Percutaneous needle biopsy has undergone considerable evolution in the past 70 yr. As a minimally invasive procedure, percutaneous needle biopsy has gained acceptance as a safe and effective procedure for the diagnosis of vertebral and disc pathology. Martin and Ellis (1), Coley et al. (2), and Robertson and Ball (3) demonstrated the feasibility and effectiveness of fine-needle aspiration (FNA) biopsy of bone in the 1930s. Valls et al. in 1968 used a mechanical device for large-bore biopsy of lumbar vertebrae (4). In the late 1960s and 1970s, several review articles were published discussing the variable success rates of the procedure (5,6). Needle biopsy systems demonstrated increasing sophistication with the development of the trephine core biopsy needle. Ackerman and Craig developed trephine needles capable of providing large bone cores for histologic diagnosis (7-9). With advancements in fluoroscopy, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and nuclear medicine, precise delineation of a lesion size, morphology, and location could be obtained (10-26). More aggressive biopsy techniques using tandem needle or coaxial biopsy techniques in areas of greater risk such as the thoracic and cervical spine could be performed (27-36). With advances in cytologic and histologic techniques, newer bone biopsy needle systems were developed to allow multiple needle types and biopsies through a single access site. Today, percutaneous vertebral biopsy is an integral procedure in the diagnosis and treatment of spinal pathology.

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