Spine biopsy timing of analysis. Spine biopsy: why and how is it done, what methods are there? Spine biopsy

06.03.2020

A spinal x-ray is mandatory when diagnosing severe injuries such as fractures. Thanks to X-ray, it is possible to determine the exact location of bone fragments and, based on this, choose a method of reduction. X-ray examination is highly informative in assessing the degree and nature of the displacement of the vertebrae relative to each other, therefore it is used in the examination of all types of curvature of the spinal column. Bone, cartilaginous and soft tissue have different densities, therefore they are displayed differently on the X-ray. This makes it possible to include in the scope of X-ray the diagnosis of joint diseases, including the formation of cartilaginous bodies in the joint fluid. Often, it is the x-ray that can detect tumors in the spine. The study itself speaks only of the presence of a tumor, in order to accurately determine its nature, a biopsy is used. To make the X-ray examination more reliable, it is carried out in 2 projections: lateral and posterior.

As directed by the attending physician, an image can be used in the position of flexion or extension of the spine at a certain angle. For each part of the spine, a separate X-ray in 2 projections can be performed.

There is a limitation on the X-ray of the spine in pregnant women for early date... Only in emergency situations can x-rays be used, for example, if a fracture is suspected or if other equipment is not available. In people with significantly pronounced obesity, X-rays are also not used, since it is impossible to obtain a sufficiently informative picture through the thickness of soft tissues. Usually the limitation applies to patients weighing more than 200 kg. Sometimes preliminary preparation of a person for an x-ray is required. If the patient is unable to maintain immobility even for a short time (for example, with strong psychomotor agitation), tranquilizers are first taken, and only after that a picture is taken.

What does an x-ray of the spine show? The picture shows:

structural disorders of each vertebra, complete and incomplete fractures;
distances between individual vertebrae, dislocations, subluxations;
the location of the vertebrae relative to the normal trajectory of the spinal column, curvature, displacement;
the formation of bone processes, osteophytes.

Read about what osteochondrosis looks like on a radiograph here.

In order to get a complete picture of the clinical picture of each disorder, it may be necessary to use other diagnostic methods:

ultrasound procedure;
cT scan;
magnetic resonance imaging;
myelography.

Injuries and deformations of soft tissues are not displayed on the X-ray image or their display is not clear enough. In some cases, tumors may appear as areas of darkening, which does not give a complete picture of their size. Frequent spinal injuries are dislocations and subluxations, as a result of these injuries, the integrity of the ligaments and blood vessels is disrupted. X-ray allows only to exclude a fracture of the vertebrae, but does not provide almost any data on the condition of the ligaments or muscles.

To embrace clinical picture in combination, usually 2 (or more) survey methods are used. An X-ray of each spine has its own characteristics.

X-ray of the cervical spine is indicated for:

skull injuries;
bruises, dislocations and fractures of the cervical vertebrae;
headaches of unknown origin;
curvatures and deformities of the spinal column in the cervical spine;
with complaints of dizziness, visual impairment;
if the victim has neurological symptoms, numbness of the upper limbs or neck, difficulty with coordination of movements.

X-ray allows you to specify the location of each vertebra, but does not provide detailed information about intervertebral discs or hernias (more details here). How is X-ray done for multiple spinal injuries? First of all, the examination of the cervical spine is carried out, because fractures and hematomas in this area can provoke death within a short period of time. For the cervical spine, an image is often taken in 3 projections: oblique, straight and through the open mouth.

Studies of all departments, except for the cervical, require preliminary preparation. In order not to complicate the study, products that contribute to flatulence should be excluded from the diet in advance:

cabbage;
legumes;
carbonated drinks;
white bread and pastries.

For X-ray thoracic the condition of the spine is more important than the state of the intestines, therefore, in order to prepare for the study, you need to stop eating for 8-12 hours. Modern hardware has different requirements, so no specific training may be required. First, you need to consult with your doctor, and he will give recommendations on how best to conduct an X-ray. Before the X-ray on any equipment, the patient removes all clothing and jewelry from the upper body. A record is made on the personal card about the radiation dose received during the X-ray.

When conducting multiple studies, the data are summarized so that the total dose does not exceed the safe limit for humans.

A chest X-ray is prescribed for:

chest injuries (eg, ribs);
diseases of the heart and blood vessels;
inflammatory processes in the lungs and pleura;
ingress of foreign objects into the gastrointestinal tract and respiratory tract;
suspected pulmonary tuberculosis;
injuries and curvatures of the spinal column.

The research time is on average about 20 minutes. Without professional training, it is impossible to interpret the image correctly, therefore a specialist should deal with decoding.

Lumbar and sacral x-ray

Sometimes, to improve the quality of the results, especially if the study is carried out on old-style equipment, the patient is pre-prescribed enemas or a laxative so that the accumulation of gas and feces does not appear in the picture. Preparation for research includes:

diet to prevent flatulence;
taking absorbent products (for example, activated carbon) a few days before the study;
immediately before the study, a natural emptying of the intestines with the help of a laxative or enema.

The interpretation of the image is significantly influenced by the cognitive abilities of the doctor, so it is worth taking care of choosing a truly competent specialist. For what violations is x-ray shown? It:

bruises, fractures and dislocations in the lower part of the spinal column;
pain and numbness in lower limbsloss of sensitivity and muscle control;
back pain, especially localized in the lower back, coccyx and sacrum;
structural deformities of the vertebrae in shape, height, location relative to each other.

To conduct an X-ray of the lumbar spine, a person takes a horizontal position on a special rigid table. It is very important to remove piercings and jewelry, including from intimate areas. In order to choose the best and sharpest image, several shots are taken in a row. In this case, the patient cannot move, talk, breathe. To reduce potentially harmful effects on the body, special aprons are used with a lead insert fixed inside. The metal helps protect certain parts of the body from X-rays. If necessary, you can take a picture of only one part of the spine in isolation, for example, an x-ray of the coccyx. This study is mandatory for diagnosing bruises, fractures or dislocations of the last 5 vertebrae.

Functional tests

In some cases, it is required to take an X-ray of the spine while performing flexion or extension at a certain angle in order to assess the nature of the displacement of the vertebrae relative to each other, not at rest, but under load. In some types of scoliosis, studies are required with a deviation of the body forward and backward. The exact list of movements that a person makes is selected by the doctor on an individual basis, depending on the objectives of the study. Most often, maximum flexion and extension of the spinal column is used in the standing, sitting and lying positions.

Pictures are taken in 3 projections: 2 side and back. Functional examinations are very rarely used for the thoracic region; they are usually used for the lumbar and cervical regions, because the range of movements in them is wider. Modern equipment allows you to save the image in a very good quality directly on digital media. This allows you to enlarge individual parts of the images. Old-style equipment can only reproduce a picture on film, which creates many inconveniences for doctors, especially when it is necessary to diagnose incomplete fractures of individual vertebrae. When ordering a study in any private laboratory, the patient can get his hands on a disk or a USB flash drive with all the data, in order to then provide them to the attending physician for interpretation.

MRI of the joint: what is this procedure and how is it done

Joint MRI is one of the most accurate and promising medical diagnostics in orthopedics. In the case of magnetic resonance imaging, it is possible to investigate not only pathological and structural changes, but also to assess the pathophysiological processes occurring in the whole joint and some of its structures.

Moreover, magnetic resonance imaging for examining joints is highly valued due to the fact that it makes it possible to not easily create a three-dimensional image of the investigated area, but also to show the nerve trunks, vasculature and vessels that pass in the projection of the examined joint.

During magnetic resonance therapy, magnetic radiation is used, which is harmless to humans.

MRI is necessary for the diagnosis of joint diseases in the early stages, allowing the doctor to see even insignificant pathological processes that are the harbingers of a future disease.

Therefore, this diagnostic procedure is used when examining occupational and sports injuries.

Due to the rapid modernization of surface coils for joints, today such diagnostics has become the main method of visual representation of the supporting organs and the area of \u200b\u200btheir manifestation.

The increased contrast of soft tissues and multiplanar imaging allows for the best visualization of extra-articular and intra-articular joint structures, including:

bone marrow;
muscles;
periarticular bags;
tendons;
articular capsule;
fibrous and hyaline cartilage.

What does the MRI procedure show and its capabilities?

IN human body the joint is an important component of the musculoskeletal system. If a disease of these compounds appears, then the quality of a person's life deteriorates significantly. Today, MRI procedure has become the best method for diagnosing joint pathologies, such as:

marching fracture;
thinning of cartilage tissue;
rupture of muscle tissue;
damage to discs, inflammation of the meniscus;
ligament rupture.

MRI of the joints makes it possible at the initial stages to determine degenerative changes in the joints. For example, minor ruptures of tendons, muscles, ligaments, chronic arthritis and fractures that cannot be diagnosed with a simple X-ray.

Also, such diagnostics are necessary when planning surgical intervention on the joints and for the purpose of postoperative monitoring of the human condition.

Due to the fact that MRI makes it possible to obtain a clear image of soft tissues, it is often used to examine large joints (shoulder, knee, etc.), extremities and the spine.

Compared with radiography, computed tomography is characterized by high clarity and accuracy of a three-dimensional image.

In terms of imaging quality and tissue sensitivity, MRI is much better ultrasound diagnostics, thanks to which it is possible to more clearly distinguish between the affected and healthy tissue.

In addition, magnetic resonance imaging does not often cause complications such as allergic reaction in comparison with X-ray and traditional computed tomography, which uses an iodine contrast agent, which often contributes to the occurrence of side effects.

MRI of large joints and bones

Damage to large joints is of no small medical and social importance. This form of injury occurs in 65% -70% of all types of injuries.

Modern principles of treatment of people with injuries of large joints and bones require extremely accurate diagnostics of processes inside and outside the articular structures. In this case, MRI is the best method.

When diagnosing injuries, the knee and shoulder joints are the hardest to examine. The fact is that in these joints there are a lot of functionally significant structural structures inside and outside.

The classical study of bones and joints using X-rays makes it possible to obtain detailed data on the bone structure, assess the condition of the joint spaces, detect changes in the size and shape of bones and determine their ratio.

But such a procedure does not make it possible to identify indicators of damage to the inside and extra-articular soft tissues of the joints. Moreover, the sensitivity x-ray examination in the detection of such pathologies no more than 7%.

Today MRI is a priority diagnostic procedure if it is necessary to visualize the structure of the knee and shoulder joints. This technique allows you to detect pathological processes not only in the structure of bones, but also in soft tissues.

To further improve the diagnostic accuracy in last years new methods of magnetic resonance imaging of bones and joints have been developed, in which paramagnetic contrast agents are used.

Some doctors are convinced that it is the use of direct MR-arthrography that makes it possible to depict the pathological processes occurring in the articular tissues. At the same time, others note some disadvantages of such a diagnosis, the main one being invasiveness.

An alternative to direct MR - arthrography has become indirect MR - arthrography, which is based on the penetration of paramagnetic contrast agent into the articular cavity after intravenous administration.

Thus, MRI of the joints is the most effective diagnostic technique.

Pros of the procedure

The main advantages of this procedure include:

visualization of any tissue;
the highest diagnostic efficiency;
absolute harmlessness, since there is no radiation exposure;
high resolution (MRI shows elements up to several ml in size and you can get a picture in any projection).

Indications and contraindications for MRI

Indications for MRI examination of bones and joints are herniated intervertebral discs, acute injuries and osteomyelitis. The procedure is also performed for chronic arthritis, inflammatory infectious diseases of soft tissues and bones, degenerative pathologies of joints and tumors of soft tissues and bones.

Despite the fact that MRI is the best diagnostic procedure, it still has some contraindications, such as:

presence of foreign metal bodies either ferromagnetic implants;
the presence of a neurostimulator and artificial pacemakers.

How is the operation to remove a hernia of the lumbar spine

Herniated discs are completely curable. The operation to remove it is the most extreme measure. Methods surgical treatment there are several, so it's worth talking about them in detail.

When an operation is needed

The intervertebral disc is a "spacer" between the vertebrae, consisting of a fibrous ring ( hard shell) and nucleus pulposus (liquid "filling" of the disc). It doesn't take much to damage the annulus - sometimes it is enough to bend over incorrectly. Through the crack, the nucleus pulposus comes out, pinching the nerve endings. This is what causes the pain and protrusion of the disc. The operation is prescribed in cases where conservative methods of treatment for long time it is not possible to cope with pain, and blockages do not help, and if the hernia negatively affects the functions of internal organs. This often happens with a hernia in lumbar... Modern surgical methods allow you to return to normal life without back pain in a couple of days.

Varieties of operations

Today, intervertebral hernia is treated with the following surgical methods:

Laminectomy

It is most applicable for ailments with complications in the form of osteophytes and for large neoplasms. The essence of the operation is to release the squeezed fragments by dissecting the disc (partial) or sequestering its arch. The price of a laminectomy starts at 25 thousand rubles.

Endoscopy

Appointed in the following cases:

with a rapidly progressing hernia and an unstable condition of the patient;
with radicular syndrome, which is actively progressing;
if the hernia is located in the foramenal lumbar region or posterolateral.

Contraindicated in tumors and infections, with medial protrusion and with a narrowed spinal canal.

The endoscope is inserted through a hole in a couple of centimeters, the instruments for the operation are miniature. All this makes endoscopy minimally traumatic. The price in Russia is about 130 thousand rubles, in Germany - from 5000 thousand euros.

Microdiscectomy

The same gold standard for hernia surgery. It is prescribed if the hernia has given a lot side effects, among which:

permanent lumbodynia;
weakness and muscle atrophy;
sexual dysfunctions;
constipation and kidney dysfunction.

During the operation, the surgeon removes a piece of bone tissue of the vertebra located above the nerve, or part of itself intervertebral disc, which helps to stop squeezing. It is carried out as follows:

first, a muscle is lifted with a special hook, which straightens the back;
a membrane is removed above the nerve roots, due to which access to the spine opens;
the surgeon can remove a small part of the inner surface of the facet joint;
the nerve root is shifted to the side and the tissues of the intervertebral disc are removed from under it.

Considered the most effective method fight against protrusions. Price in Russia from 20 thousand rubles.

Laser removal

Also called drying. The damaged disc is irradiated here with a laser, which reduces the hernia. Suitable for young patients (up to 50-52 years old). The price in Germany is from 5,000 euros, in Russia - up to 80 thousand rubles. Laser reconstruction is also possible, in which the disc heats up and the metabolic processes in it are activated. As a result, new cartilage cells are formed that fill the cracks in the disc. It is carried out using a puncture with a special needle.

Destruction of facet nerves

Most effective if you have facet syndrome and arthrosis of the intervertebral discs. With it, pain receptors are inactivated. A radio frequency probe is used for conducting. It is brought to the nerve and inactivation is carried out there. pain receptors... The cost of the operation is from 17 thousand rubles.

How to prepare for surgery

Preparation for the operation to remove a hernia is not difficult:

first of all, you should undergo an MRI of the spine (or CT);
pass urine and blood tests;
you cannot eat for 8 hours before the operation itself;
an examination and questioning of the anesthesiologist is needed.

Complications

With modern surgical methods removal of hernias, they are rare. Nevertheless, sometimes the following phenomena are observed:

sometimes the lining of the spinal cord is torn or the cerebrospinal medulla leaks. The risk of such complications is up to 2%. They do not bring much harm, they do not affect the outcome of operations, but if this happens, to heal the rupture, after the operation, spend a day or two in bed rest and lying on your back;
damage to the nerve root;
infection;
fecal or urinary incontinence.

When laser treatment such complications are extremely rare, but its effectiveness is also lower than that of the same minidiscectomy.

Rehabilitation after surgery

The main task after surgery is to restore the back muscle corset. In the first 14 days, you need to eliminate all pain and swelling. The first day you may need bed rest. Next, medications are used to relieve pain. You may also be prescribed an orthopedic corset. Further physiotherapy will be needed (ultrasound, electrotherapy and laser). In addition, a therapeutic massage will be needed two weeks after the operation. All this is necessary to quickly restore blood circulation in the spine and to improve the elasticity of the back muscles and increase their tone.

After 20 days after the operation, you can start physiotherapy exercises (it is also prescribed by a doctor, the task is the same as for physiotherapy and massage). After a month, you can work out on special simulators. During recovery, it is prohibited to:

move without a corset;
lift more than two kg (for three months);
lean to the sides or forward, twist, make sharp movements with a large amplitude;
engage in osteopathic treatment;
you can't sit for two weeks.

Hernia surgery is the most extreme measure. But if all other methods do not save you from pain, it is necessary.

You can learn about the operation from this video.

A spine biopsy is a diagnostic test that involves removing a small piece of bone from the spine. Sometimes, it involves removing a portion of the posterior arch of the vertebrae, intervertebral discs, epidural space, and intervertebral foramen. The procedure is considered effective remedy to determine the lesion of the vertebrae, discs and paraspinal soft tissues. It has an accuracy rate of about 80-95%, while it has high reliability in the study of osteolytic lesions.

What is the purpose of a spine biopsy?

A spine biopsy is done to check for neoplasms (spinal or paraspinal), infections, and metabolic bone diseases.

What steps should be taken to prepare for a spine biopsy?

Before a patient is referred for biopsy, the patient should be assessed with physical examination and other diagnostic imaging techniques such as spinal x-rays, computed tomography (CT), magnetic resonance imaging (MRI), and bone scintigraphy.

A spinal biopsy is prescribed for tumor processes of the spine or suspicion of them, the presence of destruction of the vertebra of an unclear nature or refractory conservative therapy, increasing pain syndrome against the background of treatment.

A vertebral biopsy is prescribed by a neurologist to accurately determine the nature of the pathological process occurring in the spine (tumor, infection, inflammation or degeneration), establish the histological type of the tumor and the degree of its malignancy, identify pathogenic microorganisms and study their sensitivity to drugs. These data allow you to correctly develop treatment tactics and plan an operation.

Is a spine biopsy painful or dangerous?

The patient may feel short-term discomfort, this procedure is painless, as it is performed under spinal anesthesia. The patient is monitored by medical personnel for several hours after the biopsy. For control possible complications an x-ray or other examination is performed.

The patient can return home immediately after the examination, which, however, depends on the type of biopsy performed.

Biopsy by qualified medical personnel almost completely eliminates the risk of unwanted side effects and the negative consequences of biopsy. The procedure may be accompanied by postoperative bleeding or the formation of subcutaneous hematomas due to damage to the blood vessels.

How is a spine biopsy performed?

Biopsy requires general preoperative preparation of the patient and local anesthesia. After processing the skin, a percutaneous puncture of the examined vertebra is performed. The puncture site and the position of the patient depend on the localization of the vertebra. Obtaining material from the bodies of the cervical vertebrae is carried out in a sitting position with a fixed head. Transoral biopsy is performed by puncture of the posterior pharyngeal wall. Puncture biopsy can be done with a bone biopsy needle or a special trocar. When biopsy tumors of small size or hard-to-reach localization, the procedure is carried out under the control computed tomography... It is possible to use endoscopic techniques for vertebral biopsy. This allows you to visually control the biopsy procedure, take a larger amount of material for research, excludes sampling not from the lesion focus and reduces the likelihood of damage to internal organs. Received material bone tissue the vertebra is sent for analysis. The histologist examines it under a microscope, determines abnormalities in the structure of the tissue, the histological type of tumor or the type of pathogen.

A spinal tumor is a rare pathology that occupies 3-5% of cases among all bone tumors. However, the anatomical features of the spinal column, rich vasculature, the spinal cord located in the spinal canal, nerve roots, influence on internal organs… - all this makes a spinal tumor a difficult problem to solve.

Depending on the structure, there are:

Benign neoplasms of the spine;
Malignant tumors;
Metastatic processes;
Tumor-like formations.

Spinal tumors should be diagnosed with the direct participation of biochemists, morphologists, therapists, and neurosurgeons. It is very important to establish the process of tumor development: primary or secondary, benign or malignant, morphological structure, stage and site of localization.

According to modern international recommendations, the minimum set includes:

Clinical and biochemical analysis blood;
CT of the spine, sometimes with myelography;
MRI, most often with a statement;
Biopsy.

The earlier the diagnosis is made and the diagnosis is made, the more favorable the prognosis for the patient. In modern medicine, a tumor is not a sentence, but its cure is the result of the joint work of several specialists " Open clinic”.

The American Cancer Association reports that more than 2,000 new cases are diagnosed worldwide each year. benign tumors skeletal system and 6000 malignant. And 5% of them are spinal tumors!

Spine biopsy - reliable tumor diagnosis

Despite the development modern methods diagnosis, spinal biopsy is still one of the main methods of examination. Only with its help it is possible to obtain a "piece of tumor" for further research, to obtain information about the histological structure of the tumor, to conduct a histochemical study, to find out the degree of its malignancy, to establish the primary tumor and, if necessary, to select chemotherapeutic drugs and the dose of gamma therapy.

A biopsy of a tumor in a vertebra can be done in 2 ways:

Puncture biopsy - using a navigation device, a special needle is drawn to the desired point of the affected vertebra, from where a part of the tumor is taken for examination.
Endoscopic biopsy is the most modern look biopsy, however, in cases of vertebral tumors, its use is not possible in all cases.

The biopsy is carried out under the control of a navigation device, it allows you to take material from any, even inaccessible place.

Spine tumor treatment

Spinal tumors require compulsory treatment. The method of treatment will depend on many factors: the type and type of tumor, its size, location, severity of clinical symptoms, whether it is primary or secondary. The share of primary tumors of the spine accounts for only 10%, metastatic lesions are much more common.

The choice of methods for treating spinal tumors is not great, as with tumors of any other localization, three main methods are used here: surgery, chemotherapy and radiation therapy.

The task of surgical treatment is to remove the neoplasm as much as possible, remove the surrounding tissues, if they are also affected, and, just as important, stabilize the spine. Modern medicine offers a variety of techniques surgical treatment using new endoscopic devices. As a result of this approach, the recovery period after surgery is significantly shortened, and patients quickly return to their normal life.

Chemotherapy can help reduce the size of the lesion. Most often, this method is used for large inoperable tumors. After chemotherapy, the neoplasm shrinks and surgery becomes possible.

Radiation therapy is also prescribed when an inoperable tumor is present, as a result of which the neoplasm shrinks. Most often, this method is used for secondary tumors. The number of courses, the duration of treatment - all this is determined by your attending physician, taking into account many factors.

Operation

Operations are carried out in two cases:

Impaired support of the spine: as a result of replacement of the normal bone structure of the vertebra with soft non-structural tumor tissue.
Compression of the spinal cord by tumor tissue or as a result of spinal deformity

In the case when a pathological vertebral fracture has not yet happened or it is minimal, an operation is performed: vertebroplasty of the affected vertebra. The essence of the operation is that under the control of a navigation device, a needle is passed to the required point of the vertebra affected by the tumor, and a liquid polymer (bone cement) is injected (“pumped”) into the vertebra through the needle using a special "delivery system" After 15 minutes, the cement begins to harden (polymerize), after 2 hours it completely solidifies. When solidified, the cement heats up to 50g, which kills tumor cells and gives an analgesic effect. After hardening, the strength of the cement is several times greater than the strength of the bone. The duration of the operation is 30 minutes. Postoperative observation 4 hours. On the same day, the patient can be allowed to go home, walk, and even play sports. The operation is performed under intravenous and local anesthesia. Bone cement is absolutely compatible with body tissues, does not cause rejection.

If, as a result of a fracture, a significant decrease in the height of the vertebra occurs, a deformity of the spine has developed, or the spinal cord is compressed, an operation is necessary to radically remove a part of the vertebra affected by the tumor, as well as to correct the deformity of the spine. Instead of the affected vertebra, a prosthesis is installed (most often made of titanium). The prosthesis is hollow, inside it is filled with the patient's own bone, or with osteogenic material, so that later fusion (corporodesis) with healthy vertebrae occurs.

In order to prevent the development of a pathological fracture, deformity of the spine with their catastrophic consequences (the fracture is often accompanied by compression of the spinal cord, which leads to paralysis in the legs, arms, dysfunction of urination and defecation), an operation is performed: transpedicular stabilization of the spine. During this operation, titanium "brackets" are installed in the vertebrae adjacent to the broken one, as a result of this, the load is removed from the vertebra destroyed by the tumor, and the risk of its fracture and the development of spinal deformity is prevented.

If there is compression of the spinal cord, one of the methods of surgery is decompression of the spinal cord, laminectomy is performed - removal of the posterior semi-ring of the vertebra and thereby creates a reserve space for the spinal cord.

Spinal surgery has made significant progress in recent years due to the development of modern minimally invasive techniques, the proliferation of operations performed through punctures or small incisions. This became possible thanks to the advent of modern operating equipment. With its help, it became possible to carry out the most complex interventions for tumors of various localization, with minimal surgical trauma and with minimal risks of complications, because the operation to remove a spinal tumor is the only radical method of treating this pathology.

The operating rooms of the Open Clinic are equipped with the most modern equipment, thanks to which our specialists perform the most complex spinal surgeries at the level of the largest European centers.

Why should you come to us?

We promptly conduct an examination of the spine to detect tumors on early stage development;
We use only high-precision operating equipment;
Our neurosurgeons operate in specialized departments of leading clinics in Russia;
The innovative technology of the operation allows to reduce the rehabilitation period to several hours.

"You need to take a biopsy" - this phrase many have heard from the attending physician. But why is it needed, what does this procedure give and how is it performed?

Concept

A biopsy is a diagnostic study that involves the collection of biomaterial from a suspicious area of \u200b\u200bthe body, for example, a seal, tumor formation, a wound that does not heal for a long time, etc.

This technique is considered the most effective and reliable among all those used in the diagnosis of oncological pathologies.

Breast biopsy photo

Thanks to the microscopic examination of the biopsy specimen, it is possible to accurately determine the cytology of the tissues, which gives complete information about the disease, its degree, etc.
The use of a biopsy allows you to identify a pathological process at its earliest stage, which helps to avoid many complications.
In addition, this diagnosis allows you to determine the volume of the forthcoming surgery in cancer patients.

The main task of biopsy is to determine the nature and nature of the tissues of the pathology. For detailed diagnostics, a biopsy study is supplemented with water X-ray techniques, immunological analysis, endoscopy, etc.

Views

The collection of biomaterial can be done in different ways.

- a technique for obtaining a biopsy using a special thick needle (trepan).
Excisional biopsy is a type of diagnosis in which an entire organ or tumor is removed during surgery. It is considered a large-scale biopsy.
Puncture - This biopsy technique involves obtaining the necessary samples by puncturing with a fine-bladed needle.
Incisional. Removal affects only a certain part of an organ or tumor and is carried out in the course of a full-fledged surgical operation.
Stereotactic - a minimally invasive diagnostic method, the essence of which is to build a specialized scheme for accessing a certain suspicious area. Access coordinates are calculated based on a preliminary scan.
Brush biopsy - a variant of the diagnostic procedure using a catheter, inside which a string with a brush is inserted, collecting a biopsy specimen. This method is also called brushing.
Fine needle aspiration biopsy - a minimally invasive method, in which the material is taken using a special syringe that sucks out the biomaterial from the tissues. The method is applicable only for cytological analysis, since only the cellular composition of the biopsy specimen is determined.
Loop biopsy - biopsy sampling is carried out by excision of pathological tissues. The required biomaterial is cut off with a special loop (electrical or thermal).
Transthoracic biopsy is an invasive diagnostic method used to obtain biomaterial from the lungs. He is taken through chest open or puncture method. The manipulations are carried out under the supervision of a videothoracoscope or computed tomograph.
Liquid biopsy is the latest technology for detecting tumor markers in a liquid biopsy, blood, lymph, etc.
Radio wave. The procedure is carried out using specialized equipment - the Surgitron apparatus. The technique is gentle and does not cause complications.
Open - this type of biopsy is carried out using open access to the tissues, a sample of which must be obtained.
Pre-scalded biopsy - a retroclavicular study, in which a biopsy is taken from the supraclavicular lymph nodes and lipid tissues at the corner of the jugular and subclavian veins. The technique is used to identify pulmonary pathologies.

Why is a biopsy done?

A biopsy is indicated in cases where, after carrying out other diagnostic procedures, the results obtained are not enough to make an accurate diagnosis.

Usually, a biopsy is prescribed when found to determine the nature and type of tissue in the formation.

This diagnostic procedure is today successfully used to diagnose many pathological conditions, even non-oncological ones, since in addition to malignancy, the method allows you to determine the degree of spread and severity, stage of development, etc.

The main indication is to study the nature of the tumor, however, often a biopsy is prescribed to monitor the ongoing treatment of oncology.

Today, a biopsy can be obtained from almost any area of \u200b\u200bthe body, and the biopsy procedure can fulfill not only a diagnostic, but also a therapeutic mission, when a pathological focus is removed in the process of obtaining a biomaterial.

Contraindications

Despite all the usefulness and highly informative technique, biopsy has its contraindications:

The presence of blood pathologies and problems associated with blood clotting;
Intolerance to certain drugs;
Chronic myocardial insufficiency;
If there are alternative non-invasive diagnostic options that have similar informative value;
If the patient has refused to carry out such a procedure in writing.

Material research methods

The resulting biomaterial or biopsy is subjected to further research, which takes place using microscopic technologies. Usually biological tissues are sent for cytological or histological diagnostics.

Histological

Sending a biopsy for histology involves microscopic examination of tissue sections, which are placed in a specialized solution, then in paraffin, after which staining and sections are performed.

Staining is necessary so that the cells and their areas are better distinguished during microscopic examination, on the basis of which the doctor draws up a conclusion. The patient receives the results in 4-14 days.

Sometimes histological examination needs to be done urgently. Then the biomaterial is taken during the operation, the biopsy is frozen, and then sections are made and stained in a similar way. The duration of such an analysis is no more than 40 minutes.

Doctors have a fairly short period of time to determine the type of tumor, to decide on the scope and methods of surgical treatment. Therefore, in such situations, urgent histology is practiced.

Cytological

If histology relied on the study of tissue sections, then it involves a detailed study of cellular structures. A similar technique is used if there is no way to get a piece of tissue.

Such diagnostics are carried out mainly in order to determine the nature of a specific formation - benign, malignant, inflammatory, reactive, precancerous, etc.

The resulting biopsy specimen makes a smear on glass, and then conduct a microscopic examination.

Although cytological diagnosis is considered simpler and faster, histology is still more reliable and accurate.

Training

Before the biopsy, the patient needs to undergo a laboratory study of blood and urine for the presence of various kinds of infections and inflammatory processes... In addition, magnetic resonance imaging, ultrasound, and X-ray diagnostics are carried out.

The doctor examines the picture of the disease and finds out if the patient is taking medication.

It is very important to tell the doctor about the presence of pathologies of the blood coagulation system and allergies to medications... If the procedure is planned to be carried out under anesthesia, then you cannot eat and drink liquid for 8 hours before taking a biopsy.

How are biopsies done in certain organs and tissues?

The sampling of biomaterial is carried out using general or local anesthesia, therefore, the procedure is usually not accompanied by painful sensations.

The patient is placed on a couch or operating table in the position necessary for a specialist. Then they begin the process of obtaining a biopsy. The total duration of the process is often several minutes, and with invasive methods it can be up to half an hour.

In gynecology

The indication for biopsy in gynecological practice is the diagnosis of pathologies, and the vagina, ovaries, external organs of the reproductive system.

Such a diagnostic technique is decisive for the detection of precancerous, background and malignant formations.

In gynecology they use:

Incisional biopsy - when a scalpel excision of tissue is performed;
Targeted biopsy - when all manipulations are controlled by extended hysteroscopy or colposcopy;
Aspiration - when the biomaterial is obtained by aspiration;
Laparoscopic biopsy - This is usually the way to take a biopsy from the ovaries.

Endometrial biopsy is performed using a pipel biopsy, in which a special curette is used.

Intestines

Biopsies of the small and large intestines are performed in various ways:

Puncture;
Petlev;
Trepanation - when a biopsy sample is taken using a sharp hollow tube;
Shchipkov;
Incisional;
Scarification - when the biopsy is scraped off.

The specific choice of method is dictated by the nature and location of the area being examined, but colonoscopy with biopsy is most often used.

Pancreas

Biopsy material from the pancreas is obtained in several ways: fine-needle aspiration, laparoscopic, transduodental, intraoperative, etc.

Indications for a pancreatic biopsy is the need to determine morphological changes in pancreatic cells in the presence and to identify other pathological processes.

Muscle

If the doctor suspects that the patient is developing systemic connective tissue pathologies, which are usually accompanied by muscle damage, then a biopsy examination of the muscle and muscle fascia will help determine the disease.

In addition, this procedure is carried out with suspicions of the development of periarteritis nodosa, dermatopolymyositis, eosinophilic ascites, etc. Such a diagnosis is used with needles or an open method.

Heart

Biopsy diagnostics of the myocardium helps to detect and confirm pathologies such as myocarditis, cardiomyopathy, ventricular arrhythmia of unknown etiology, as well as to identify the processes of rejection of the transplanted organ.

According to statistics, right ventricular biopsy is more often performed, while access to the organ is carried out through jugular vein right, femoral or subclavian vein. All manipulations are controlled by fluoroscopy and ECG.

A catheter (bioptom) is inserted into the vein, which is brought to the required area where the sample is to be obtained. Special tweezers open on the bioptome, which bite off small piece fabrics. To avoid thrombosis during the procedure, a special medication is delivered through the catheter.

Bladder

Bladder biopsy in men and women is performed in two ways: cold and TUR-biopsy.

The cold method involves transurethral cytoscopic penetration and biopsy sampling with special forceps. TUR-biopsy involves removing the entire tumor to healthy tissue. The purpose of this biopsy is to remove all visible lesions from the bladder wall and make a precise diagnosis.

Blood

Bone marrow biopsy is performed in the case of malignant neoplastic blood pathologies like.

Also, biopsy examination of bone marrow tissue is indicated for iron deficiency, splenomegaly, thrombocytopenia and anemia.

With a needle, the doctor takes a certain amount of red bone marrow and a small bone tissue sample. Sometimes the study is limited to obtaining only a bone tissue sample. The procedure is performed using an aspiration method or trepanobiopsy.

Eyes

Examination of eye tissues is necessary, if there is a tumor formation of malignant origin. These tumors are common in children.

A biopsy helps to get a complete picture of the pathology and determine the extent of the tumor process. In the process of diagnosing retinoblastoma, the technique is used aspiration biopsy using vacuum extraction.

Bone

Bone biopsy is performed to detect either infectious processes. Usually, such manipulations are carried out percutaneously by puncture, with a thick or thin needle, or surgically.

Oral cavity

Biopsy examination of the oral cavity involves obtaining a biopsy from the larynx, tonsils, salivary glands, throat and gums. Such a diagnosis is prescribed when pathological formations of the jaw bones are detected or, to determine salivary glandular pathologies, etc.

The procedure is usually performed by a facial surgeon. He uses a scalpel to take a part and a tumor as a whole. The whole procedure takes about a quarter of an hour. Soreness is observed when an anesthetic is injected, and there is no pain when taking a biopsy.

Analysis results

The results of biopsy diagnostics are considered normal if the patient does not have any cellular changes in the examined tissues.

Effects

The most common consequence of such a diagnosis is rapidly passing bleeding and soreness at the site of biopsy sampling.

Moderately mild painful sensations are experienced by about a third of patients after a biopsy.

Serious complications after biopsy usually do not occur, although in rare cases, fatal consequences of biopsy do occur (1 in 10,000 cases).

Care after the procedure

With severe pain syndrome, analgesics can be used. Taking care of the puncture site or suture (depending on the type of procedure) may differ slightly, but you can remove the bandage only a day after the biopsy, then you can take a shower.

Closed biopsy can be aspiration and puncture. Aspiration is carried out with a thick needle, and a special trocar is used for puncture, allowing to obtain a "column" of tumor tissue. Taking material for research without using an open surgical access not always possible. With some localizations of tumor formations or a certain nature of the process, tissue can only be obtained through an open incision during the operation. But in most cases, a closed biopsy of spinal tumors is effective and makes it possible to study the morphology of the formation.

The needle or trocar is inserted into the affected area under the control of an X-ray unit. This makes it possible to reduce the risk of complications in the form of injury to the nerve or vascular formations of the spinal column. In addition, visual control allows the doctor to take a targeted tissue sample from a selected area and obtain reliable information about the structure of the tumor.

The procedure is performed on an outpatient basis and is part of the standard examination program for patients with suspected metastatic or primary tumor lesions. With the help of a biopsy, it is also possible to distinguish a neoplasm from other pathologies accompanied by destructive changes in the spine, for example, from tuberculosis.