Percutaneus biopsy of spine metastases

Many malignancies in elderly population are firstly presented by spine metastases. Taking into account the complexity of metastatic diseases, it is very important to complete tumor staging and determine its pathohistology. In this paper, we present a group of patients on which a percutaneous biopsy of tumor at the Department of orthopedics and traumatology in Sarajevo was made. Including factors were: X-ray, CT or MRI diagnosed spine metastasis of thoracic or lumbar spine of unknown origin. Needle biopsy in local anesthesia was performed on 25 patients in total, and on 21 of them, we confirmed histological metastatic disease (84%). Other four patients had inadequate material for analysis and we had to repeat the procedure. Spine surgery was indicated in 8 of 25 patients (32%). Metastatic disease advanced to the rest of them (68%) and they were only indicated with chemo/radio-therapy (low Tomitta score and short life expectancy). Despite the presence of many metastases, the most symptomatic are spinal metastases. Therefore, other specialists expect orthopedic-trauma spine surgeons to be leaders of the team, although it should be oncologists. Percutaneous spine biopsy allows the acceleration of diagnostic procedure, and, as soon as possible, the beginning of definite therapy.