Initial Experience with Percutaneous Needle Aspiration of Paraspinal Lesions Using XperGuide Cone-Beam CT

The aim of this study is to report our initial experience using XperGuide cone-beam computed tomography (CBCT) for percutaneous needle aspiration of the paraspinal lesions. Between September 2011 and September 2012, 12 patients who underwent percutaneous needle aspiration of the paraspinal lesions for suspected pyogenic spondylitis, tuberculous spondylitis, or metastasis were included. The procedure was performed on the XperGuide CBCT. Based on the initial CBCT, target points and entrance were determined, using dedicated guidance software (XperGuide), and the needle pathway was visualized in various reconstructed images. Needle aspiration was performed using Westcott needle and correct needle positioning was confirmed with the second CBCT. The technical success was defined as the needle tip reached within 5 mm of the target point. Culture, smear, and polymerase chain reaction of obtained samples were performed. In all twelve patients, target areas could be determined based on XperCT data and achieved 100% technical success. Diagnosis could be made in 91.7% of cases and the median interventional procedure time was 27.8 minutes. There was no major complication in all patients. Percutaneous needle aspiration of paraspinal lesions using XperGuide CBCT is easy, accurate, safe, and useful in determining the treatment of direction.