Use of the Craig Needle for Biopsy of Bone

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BIOPSY of a bone lesion often is necessary to arrive at an accurate pathologic diagnosis of orthopedic disease. In obtaining such a biopsy, the pertinent factors are the anatomic site of the bone and the density of the tissue forming the lesion. Some bones, such as the vertebral bodies, are technically difficult to approach surgically. When the lesion is deep, open biopsy can be a formidable procedure involving considerable morbidity and risk. The reports on methods of biopsy have been numerous. In 1948, aspiration of material was recommended,1 but tissue obtained by this method is usually sparse and distorted, and renders interpretation difficult. Moreover, aspiration of a dense sclerotic bone lesion is virtually impossible. The Vim-Silverman needle is used on soft-tissue lesions2 or on lytic bone lesions, but only a thin sliver of tissue is obtained and this may be compressed and distorted if firm elements are present to compress soft-tissue structures.

Currently we are using the Craig needle to obtain tissue from bone lesions, and have found the procedure simple and safe. In 1955, Dr. Frederick S. Craig3 of the New York Orthopedic Hospital described the needle he designed especially for a biopsy of bone. The instrument consists of a cylinder with a saw-tooth cutter end and an inside diameter of 3.5 mm.; a sharp S-hook stylet is used to remove the plug of tissue (Fig. 1). The needle is used under local anesthesia and with radiographic control. It is used with much less risk than that entailed with . . .



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