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Core Assure Bone Biopsy Device for Percutaneous Vertebral Body Biopsies 2004

Do, Huy, M.D., Curtis, Lisa, M.D., Versnick, Eric, M.D., Marks, Michael, MD

Purpose:
To report our experience with using the Parallax Medical Inc. Core Assure bone biopsy needle for percutaneous vertebral body biopsy in conjunction with percutaneous vertebroplasty.

Materials and Methods:
Nineteen vertebral body biopsies were performed in conjunction with percutaneous vertebroplasty for treatment of painful vertebral body compression fractures from February 2002 to March 2003. Preoperative imaging consisting of radiographs, CT scans, and MRI scans and clinical history were suspicious for possible malignancy in all cases. Vertebral body biopsies were performed via the transpediculate approach similar to the approach used for percutaneous vertebroplasty us ing biplane fluoroscopic guidance. Following the bone biopsy in the region of suspected abnormality, percutaneous vertebroplasty was performed following advancement of the outer cannula to the appropriate site for polymethylmethacrylate injection. All biopsy specimens were sent to surgical pathology in formalin and saline for analysis.

Results:
Ten biopsies/vertebroplasties were in the thoracic region (T7 to T12) and 9 were in the lumbar region (L1 to L4). All biopsies yielded large core specimens. Thus, all biopsies had adequate material for tissue analysis and testing. Sixteen biopsies were normal. Three biopsies were positive for malignancy (one for carcinoma and two for plasmacytoma). Percutaneous vertebroplasty was successful in all patients in terms of pain alleviation, increased mobility, and decreased narcotics intake. There were no complications related to the procedure (either the biopsies or vertebroplasties).

Conclusion:
The Parallax Core Assure bone biopsy device is reliable for yielding adequate specimens for vertebral body bone biopsy. This device works well in conjunction with percutaneous vertebroplasty and appears to be safe with no complications related to the procedure.