Name of the Procedure:

Biopsy, vertebral body, open; lumbar or cervical

Summary

An open vertebral body biopsy is a surgical procedure used to extract a small sample of bone tissue from the vertebral body in the lumbar (lower back) or cervical (neck) spine. The sample is then analyzed in a lab to diagnose various conditions.

Purpose

The procedure is performed to diagnose abnormalities in the vertebral body, such as infections, tumors, or other bone diseases. The goal is to obtain a tissue sample that can be examined under a microscope to understand the nature of the abnormality.

Indications

• Persistent back or neck pain with unknown cause
• Abnormal results from imaging tests like MRI or CT scans
• Suspicion of bone infection (osteomyelitis)
• Detection of metastatic or primary spinal tumors

Preparation

• Patients are usually advised to fast for 6-8 hours before the procedure.
• Blood tests and imaging studies (MRI or CT scans) may be required.
• Medication adjustments, such as stopping blood thinners, may be necessary.

Procedure Description

1. The patient is positioned either prone (face-down) for lumbar biopsy or supine (face-up) for cervical biopsy.
2. General anesthesia is administered to ensure the patient is asleep during the procedure.
3. The area to be biopsied is sterilized and an incision is made.
4. The surgeon carefully exposes the vertebral body.
5. A small sample of bone tissue is removed using specialized instruments.
6. The tissue sample is sent to a pathology lab for analysis.
7. The incision is then closed with sutures or staples.

Duration

The procedure typically takes about 1-2 hours, though this can vary based on complexity.

Setting

It is generally performed in a hospital operating room.

Personnel

• Orthopedic or neurosurgeon
• Anesthesiologist
• Surgical nurses
• Pathologist (who will analyze the biopsy sample)

Risks and Complications

• Infection at the biopsy site
• Bleeding or hematoma formation
• Damage to surrounding tissues, including nerves
• Pain at the biopsy site
• Adverse reactions to anesthesia

Benefits

• Accurate diagnosis of bone abnormalities
• Helps in planning further treatment, such as surgery, chemotherapy, or radiation therapy

Recovery

• Post-procedure, patients may need to stay in the hospital for observation.
• Pain management includes prescribed pain relief medications.
• Patients are often instructed to avoid strenuous activities for several weeks.
• Follow-up appointments are scheduled to monitor healing and discuss biopsy results.

Alternatives

• Needle biopsy: Less invasive but may not provide as comprehensive a sample.
• Imaging studies alone: Non-invasive but can sometimes be inconclusive.

Patient Experience

Patients will be under general anesthesia and will not feel anything during the procedure. Postoperative pain is managed with medications, and discomfort at the incision site is expected. Full recovery can take a few weeks, with activity limitations to ensure proper healing.