Objective: Percutaneous vertebroplasty (PVP) is widely used all over the world, especially in elderly patients for osteoporotic, traumatic, and pathological vertebral compression fractures (VCFs). Previous studies have reported incidental tumors in vertebral biopsy. However, whether a routine biopsy should be performed during PVP is controversial. The aim of this study was to evaluate the importance of routine biopsy during PVP in the treatment of VCF. Materials and Methods: The patients who underwent PVP under sedo-analgesia for single or multi-level thoracolumbar vertebrae fracture were reviewed retrospectively between March 2015 and June 2019. The study included 87 patients with VCF. A hundred eleven vertebral levels were treated with PVP. Vertebral bone biopsy was performed in 67 (77.01%) patients. These biopsy specimens were examined pathologically. The mean age of the patients was 74.18±9.08 years (91-48 years), and 12 of them (17.91%) were male and 55 (82.09%) were female. Results: Malignancy was detected in 3 patients (4.48%). Two of them were multiple myeloma and the other one was renal cell carcinoma metastasis. Conclusion: Bone biopsy during PVP procedures does not cause significant time loss or complications. Therefore, revealing the underlying pathology provides a great advantage to the patient and the surgeon. We recommend routine vertebral bone biopsy using a biopsy needle during the PVP procedure.
1. Constantin C, Albulescu DM, Diţă DR, Georgescu CV, Deaconu AC. Vertebral body clinico-morphological features following percutaneous vertebroplasty versus the conservatory approach. Rom J Morphol Embryol 2018;59:159-64.
2. Guarnieri G, Izzo R, Muto M. Current trends in mini-invasive management of spine metastases. Interv Neuroradiol 2015;21:263-72.
3. Health Quality Ontario. Vertebral augmentation involving vertebroplasty or kyphoplasty for cancer-related vertebral compression fractures: a systematic review. Ont Health Technol Assess Ser 2016;16:1-202.
4. Kırcelli A, Çöven İ. Percutaneous balloon kyphoplasty vertebral augmentation for compression fracture due to vertebral metastasis: a 12-month retrospective clinical study in 72 patients. Med Sci Monit 2018;4:2142-8.
5. Langdon J, Way A, Heaton S, Bernard J, Molloy S. The management of spinal metastases from renal cell carcinoma. Ann R Coll Surg Engl 2009;91:649-52.
6. Muijs SP, Akkermans PA, van Erkel AR, Dijkstra SD. The value of routinely performing a bone biopsy during percutaneous vertebroplasty in treatment of osteoporotic vertebral compression fractures. Spine 2009;34:2395-9.
7. Mukherjee S, Thakur B, Bhagawati D, Bhagawati D, Akmal S, Arzoglou V. Utility of routine biopsy at vertebroplasty in the management of vertebral compression fractures: a tertiary center experience. J Neurosurg Spine 2014;21:687-97.
8. Nas ÖF, İnecikli MF, Hacıkurt K, Büyükkaya R, Özkaya G, Özkalemkaş F. Effectiveness of percutaneous vertebroplasty in patients with multiple myeloma having vertebral pain. Diagn Interv Radiol 2016;22:263-8.
9. Ozsoy KM, Oktay K, Gezercan Y, Cetinalp NE, Okten AI, Erman T. Percutaneous vertebroplasty for the treatment of osteoporotic thoracolumbar fractures with posterior body involved in elderly patients. Turk Neurosurg 2019;29:90-4.
10. Pagdal SS, Nadkarni S, Hardikar SM, Hardikar MS. Role of transpedicular percutaneous vertebral biopsy for diagnosis of pathology in vertebral compression fractures. Asian Spine J 2016;10:925-9.
11. Pneumaticos SG, Chatziioannou SN, Savvidou C, Pilichou A, Rontogianni D, Korres DS. Routine needle biopsy during vertebral augmentation procedures. Is it necessary? Eur Spine J 2010;19:1894-8.
12. Togawa D, Lieberman IH, Bauer TW, Reinhardt MK, Kayanja MM. Histological evaluation of biopsies obtained from vertebral compression fractures: unsuspected myeloma and osteomalacia. Spine 2005;7:781-6.
13. Yuan WH, Hsu HC, Lai KL. Vertebroplasty and balloon kyphoplasty versus conservative treatment for osteoporotic vertebral compression fractures: a meta-analysis. Medicine (Baltimore) 2016;95:e4491.
14. Zerlauth JB, Meuli R, Dunet V. Renal cell carcinoma metastasis involving vertebral hemangioma: dual percutaneous treatment by navigational bipolar radiofrequency ablation and high viscosity cement vertebroplasty. BMJ Case Rep 2017;2017. pii: bcr2016012931.
15. Zhang L, Li J, Yang H, Luo Z, Zou J. Histological evaluation of bone biopsy results during PVP or PKP of vertebral compression fractures. Oncol Lett 2013;5:135-8.