Percutaneous vertebral biopsy through intact bone: a coaxial bone transgressing technique with 18 gauge needle

Advancement of radiologic technologies allows the detection of vertebral lesions at an earlier stage, thereby increasing the proportion of vertebral lesions that are surrounded by intact bone when they are detected. While biopsy guns are effective in obtaining good-quality tissue samples of osteolytic bone lesions, lesions that are covered by intact bone are not accessible with a biopsy gun. For percutaneous biopsy of osteolytic vertebral lesions, an intact-bone transgressing technique is described in which a simple, inexpensive and small-calibre (18-gauge) instrument is used to allow multiple passage of 20-gauge biopsy guns for effective tissue sampling. In this series consisting of metastatic and myeloproliferative lesions, the effectiveness and safety of this well-tolerated technique are demonstrated in thoracic and lumbar vertebrae.