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Title: CT-GUIDED PERCUTANEOUS BIOPSY USING INFERIOR COSTOTRANSVERSE APPROACH IN A SUSPECTED CASE OF SPINAL TUBERCULOSIS
e-poster Number: EPOS 48
Category: e Poster
Author Name: Dr. Ayesha Mansoor
Institute:
Co-Author Name:
Abstract :
INTRODUCTION: There are multiple approach-based techniques for CT-guided biopsy of vertebral lesions. These techniques depend on multiple factors including the following: location of the lesion within the vertebrae; focal or diffuse lesion; location within the spinal column. Percutaneous CT-guided biopsy of the vertebral lesion is a safe, effective and accurate diagnostic tool.
METHOD: A 24 year old male patient presented to our institution with lower back pain since 2 months. Based on MRI findings and clinical history, spinal TB was suspected. CT guided percutaneous vertebral biopsy was performed with patient in prone position under local anesthesia using a 14G Jamshidi needle. Inferior costotransverse technique was used to perform biopsy at T9-T10 level. Culture and CBNAAT assay came positive for M. tuberculosis, not rifampicin resistant.
DISCUSSION: Inferior costotransverse approach is performed in thoracic vertebral biopsy. This is preferred over the most commonly used transpedicular approach as it is easier than drilling through the inferior part of the facet joint to get into the lesion for a transpedicular approach. This approach cannot be performed in patients with costotransverse arthrosis or fusion wherein the gap between the rib and transverse process is obliterated. In such patients posterolateral approach (lateral to costotransverse joint) is used.
CONCLUSION: The inferior costotransverse technique is a valuable alternative for obtaining biopsies in the thoracic region, allowing for targeted sampling with minimal disruption to surrounding tissues. Proper technique and imaging guidance are critical for successful outcomes.
