The role of needle biopsy in the management of malignant spinal compression

With the changing management of malignant spinal cord compression there has been a reduction in numbers of patients treated by conventional laminectomy. This has resulted in a move either to the use of radiotherapy or to the use of more major surgical procedures such as the transthoracic approach. In both of these situations a more logical approach to deciding on the treatment modality to be used can be achieved by determining the histology of the lesion by percutaneous needle biopsy. This paper describes the technique of needle biopsy and presents evidence that shows that a reliable and immediate diagnosis can be achieved by the use of smear histology.