Histological evaluation of bone biopsy results during PVP or PKP of vertebral compression fractures

摘要

Percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) is utilized for the treatment of vertebral compression fractures (VCFs). The present study was conducted to evaluate biopsy results obtained from VCFs during PVPor PKP. Between January 2003 and December 2011, 692 vertebral body biopsies were obtained from 546 patients (442 females and 104 males; mean age, 72.3 years), who underwent PVP or PKP for treatment of VCFs. A history of malignancy was identified in 44 patients. Histological/immunohistochemical evaluations were performed by experienced pathologists and 89.9% of biopsies obtained from 546 patients were suitable for histological/immunohistochemical evaluation. The biopsy results of 398 patients were in good agreement with the diagnosis of osteoporotic VCFs. Among the 44 patients with a history of malignancy, malignancy was identified in 25 patients, while osteoporosis was identified in 16 patients. Biopsies of the other 3 patients were not suitable for pathological examination. There were only 2 patients with previously undiagnosed malignancy. One patient was diagnosed with multiple myeloma, while another patient was diagnosed with metastatic carcinoma. In the present study, the rate of unsuspected malignancy was 0.4%. No symptomatic complications occurred as a result of biopsy. The results indicate that biopsy is safely performed during PVP or PKP and it is an efficacious procedure that verifies the pathological process and assists in identifying previously unsuspected processes responsible for VCFs. We recommend obtaining the biopsy of every collapsed vertebral body during PVP or PKP procedures.