STUDY DESIGN: Retrospective study. OBJECTIVE: To determine the malignancy rate and histology in bone biopsies obtained during PVP for VCF. SUMMARY OF BACKGROUND DATA: Osteoporotic vertebral compression fractures (VCF) affect approximately 20% of postmenopausal women and can lead to long-term disability. Percutaneous vertebroplasty (PVP) is a minimally invasive procedure, primarily used in patients with severe pain after VCF. Even with a thorough clinical examination, magnetic resonance imaging (MRI) scans, and blood samples, some fractures maybe caused by an underlying malignant disease. METHODS: 144 consecutive patients underwent PVP for painful VCF, at the Center for Spine Surgery and Research, Middelfart Hospital. All patients had bone biopsies obtained during the PVP, and these biopsies were sent to the Department for Pathology at Vejle Sygehus for histologic diagnosis. RESULTS: About 144 patients were included in this study. The majority of the biopsy specimens (137, 95.1%) were acceptable for histological diagnosis. One hundred and twenty nine (89.6%) biopsies showed no signs of malignancy. Seven (4.9 %) were positive for malignancy. One biopsy was positive for MGUS. Seven (4.9 %) of the biopsies were unsuitable for histologic diagnosis. CONCLUSION: Our study shows an incidence of unsuspected malignancy in biopsies during PVP of 4.9%. Conservative treatment with analgesics and brace can potentially delay diagnosis and treatment of underlying malignant disease. We recommend biopsy during PVP as a standard procedure, to insure not to overlook any underlying malignancy despite the MRI-scan, blood analysis, and clinical examination being inconspicuous.
STUDY DESIGN: Retrospective study. OBJECTIVE: To determine the malignancy rate and histology in bone biopsies obtained during PVP for VCF. SUMMARY OF BACKGROUND DATA: Osteoporotic vertebral compression fractures (VCF) affect approximately 20% of postmenopausal women and can lead to long-term disability. Percutaneous vertebroplasty (PVP) is a minimally invasive procedure, primarily used in patients with severe pain after VCF. Even with a thorough clinical examination, magnetic resonance imaging (MRI) scans, and blood samples, some fractures maybe caused by an underlying malignant disease. METHODS: 144 consecutive patients underwent PVP for painful VCF, at the Center for Spine Surgery and Research, Middelfart Hospital. All patients had bone biopsies obtained during the PVP, and these biopsies were sent to the Department for Pathology at Vejle Sygehus for histologic diagnosis. RESULTS: About 144 patients were included in this study. The majority of the biopsy specimens (137, 95.1%) were acceptable for histological diagnosis. One hundred and twenty nine (89.6%) biopsies showed no signs of malignancy. Seven (4.9 %) were positive for malignancy. One biopsy was positive for MGUS. Seven (4.9 %) of the biopsies were unsuitable for histologic diagnosis. CONCLUSION: Our study shows an incidence of unsuspected malignancy in biopsies during PVP of 4.9%. Conservative treatment with analgesics and brace can potentially delay diagnosis and treatment of underlying malignant disease. We recommend biopsy during PVP as a standard procedure, to insure not to overlook any underlying malignancy despite the MRI-scan, blood analysis, and clinical examination being inconspicuous.
Authors: Frederic Carsten Schmeel; Julian Alexander Luetkens; Simon Jonas Enkirch; Andreas Feißt; Christoph Hans-Jürgen Endler; Leonard Christopher Schmeel; Peter Johannes Wagenhäuser; Frank Träber; Hans Heinz Schild; Guido Matthias Kukuk Journal: Eur Radiol Date: 2018-06-01 Impact factor: 5.315
Authors: Georg Osterhoff; Denis Rappert; Max J Scheyerer; Alexander C Disch; Bernhard W Ullrich; Ulrich A Spiegl; Klaus J Schnake Journal: Unfallchirurgie (Heidelb) Date: 2022-07-15
Authors: Chew Zhihong; Cheng Sheng DA Jowell; Syed Aftab; Seang Beng Tan; Chang Ming Guo; John Chen Li Tat; Poh Ling Fong; William Yeo; Mashfiqul A Siddiqui Journal: Int J Spine Surg Date: 2019-10-31
Authors: Dimitrios C Karampinos; Stefan Ruschke; Michael Dieckmeyer; Maximilian Diefenbach; Daniela Franz; Alexandra S Gersing; Roland Krug; Thomas Baum Journal: J Magn Reson Imaging Date: 2017-06-01 Impact factor: 4.813