Percutaneous core needle biopsies: the yield in spinal tuberculosis

Area of Science:

• Infectious Diseases
• Orthopedic Surgery
• Radiology

Background:

• Spinal tuberculosis (TB) diagnosis often relies on core needle biopsy for confirmation and drug sensitivity testing.
• International studies report a positive culture yield from core needle biopsies ranging from 50% to 83%.

Purpose of the Study:

• To evaluate the diagnostic yield of percutaneous needle biopsies for spinal TB.
• To identify factors associated with negative biopsy results.
• To determine the justification for needle biopsy in suspected spinal TB cases.

Main Methods:

• A multicenter retrospective review of 44 patients with suspected spinal TB who did not require open surgery was conducted.
• Data included demographics, patient history, investigation outcomes, and histopathological findings.

Main Results:

• The overall positive TB culture rate was 59%.
• Factors such as age, symptom duration, HIV status, and neurological status did not significantly influence results.
• Specimen decontamination prior to culture and prior TB treatment were found to negatively impact culture yield.

Conclusions:

• Percutaneous needle biopsy is an essential diagnostic and management tool for spinal TB.
• The study's biopsy yield aligns with international findings.
• Practices like specimen decontamination and prior TB treatment should be considered as they reduce biopsy effectiveness.