Resumen:
Aim: To determine the reliability of cytology during vertebroplasty for the diagnosis of neoplastic disease.
Material and Methods: Review of patients who underwent vertebroplasty (for osteoporotic or tumor fractures), in whom samples were obtained by cytology and/or biopsy. The results were compared with the radiologic diagnosis.
Results: Cytology and/or biopsy were performed in 63 patients (102 vertebrae) during vertebroplasty surgery. In 41, only cytology was done, in 16 only biopsy, and in six biopsy and cytology. In six patients, a discordant diagnosis was obtained between MR study, which indicated tumor involvement and the histological diagnosis, which indicated that there was no tumor. Five of these six patients only had a cytology study (reported as hemorrhagic or without tumor cells) and one patient had cytology and biopsy, in which the cytology was negative and the biopsy positive. Cytology did not test positive for tumor cells in any patient in whom tumor was not suspected on imaging and in six cases (9.5%), cytology failed to
detect disease: two myelomas, one breast cancer metastasis, and three lung cancer metastasis. There were no erroneous diagnoses in any patient who underwent bone biopsy (2 with insufficient material).
Conclusion: As a diagnostic technique during vertebroplasty, cytology presented a false-negative rate that could be improved with trocar bone biopsy. Cytology should be used when it is impossible to remove a specimen of vertebral bone.
