There’s a chance that I have a cancerous spinal tumor. The medical facility here doesn’t have a way to biopsy this safely. My oncologist wants me to go to a larger cancer center to have this done. What sort of equipment is needed for this procedure?

With improved technology and surgical technique, percutaneous biopsy of bone lesions are starting to replace the more traditional open-incision biopsy. Percutaneous means through the skin.

During a percutaneous biopsy, a very long, thin needle is inserted through the skin and soft tissues and then into the bone. A sample of the suspicious tissue is removed and sent to the lab. An accurate diagnosis is the best way to determine the most effective treatment.

In order to guide the needle to the right spot, the surgeon uses an X-ray device called fluoroscopy. This type of imaging allows the surgeon to see while moving the needle. The advantage of this type of biopsy is that the muscles aren’t cut open and the surgeon can avoid damaging nearby nerves. The disadvantage is that it is less accurate than an open biopsy.

The percutaneous technique has advanced so much that studies are now being done to refine the procedure. Researchers are looking at the effect of needle size and type of imaging used (fluoroscopy versus CT scans) on accuracy. Other factors under study include the location of the lesions, expertise of the surgeon, and complication rate.