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Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis
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Published on: May 23, 2021

Biopsy for suspected spondylodiscitis.

A Gasbarrini1, L Boriani, C Salvadori

  • 1Oncologic and Degenerative Spine Surgery, Rizzoli Orthopaedic Institute, Bologna, Italy.

European Review for Medical and Pharmacological Sciences
|June 5, 2012
PubMed
Summary

CT-guided percutaneous spinal biopsy (CTSB) is crucial for diagnosing spinal lesions, especially infections. Histological examination of biopsy samples is vital for accurate treatment and prognosis, even when malignancy is suspected.

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Area of Science:

  • Spinal oncology
  • Infectious diseases
  • Radiology

Background:

  • Vertebral biopsy is essential for diagnosing spinal lesions of infectious or neoplastic origin.
  • Accurate diagnosis impacts patient treatment and prognosis.
  • CT-guided percutaneous spinal biopsy (CTSB) can reduce contamination and complications.

Purpose of the Study:

  • To highlight the importance and effectiveness of CTSB.
  • To emphasize the role of subsequent microbiologic/histological examination.
  • To improve diagnosis of spinal lesions, particularly infectious ones.

Main Methods:

  • Analysis of two patient series (prospective: 69 patients, 24 CTSB; retrospective: 130 patients, 65 CTSB).
  • All patients underwent microbiologic and histological testing of biopsy samples.
  • CT-guided percutaneous spinal biopsy (CTSB) was utilized.

Main Results:

  • Histological examination yielded diagnoses in 81.8% (2009-2011) and 69% (1999-2008) of cases.
  • Microbiologic culture and PCR for Mycobacterium tuberculosis achieved 45.8% diagnosis (2009-2011).
  • Four patients with suspected metastasis were diagnosed with spondylodiscitis post-biopsy.

Conclusions:

  • CT-guided needle biopsy is the primary diagnostic method for spine lesions of unknown origin.
  • Histological diagnosis is critical before treatment, especially if cultures are negative.
  • Spinal lesions in patients with prior malignancy require consideration of infection and new primary lesions, not just metastasis.