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The value of percutaneous transpedicular vertebral bone biopsies for histologic examination. Results of an
J C Ward1, B Jeanneret, C Oehlschlegel
1Klinik für Orthopädische Chirurgie, Kantonsspital St. Gallen, Switzerland.
Study Design:
A 3.5-mm trephine was designed to overcome difficulties encountered in the histologic evaluation of vertebral bone samples obtained with a 2-mm trephine.
Objectives:
To compare the 3.5-mm trephine with the 2-mm trephine.
Summary Of Background Data:
A review of results obtained with a 2-mm trephine showed that histologic examination of vertebral bone cores was disturbed by artifacts in 32 of 70 cases (46%). Although tissue diagnosis was possible from 61 samples, only 36 (51%) bone cores yielded a secure diagnosis.
Methods:
Transpedicular bone cores were obtained from the bodies of 54 fresh cadaver vertebrae with both trephines. In each vertebra, the 2-mm trephine was used on one side, and the 3.5-mm trephine was used on the other side. Longitudinal sections were prepared and examined macroscopically for length and breakages and microscopically for trabeculae, marrow, and artifacts. Each sample was graded for its value for histologic examination.
Results:
Significant differences were found between the two trephines for all criteria evaluated. Of 54 samples taken with the 2-mm trephine, 13 (24%) were graded "good," compared with 45 (83%) from the 3.5-mm trephine. Twelve (22%) "bad" samples were taken from the 2-mm trephine compared with three (6%) "bad" samples taken from the 3.5-mm trephine.
Conclusions:
The 2-mm trephine does not provide suitable bone cores for histologic examination, whereas samples obtained with the 3.5-mm trephine are suitable.
