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Fluoroscopy-guided intervertebral disc biopsy with a coaxial drill system
Adam N Wallace1, Rafael A Pacheco2, Ross Vyhmeister3
1Mallinckrodt Institute of Radiology, 510 South Kingshighway Boulevard, Saint Louis, MO, 63110, USA. wallacea@mir.wustl.edu.
Skeletal Radiology
|November 18, 2015
Summary
Drill-assisted fluoroscopic intervertebral disc biopsies require less sedation and yield better quality specimens than manual methods. This technique improves diagnostic accuracy for discitis-osteomyelitis.
Area of Science:
- Interventional Radiology
- Musculoskeletal Imaging
- Infectious Disease Diagnosis
Background:
- Percutaneous intervertebral disc biopsy is crucial for diagnosing discitis-osteomyelitis.
- Accurate diagnosis relies on identifying causative microorganisms and ruling out other conditions.
- Optimizing biopsy techniques can improve diagnostic yield and patient comfort.
Purpose of the Study:
- To compare drill-assisted versus manual fluoroscopy-guided intervertebral disc biopsies.
- To evaluate differences in conscious sedation requirements.
- To assess the histologic quality of specimens obtained by each method.
Main Methods:
- Retrospective review of fluoroscopy-guided intervertebral disc biopsies (January 2010-March 2015).
- Comparison of sedation duration and medication doses.
- Analysis of pathology reports for specimen adequacy and microbiology reports for organism isolation.
Main Results:
- Drill-assisted biopsies showed significantly shorter sedation times (30 vs. 39 minutes) and lower midazolam doses.
- All drill-assisted specimens were adequate for histopathology; only 5% of manual specimens were inadequate.
- Microbiology yields were comparable between the two techniques (14% vs. 20%).
Conclusions:
- Drill-assisted fluoroscopic intervertebral disc biopsy is a superior technique.
- It requires less conscious sedation and provides histologically adequate specimens.
- This method enhances diagnostic capabilities for spinal infections.
