were reviewed to determine the pathological nature of each biopsy. If the biopsy returned a positive diagnosis, or if the biopsy confirmed normal vertebral microbiology and histology in a patient who was subsequently disease-free, then the biopsy was deemed to have provided a diagnosis.
Results: The technique provided a diagnosis in 88% of cases, with a sensitivity of 87% and specificity of 100%. Where the provisional diagnosis was of a neoplastic lesion (n = 48), the diagnosis rate was 88%. Where the provisional diagnosis was of an infective lesion (n = 26), the diagnosis rate was 89%. Where the provisional diagnosis was uncertain (n = 8), the diagnosis rate was 88%.
Conclusions: Percutaneous biopsy of vertebral lesions using the Harlow-Wood bone trephine under fluoroscopic guidance can be performed safely and efficaciously. The high accuracy and sensitivity of this closed percutaneous technique, particularly in infective lesions, allows a timely diagnosis and subsequent early commencement of appropriate treatment.
These abstracts were prepared by Mr. Brian J C Freeman FRCS (Tr & Orth). Correspondence should be addressed to him at The Centre for Spinal Studies and Surgery, University Hospital, Queens Medical Centre, Nottingham NG7 2UH.
