 The patient was placed in a prone position. A radiopaque grid was placed over the patient's mid back for needle localization. Using multidetector helical CT, axial 3 mm scans were obtained through the thoracic spine demonstrating osteolytic lesion in the T7-T8 vertebral body and disk space suspicious for osteomyelitis/diskitis as seen on the patient's recent MRI study.A trajectory was plotted into the T7-T8 intervertebral disk space using a left parapedicular approach. The patient's back was prepped with Betadine and draped in sterile fashion. The subcutaneous and deeper soft tissues were anesthetized with 1% lidocaine. A 13-gauge Bonopty needle was advanced into the posterior aspect of T7-T8 intervertebral disk. Aspiration through the coaxial13- gauge Bonopty needle yielded approximately 2 ml of viscous sero-sanguinous fluid. Next, a 22-gauge x 15-cm Chiba needle was utilized to perform fine needle aspiration which yielded another 1 ml of serosanguineous aspirate. Finally, the inner bone cutting needle was utilized to obtain a core tissue disk biopsy. The samples were placed into a vial and mixed with normal saline to facilitate microbiology analysis. The sample was sent directly to microbiology for infectious analysis (viral/bacterial/fungal, and mycobacterial cultures).The coaxial needle was removed and adequate hemostasis was achieved with manual compression for 5 minutes.The patient tolerated the procedure well with no immediate complications. The patient remained neurologically at baseline at the end of the procedure. The patient was transferred back to the inpatient unit in stable condition.
Successful CT-guided fine-needle aspiration and core needle biopsy of the T7-T8 intervertebral disk.