Baldi J, Attala D, Scotto di Uccio A, Laquintana V, Biagini R, Zoccali C
Oncological Orthopaedics Department, Regina Elena National Cancer Institute, Via Elio Chianesi no 53, 00144 Rome, Italy.
Sant'Anna Hospital, Orthopedics and Traumatology, Pomezia, Italy.
Injury. 2018 Aug;49(8):1612-1616. doi: 10.1016/j.injury.2018.05.025. Epub 2018 Jun 9.
Core biopsy is today recognized as the gold standard for the diagnosis of bone lesions; unfortunately, when the bone is too solid it can be very difficult to penetrate it; in case of failure, open biopsy is indicated but it is associated with greater contamination and complications. A possible solution is to connect a common orthopedic drill to the core biopsy needle. The aim of the presenting study was to present a technique useful for performing biopsies in case of very strong bone lesions and to evaluate the adequacy and quality of the obtained specimen.
A standard bone biopsy set was connected to a commercial drill to perform bone biopsies. Data was collected over a 2-year period (2015-2016). Information regarding technical success, diagnostic data and complication rates was all collated to assess the technical feasibility of this technique.
Out of 357 bone biopsies, 34 patients underwent the procedure using a common orthopedic drill connected to a core biopsy needle. Diagnostic material was obtained in each patient and the artifacts were considered irrelevant. No major complications occurred in any patient.
The use of a core biopsy needle connected to a common orthopedic drill facilitates the penetration of thick cortical bone by simply applying continuous speed and pressure; nevertheless, the biopsy needle we use is not designed for a drilling procedure and for this reason it can be damaged, but if the biopsy is performed with particular attention, the mechanical failure can be avoided CONCLUSIONS: Bone biopsy using a commercial hand drill has a technically high success rate with minimal complications. Further studies with more cases are necessary to verify our results.
如今，核心活检被公认为是诊断骨病变的金标准；不幸的是，当骨质过于坚硬时，很难穿透；若活检失败，则需进行切开活检，但这会带来更大的污染和并发症。一种可能的解决办法是将普通的骨科钻头与核心活检针相连。本研究的目的是介绍一种在骨病变非常坚硬的情况下进行活检的有用技术，并评估所获取标本的充分性和质量。
将一套标准的骨活检器械与一台商用钻头相连以进行骨活检。在2年期间（2015 - 2016年）收集数据。整理有关技术成功率、诊断数据和并发症发生率的信息，以评估该技术的技术可行性。
在357例骨活检中，34例患者使用与核心活检针相连的普通骨科钻头进行了该操作。每位患者均获取了诊断材料，且认为伪像不相关。所有患者均未发生重大并发症。
将核心活检针与普通骨科钻头相连使用，通过简单地持续施加速度和压力，便于穿透厚实的皮质骨；然而，我们使用的活检针并非为钻孔操作设计，因此可能会受损，但如果在活检时格外小心，可避免机械故障。结论：使用商用手持钻头进行骨活检在技术上成功率高，并发症极少。需要更多病例的进一步研究来验证我们的结果。
