The Costovertebral Approach to Dorsal Vertebral Body Lesions

This 38 years old lady known to have carcinoma breast presented with metastatic disease. She had a D9 body lesion that needed a biopsy for ER, PR, HER2 estimation.

Transpedicular biopsies are usually the simplest to do with a very low complication rate if any. In the dorsal spine, one can go through the costovertebral joint and then through the pedicle to reach the vertebral body lesion.

As seen in these images, the needle was placed in the costovertebral joint and with gentle taps, it went easily all the way into the lesion. She was ER, PR negative and HER2 positive.

#CTbiopsy #cabreast #vertebralbiopsy