Kypho Biopsies

[manowar rules]

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Can someone please walk me through how they perform needle biopsies during kyphoplasty? I use the stryker kits. There is a lot of rep turnover unfortunately and I often don't have coverage. My current rep is good but literally just finished training a month ago. Once in the vertebral body, I put the bone biopsy needle in though the access cannula and aspirate with the supplied syringe, but most of the time that yields a small aspiration of blood at best, usually just nothing. Are they expecting me to be sucking up bone fragments with that thing? Sometimes I will get bone fragments with the drill, but this is also usually minimal since the suspected pathologic fractures are usually very soft.

Also, assuming I do get a sample, what do you put on the lab order? Cell count, immunohistology panel? I am sending this to the lab at the most clueless hospital in the state, so I must be very specific.

Thanks so much!

 

[lobelsteve]

Go in through the pedicle or patapedicular, and when you’re a few millimeters into vertebral body put the kyphoplasty biopsy needle in the cannula. Hammer into position 1 cm. Then use the aspirate syringe twist 360 and pull back. You should get a 1 cm solid core that you have to use the stylet to pop out of the biopsy needle and into the formalin container.

 

[clubdeac]

Talked with our IR guys who do a ton of these and they say the biopsies are outer fruitless. They try while in there but still recommend the patient get a good old fashioned bone marrow aspirate from the hip if they are looking for something bad

 

[BobBarker]

You really need to use the jamshidi with the cone tip to get a good biopsy. It is usually fruitless to pass a bone filler and try to aspirate with the syringe.

 

[Ferrismonk]

On a related note, do you guys always get a biopsy? I've heard some say they always get one and others say only if suspected mets.

 

[lobelsteve]

If any risk factors then get bx. I don’t recall ever not getting some bone. I use Stryker kits and their coring bx needles.

 

[BobBarker]

Lots of the reps recommend just taking a bone filler, tapping it in, aspirating. It doesn’t work but multiple reps have rec this across several companies. A proper bone bx needle probably works great 98% of the time.

 

[HyperSonic]

If any risk factors then get bx. I don’t recall ever not getting some bone. I use Stryker kits and their coring bx needles.

How much do they charge you for your Stryker kits?

 

[lobelsteve]

How much do they charge you for your Stryker kits?

I work for a hospital. Free to me. 😉