Imaging-assisted percutaneous biopsy of the thoracic spine.

Confirmation of tissue pathologic changes often is necessary before appropriate therapy can be instituted for lesions of the thoracic spine. Plain film roentgenography and computed tomography provide the key information needed for the percutaneous biopsy procedure. The location and type of bone involvement (lytic or sclerotic) and the presence or absence of a soft tissue mass determine the imaging technique and the choice of needle to use for safe and accurate performance of the procedure. In 26 patients with thoracic spinal or paraspinal lesions (or both), biopsy was done with use of fluoroscopic or computed tomographic guidance. The overall accuracy was 90%. Pneumothorax occurred in two patients. Percutaneous biopsy is a rapid, safe technique for diagnosis of lesions of the thoracic spine.