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  4. A Stepwise Posterolateral Approach for Computed Tomography Guided C2 (Axis) Transpedicular Biopsy: A Technical Note

A Stepwise Posterolateral Approach for Computed Tomography Guided C2 (Axis) Transpedicular Biopsy: A Technical Note

Journal of Orthopaedic Case Reports, 2021 · DOI: 10.13107/jocr.2021.v11.i09.2424 · Published: September 1, 2021

OncologySurgery

Simple Explanation

This paper describes a method for taking a biopsy of the C2 vertebra using a minimally invasive, CT-guided procedure. The posterolateral approach is used to avoid critical structures, and local anesthesia is administered, which is less risky for some patients than general anesthesia. The stepwise approach helps ensure the procedure is performed safely and accurately, leading to high-quality biopsy samples.

Study Duration
Not specified
Participants
One 70-year-old female
Evidence Level
Level 4, Case Report

Key Findings

  • 1
    The study demonstrates that a minimally invasive posterolateral percutaneous CT-guided approach for C2 biopsy is safe and precise.
  • 2
    The stepwise approach aids in getting repeatable and high-yielding results in technically challenging areas like C2 vertebrae.
  • 3
    The biopsy procedure, lasting 54 minutes, successfully diagnosed moderately differentiated adenocarcinoma from the lung with metastasis to C2 vertebrae.

Research Summary

This case report presents a case of adenocarcinoma diagnosed with CT-guided percutaneous biopsy of the C2 body using a posterolateral approach under local anesthesia. Stepwise approach for CT-guided minimally invasive percutaneous C2 biopsy procedure helps in getting repeatable and high yielding results with safety and accuracy especially in technically challenging areas such as C2 vertebrae. Understanding the detailed anatomy prior to CT guided minimally invasive percutaneous C2 biopsy procedure helps in increasing its safety, precision, and high yield.

Practical Implications

Improved Safety

The posterolateral approach, combined with careful anatomical consideration, minimizes the risk of injury to critical structures.

Reduced Anesthesia Risk

Using local anesthesia avoids the risks associated with general anesthesia, making the procedure suitable for debilitated patients.

Cost-Effectiveness

The minimally invasive CT-guided biopsy is cost-effective compared to open biopsies.

Study Limitations

  • 1
    Single case report limits generalizability
  • 2
    Technical difficulties due to smaller vertebral elements
  • 3
    Potential risk of injury to vertebral artery and spinal cord

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