The application of CT-guided percutaneous biopsy in diagnosis of disorders of the atlas and axis

Objective To evaluate the efficacy of the CT-guided percutaneous biopsy in the diagnosis of C1,2 lesions. Methods Twenty two patients with C1,2 lesions, including 7 males and 15 females, underwent CT-guided percutaneous biopsy under local anesthesia from the lateral or postero lateral entry. Results Twenty one of 22 cases have definite histological findings. There were 7 cases of tuberculosis, 4 metastatic tumors, 2 cases each of giant tumor of the bone, myeloma and low malignant histocytomas and one case each of chordoma, esosinophilic granuloma, neurofibroma and chondrosarcoma. The accuracy rate was 95.4%and the false negative rate was 4.6%. Ten cases were treated operatively and their pathological findings confirmed the preoperative biopsy findings. Of the 12 cases treated nonoperatively,the diagnosis in 11 cases were confirmed clinically except one lost of follow up study. There were no complications. Conclusion The diagnosis and treatment of atlas and axis are usually difficult,however definitive histological diagnosis can be obtained through CT-guided percutaneous biopsy. This procedure plays an important role in decision planning of the clinical treatment.