Stringham D R, Hadjipavlou A, Dzioba R B, Lander P
Division of Orthopedic Surgery, University of Arizona Health Sciences Center, Tucson.
Spine (Phila Pa 1976). 1994 Sep 1;19(17):1985-91. doi: 10.1097/00007632-199409000-00021.
Despite increasing information regarding pedicular instrumentation, the transpedicular biopsy of the vertebral body has not been popularized. The precise technique for percutaneous transpedicular biopsy and the volume of the vertebral body accessible through the pedicle has not been reported.
To describe the percutaneous transpedicular biopsy, its diagnostic yield, to determine the amount of bone retrievable through the pedicle.
Experience gained from open biopsy facilitates the development of the percutaneous technique. There were no complications with the open or closed procedures.
Transpedicular biopsy was performed on 18 patients (nine open and nine percutaneous). Unilateral transpedicular curetments were performed on the cadaveric lumbar spines. The volume of the vertebral body accessible through the pedicle was determined using roentgenograms, computed tomography, and image analysis.
Adequate specimens for a correct diagnosis were obtained in all biopsies. Laboratory volumetric analysis demonstrated that more than 50% of the volume of a lumbar vertebral body is accessible through a unilateral transpedicular approach, without compromising the anatomic structure of the pedicle.
The vertebral pedicle provides a safe conduit for biopsy of most vertebral body lesions. Percutaneous transpedicular biopsy can be performed with minimal morbidity and high diagnostic yield.
尽管有关椎弓根内固定的信息不断增加，但椎体经椎弓根活检尚未得到普及。经皮椎弓根活检的精确技术以及通过椎弓根可获取的椎体体积尚未见报道。
描述经皮椎弓根活检及其诊断率，确定通过椎弓根可获取的骨量。
开放活检积累的经验促进了经皮技术的发展。开放或闭合手术均无并发症。
对18例患者（9例开放活检和9例经皮活检）进行了椎弓根活检。在尸体腰椎上进行单侧椎弓根刮除术。使用X线片、计算机断层扫描和图像分析确定通过椎弓根可获取的椎体体积。
所有活检均获得了足够用于正确诊断的标本。实验室容积分析表明，通过单侧椎弓根入路可获取超过50%的腰椎椎体体积，且不影响椎弓根的解剖结构。
椎弓根为大多数椎体病变的活检提供了一条安全通道。经皮椎弓根活检可在发病率极低且诊断率高的情况下进行。
