Computed Tomography-Guided Vertebral Biopsy in Suspected Tuberculous Spondylodiscitis: Comparing a New Navigational Tram-Track Technique versus Conventional Method

Abstract

Introduction Computed tomography (CT)-guided vertebral biopsy is always recommended for histopathological and microbiological confirmation in cases of tuberculous spondylodiscitis and for antimycobacterial drug sensitivity testing. Aim To compare the conventional technique and a novel axis-defined tram-track technique of CT-guided vertebral biopsy in suspected tuberculous spondylodiscitis. Materials and Methods Sixty-seven patients of clinico-radiologically suspected tuberculous spondylodiscitis referred for CT-guided vertebral biopsy were categorized into two groups: “Group A” patients (n = 32) underwent biopsy by conventional technique, and “Group B” patients (n = 35) by axis-defined tram-track technique. The time taken for procedure, radiation exposure, and any procedural complications were recorded for both the groups. Results A statistically significant difference in procedure time and mean radiation dose was observed between the two groups: a longer procedural time was required in “Group A” (52.5 ± 3.5 minutes) as compared to “Group B” (37.3 ± 3.6 minutes) (p < 0.0001); and mean radiation dose (CTDIvol) in “Group A” and “Group B” was 8.64 ± 1.06 mGy and 5.73 ± 0.71 mGy, respectively (p < 0.0001). However, the difference in complication rate and tissue yield for successful diagnosis of the biopsies in the two groups was found to be statistically insignificant. Conclusion Axis-defined tram-track technique was found to have a significantly shorter procedural time as well as lower radiation exposure compared to the conventional technique of vertebral biopsy in our study.

Keywords

• tuberculous spondylodiscitis
• ct-guided vertebral biopsy
• conventional technique of vertebral biopsy