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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2023; 33(03): 289-294
DOI: 10.1055/s-0043-1764491
Original Article

Computed Tomography–Guided Spinal Biopsy in Suspected Infective Spondylodiscitis: An Institutional Review of Its Utility

Raj Chendur Abhishek Ravichandran 
1   Christian Medical College, Vellore, Chennai, India
,
Rohit Amritanand 
2   Department of Spine Surgery, Christian Medical College, Vellore, Chennai, India
,
Vinu Moses 
3   Department of Interventional Radiology, Division of Clinical Radiology, Christian Medical College, Vellore, Chennai, India
,
Madhavi Kandagaddala 
3   Department of Interventional Radiology, Division of Clinical Radiology, Christian Medical College, Vellore, Chennai, India
,
Venkatesh Krishnan 
2   Department of Spine Surgery, Christian Medical College, Vellore, Chennai, India
,
Kenny Samuel David 
2   Department of Spine Surgery, Christian Medical College, Vellore, Chennai, India
,
Justin Arockiaraj 
2   Department of Spine Surgery, Christian Medical College, Vellore, Chennai, India
,
Harini Kulasekaran 
2   Department of Spine Surgery, Christian Medical College, Vellore, Chennai, India
,
Maya Pavalasseril Ganesan 
4   Department of Biostatistics, Christian Medical College, Vellore, Chennai, India
,
Anne Jennifer Prabhu 
5   Department of Pathology, Christian Medical College, Vellore, Chennai, India
,
Shyamkumar Nidugala Keshava 
3   Department of Interventional Radiology, Division of Clinical Radiology, Christian Medical College, Vellore, Chennai, India
› Author Affiliations Funding None.
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Abstract

Background Infectious spondylodiscitis is a debilitating condition and evidence-based medicine dictates confirming the diagnosis before treatment. Computed tomography–guided spinal biopsy plays a major role and hence we would like to determine its utility in current clinical practice.

Purpose The purpose of this study is to determine the percentage of confirmatory positives of CT-guided spinal biopsy in patients who were clinicoradiologically diagnosed with infectious spondylitis.

Material and Methods A retrospective analysis of patients who underwent CT-guided biopsy for suspected infectious spondylodiscitis from 2017 to 2021 in a tertiary medical center was done. The data were filtered and obtained from the electronic database of the institution.

Results In all, 259 patients underwent CT-guided biopsy of the spine. The procedure provided confirmatory results in 149 (57.5%) biospecimens. Histopathology examination was confirmatory in 95 (36.6%) of the 241 biospecimens sent. The Mycobacteria Growth Indicator Tube (MGIT) was confirmatory in 51 (19.9%) of the 250 biospecimens sent and drug resistance was seen in 6/51 (11.7%) biospecimens. Xpert TB provided confirmatory results in 72 (27.8%) of the 254 biospecimens sent and rifampicin resistance was seen in 16/72 (22.2%) biospecimens. Bacterial culture was confirmatory in 29 (11.2%) of the 250 biospecimens sent. The complication documented in this study was 0.3%.

Conclusion CT-guided spinal biopsy for suspected vertebral osteomyelitis is a safe and effective minimally invasive procedure. It demonstrates a positive yield in more than half of the patients. Knowing the outcome, the patients can be appropriately counseled prior to the procedure. CT-guided biopsy results were affected by prior administration of ATT (antitubercular therapy) in suspected tuberculous spondylitis patients.

Keywords

spine biopsy - CT - infectious spondylodiscitis - tuberculous spondylodiscitis - pyogenic spondylodiscitis - antitubercular therapy


Publication History

Article published online:
06 May 2023

© 2023. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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