Transpedicular Contrast-enhanced CT-guided biopsy of the body and dens of the axis avoiding the trans-oral approach: Technical report and literature review

Nicolas Papalexis; Federico Ponti; Paola Di Masi; Giuliano Peta; Leonor Garbin Savarese; Marco Miceli; Giancarlo Facchini; Paolo Spinnato

doi:10.4103/jcvjs.jcvjs_183_23

Transpedicular Contrast-enhanced CT-guided biopsy of the body and dens of the axis avoiding the trans-oral approach: Technical report and literature review

J Craniovertebr Junction Spine. 2024 Jan-Mar;15(1):118-122. doi: 10.4103/jcvjs.jcvjs_183_23. Epub 2024 Mar 13.

Authors

Nicolas Papalexis¹, Federico Ponti¹, Paola Di Masi¹, Giuliano Peta¹, Leonor Garbin Savarese², Marco Miceli¹, Giancarlo Facchini¹, Paolo Spinnato¹

Affiliations

¹ Department of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
² Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirão Preto, Brazil.

Abstract

This technical report illustrates the technique to perform computed tomography (CT)-guided bone biopsies in the body and dens of the axis (C2 vertebra) through a posterior transpedicular approach with the use of preoperative contrast-enhanced scans to highlight the course of the vertebral artery. The technique is presented through two exemplification cases: a pediatric patient with osteoblastoma and secondary aneurysmal bone cyst and one adult patient with melanoma metastasis. This case highlights the potential of the CT-guided posterolateral/transpedicular approach for performing safe and effective biopsies in the body and dens of C2, even in pediatric patients.

Keywords: Axis; bone neoplasm; cancer metastasis; cervical vertebra; image-guided biopsy; interventional; radiology; sarcoma; spiral computed; tomography.

Publication types

Case Reports