Percutaneous biopsy of pyogenic infection of the spine in children.

Three boys had percutaneous biopsies of pyogenic infections of the spine guided by computed tomography (CT). All had typical features of chronic vertebral osteomyelitis, i.e., narrowing of disc space, destruction of the contiguous vertebral endplates, sclerosis of vertebral bodies, and soft tissue swelling as noted on radiographs, CT, and magnetic resonance imaging (MRI). All three had back pain; one was asymptomatic at the time of the biopsy. Culture of the biopsy material grew Staphylococcus aureus in two cases and Salmonella group B in one. If blood cultures are negative, a biopsy of the vertebral body is recommended in order to determine the activity of the process and the type of organism, and its susceptibility to antibiotics. CT-guided percutaneous biopsy is an alternative to open surgical biopsy.