Transpedicular biopsy for central body tuberculosis

This 21 years old man had backache. The MRI showed a focal lesion involving the L3 vertebral body. The clinico-radiologic profile was suggestive of tuberculosis, but the orthopedic surgeon wanted to be sure.

The lesion (Fig. 1 arrow) was biopsied using a transpedicular approach. An 11G needle was introduced through the pedicle into the body (Figs. 2-4) and through it, an 18G gun was passed to obtain the biopsies (Figs. 5,6).

The diagnosis of tuberculosis was confirmed on the biopsy.