The effectiveness of a standard drill connected to a core biopsy needle: How to obtain specimens in very strong bone tumors

Injury. 2018 Aug;49(8):1612-1616. doi: 10.1016/j.injury.2018.05.025. Epub 2018 Jun 9.

Abstract

Introduction: Core biopsy is today recognized as the gold standard for the diagnosis of bone lesions; unfortunately, when the bone is too solid it can be very difficult to penetrate it; in case of failure, open biopsy is indicated but it is associated with greater contamination and complications. A possible solution is to connect a common orthopedic drill to the core biopsy needle. The aim of the presenting study was to present a technique useful for performing biopsies in case of very strong bone lesions and to evaluate the adequacy and quality of the obtained specimen.

Materials and methods: A standard bone biopsy set was connected to a commercial drill to perform bone biopsies. Data was collected over a 2-year period (2015-2016). Information regarding technical success, diagnostic data and complication rates was all collated to assess the technical feasibility of this technique.

Results: Out of 357 bone biopsies, 34 patients underwent the procedure using a common orthopedic drill connected to a core biopsy needle. Diagnostic material was obtained in each patient and the artifacts were considered irrelevant. No major complications occurred in any patient.

Discussion: The use of a core biopsy needle connected to a common orthopedic drill facilitates the penetration of thick cortical bone by simply applying continuous speed and pressure; nevertheless, the biopsy needle we use is not designed for a drilling procedure and for this reason it can be damaged, but if the biopsy is performed with particular attention, the mechanical failure can be avoided CONCLUSIONS: Bone biopsy using a commercial hand drill has a technically high success rate with minimal complications. Further studies with more cases are necessary to verify our results.

Keywords: Bone biopsy; Bone tumor; Sclerotic bone lesions; core biopsy.

MeSH terms

  • Adolescent
  • Adult
  • Artifacts
  • Biopsy, Large-Core Needle* / instrumentation
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / pathology*
  • Bone and Bones / pathology*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Orthopedic Equipment*
  • Positron Emission Tomography Computed Tomography
  • Tomography, X-Ray Computed
  • Young Adult