Retrospective review of biopsy results following percutaneous fixation of vertebral compression fractures.

Title

Retrospective review of biopsy results following percutaneous fixation of vertebral compression fractures.

Creator

Schoenfeld Andrew J; Dinicola Nicholas J; Ehrler Douglas M; Koerber Andrea; Paxos Mihail; Shorten Scott D; Bowers Jacqueline; Jackson Erin; Smith Michael J

Publisher

Injury

Date

2008
2008-03

Description

BACKGROUND: Percutaneous vertebral body fixation has been found to provide pain relief and restoration of function for patients with compression fractures. Despite the prevalence of osteoporosis, there are a variety of aetiologies, such as lymphoma, myeloma or metastatic disease that may be responsible for the condition. In these instances, vertebral body biopsy can play an important role in determining fracture aetiology and assist in initiating concurrent medical treatment. MATERIALS AND METHODS: Between 2002 and 2005, 80 vertebral body biopsies were performed in conjunction with percutaneous augmentation procedures on 50 patients at our teaching institution. Eleven biopsies were performed during vertebroplasty and 69 were performed during kyphoplasty. The mean age at the time of procedure was 75.7 years. Eight patients were male and 42 were female. A pathologist interpreted all biopsy samples and all charts were reviewed examining past history, diagnoses prior to compression fracture, biopsy results and post-op conditions that developed or were diagnosed after surgery. RESULTS: All patients healed their compression fractures following surgery and no complications were experienced. Eleven patients had a diagnosis of osteoporosis prior to vertebral fracture, while 8 patients had a malignant condition initially suspected as being responsible for the compression fracture. Malignancy was identified in 4 patients, 3 of whom did not previously have such a diagnosis. In an additional 6 cases the suspected aetiology behind vertebral compression fracture was not confirmed by pathology. DISCUSSION: This study found a 20% prevalence of malignancy in our population, which is higher than other reports in the literature. Eight percent of the patients in this study were ultimately found to have a malignant aetiology behind their compression fracture, while in 18% of the cases the presumed aetiology was not confirmed on pathological examination. Compression fractures can be one of the most common manifestations of osteoporosis, but a variety of other conditions, including neoplastic processes may also be responsible. As a result, we recommend obtaining a vertebral body biopsy prior to every vertebral augmentation procedure.

Subject

80 and over; Aged; Biopsy; Bone Cements/therapeutic use; Compression/etiology/pathology/*surgery; Female; Fractures; Humans; Male; Middle Aged; Osteoporosis/complications/pathology; Polymethyl Methacrylate/therapeutic use; Retrospective Studies; Spinal Fractures/etiology/pathology/*surgery; Spinal Neoplasms/complications/pathology/secondary; Vertebroplasty/*methods

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

327–333

Issue

3

Volume

39

Citation

Schoenfeld Andrew J; Dinicola Nicholas J; Ehrler Douglas M; Koerber Andrea; Paxos Mihail; Shorten Scott D; Bowers Jacqueline; Jackson Erin; Smith Michael J, “Retrospective review of biopsy results following percutaneous fixation of vertebral compression fractures.,” NEOMED Bibliography Database, accessed March 2, 2021, https://neomed.omeka.net/items/show/3612.

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