Traumatic and nontraumatic spinal-cord-injured patients in Quebec, Canada. Part 3: pharmacological characteristics.

STUDY DESIGN: Community-based, cross-sectional study. OBJECTIVES: This study aimed at examining and comparing the pharmacological treatments administered to traumatic and nontraumatic spinal-cord-injured patients (TSCI, NTSCI). SETTING: The Interval Rehabilitation Center, Trois-Rivieres, Province of Quebec, Canada. METHODS: Medical records from a cohort of 175 chronic spinal-cord-injured patients (94 TSCI and 81 NTSCI individuals) were thoroughly studied. RESULTS: More than 19 classes and more than 300 drugs were found to be administered to SCI patients. Among them, drugs against bowel and bladder problems, blood clot or deep venous thrombosis, cardiovascular problems, depression or anxiety, stomach acidity, infections, pain, inflammation, sleeping problems and vitamin deficiency were the most commonly used (between 35 and 66% of all SCI patients). Differences between groups were found specifically for antidepressants and anxiolytics used mainly by TSCI patients whereas bisphosphonates, bronchodilators, lipid regulators and anti-inflammatory drugs were used mainly by NTSCI patients. CONCLUSION: The results revealed an unexpectedly large number of drugs that are prescribed to both groups of SCI patients. Given the existence of between-group differences and known risks of drug-drug interactions, it is suggested that recommendations for each group should be made to carefully examine either the necessity or the effectiveness of each treatment as well as the possibility of developing alternative strategies based on physical activity, nutrition and lifestyle to eventually reduce, hopefully, the number of pharmacological treatments administered to these individuals.

Traumatic and non-traumatic spinal cord-injured patients in Quebec, Canada. Part 2: biochemical profile.

STUDY DESIGN: Community-based, cross-sectional study. OBJECTIVES: This study aimed at examining and comparing biochemical profiles (blood and urine) of traumatic and non-traumatic spinal cord-injured patients (TSCIs vs NTSCIs). SETTING: The Interval Rehabilitation Center, Trois-Rivieres, Province of Quebec, Canada. METHODS: Medical records from a cohort of 175 chronic spinal cord-injured patients (94 TSCI and 81 NTSCI individuals) were thoroughly studied. RESULTS: Augmentations over time of red blood cell (erythrocyte), hematocrit and hemoglobin levels were generally found after spinal cord injury (SCI), specifically in NTSCI patients (late vs early chronic). In contrast, although leukocyte levels generally decreased over time after SCI, higher lymphocyte levels were detected only in NTSCI patients (late vs early chronic). Higher total cholesterol, triglyceride, high-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C), protein and albumin serum levels were generally found over time after SCI, again, specifically in chronic NTSCI patients (late vs early chronic), whereas increased (twofold) nitrite and decreased (twofold) ubilirogen urine levels were found specifically in TSCI individuals (late vs early chronic). CONCLUSION: Clear differences were reported between subgroups of SCI patients strongly supporting the idea that therapeutic approaches aimed to treat these problems should be specifically designed for each type of patients (that is, NTSCI vs TSCI or early vs late chronic patients).

Non-assisted treadmill training does not improve motor recovery and body composition in spinal cord-transected mice.

STUDY DESIGN: Experiments in a mouse model of complete paraplegia. OBJECTIVES: To evaluate the effect of non-assisted treadmill training on motor recovery and body composition in completely spinal cord-transected mice. SETTINGS: Laval University Medical Center, Neuroscience Unit, Quebec City, Quebec, Canada. METHODS: Following a complete low-thoracic (Th9/10) spinal transection (Tx), mice were divided into two groups that were either untrained or trained with no assistance. Training consisted of placing the mice during 15 min with no further intervention (that is no tail pinching or body weight support) on a motorized treadmill (8-10 cm s(-1)) five times per week for 5 weeks. Locomotor performances were assessed weekly in both groups using two complementary locomotor rating scales. After 5 weeks, all mice were killed and adipose tissue, soleus, and extensor digitorum longus muscles were dissected for analyses. RESULTS: No significant difference in locomotor performances or in muscle fibre type conversion was found between trained and untrained mice. In contrast, body weight, adipose tissue, whole muscle, and individual fibre cross-sectional area (CSA) values were significantly lower in trained compared with untrained animals. CONCLUSIONS: Non-assisted treadmill training in these conditions did not improve motor performances and contributed to further accentuate body composition changes post-Tx, suggesting that assistance provided manually, robotically, or pharmacologically may be key to spinal learning and recovery of locomotor function and body composition.

Abnormal IFN-gamma-dependent immunoproteasome modulation by Trypanosoma cruzi-infected macrophages.

Proteasomes are the main producers of Ag loaded onto MHC class I molecules. Following IFN-gamma stimulation however, the constitutive subunits of the proteasome are replaced by the immunosubunits low molecular weight protein 2 (LMP2), multicatalytic endopeptidase complex-like 1 and low molecular weight protein 7 (LMP7), which generally heighten the immunogenecity of proteasome generated epitopes. Given that Trypanosoma cruzi, the aetiological agent of Chagas' disease, elicits a T(helper)1 response from its host if the infection is to be contained, the aim of this study was to verify whether this parasite modulates J774 and B10R mouse macrophage (MuPhi) immunoproteasome subunit and MHC class I expressions and, if so, identify the mechanism(s) responsible for that modulation. Results show that T. cruzi infection of mouse MuPhi reduces IFN-gamma-mediated immunoproteasome synthesis, along with MHC class I mRNA synthesis and cell surface expression. The infection by T. cruzi induces the release of reactive oxygen species (ROS) from MuPhi, and those ROS significantly inhibit protein tyrosine phosphatase activity, thereby leading to the activation of the SAPK/JNK signalling pathway, which is responsible for the observed IFN-gamma-mediated immunoproteasome synthesis and MHC class I down-regulation. To our knowledge, this is the first report that specifically identifies a mechanism by which a pathogen achieves immunoproteasome down-modulation.

Use of peak expiratory flow rate to identify patients with increased risk of contrast medium reaction. Results of preliminary study.

Although the intravenous injection of iodinated contrast media is usually well tolerated by patients, it does cause a significant number of side effects. The current study was designed to determine whether the measurement of peak-expiratory-flow rate before injection of contrast medium can be taken as a predictor of reactions to contrast media. The study covers a population of 100 patients who underwent excretory urography; those with a history of allergy or atopic hypersensitivity were given premedication before contrast injection. Peak-expiratory-flow measurements were made 10 minutes before, and immediately before injection, and at 1 and 15 minutes postinjection by a Wright flow meter. They revealed a subclinical bronchospasm after the intravenous injection of iodinated contrast medium that was more severe for subjects demonstrating an untoward reaction to contrast media. A single measurement of peak expiratory flow 10 minutes before contrast injection is, in itself, a good indicator of increased risk. A patient with a peak expiratory flow of less than 400 L/min 10 minutes before the injection, runs a 3.8 times higher risk of developing an adverse reaction to intravascular radiodiagnostic compounds in this study.

Carotid artery tandem lesions: frequency of angiographic detection and consequences for endarterectomy.

BACKGROUND AND PURPOSE: Several prospective trials have shown that ischemic stroke can be prevented by performing an endarterectomy in patients with high-grade carotid stenosis. Our purpose was to ascertain the frequency of carotid artery tandem lesions and to determine whether their presence alters the surgeon's decision to perform an endarterectomy. METHODS: We retrospectively reviewed the cerebral angiograms obtained between January 1994 and June 1996 in 853 patients with carotid occlusive disease. Studies were analyzed for the presence of internal carotid artery (ICA) stenosis as well as for tandem lesions (defined as > or = 50% diameter stenosis) within the common carotid artery, carotid siphon, or proximal intracranial arteries. The frequency of intracranial saccular aneurysms was determined. RESULTS: Six hundred seventy-two of the 853 patients had a carotid bifurcation stenosis of 70% or greater or underwent an endarterectomy. Of these, a carotid siphon stenosis of 50% or greater was noted in 65 patients (9.7%) and was ipsilateral to an ICA stenosis in 37 patients (5.5%). A common carotid stenosis was present in 29 patients (4.3%), ipsilateral to an ICA stenosis in 14 patients (2.1%). A stenosis of 50% or greater within the proximal intracranial circulation was present in 28 patients (4.2%), ipsilateral to an ICA stenosis in 15 patients (2.2 %). Four patients had tandem stenoses at more than one site. Tandem stenoses in the siphon or intracranial segments were noted in 13.5% with a bifurcation stenosis and in 8.8% of those with no bifurcation stenosis. Endarterectomy was performed in 48 of the 66 patients with tandem stenotic lesions. CONCLUSION: The presence of a tandem lesion infrequently alters the surgeon's decision to perform an endarterectomy. However, the importance of detecting tandem stenoses cannot be underestimated, since they may have important implications for long-term medical management in symptomatic patients.

Immediate and delayed tolerance of iohexol and ioxaglate in lower limb phlebography: a double-blind comparative study in humans.

RATIONALE AND OBJECTIVES: We compared the tolerance and efficacy of iohexol-300, a nonionic low-osmolar monomer, with those of ioxaglate-320, an ionic low-osmolar dimer, in lower limb phlebography. METHODS: One hundred twenty inpatients were randomly divided into two groups in this double-blind comparative study. Two hundred milliliters of contrast medium (100 ml per leg) was injected intravenously. The immediate tolerance was classified as discomfort (i.e., sensation of warmth, pain, coldness related to the injection) and adverse events occurring up to 1 hr after administration. Delayed tolerance was followed up to 8 days after the examination. The main parameter was immediate adverse events. Image quality was assessed by a radiologist using a visual analog scale. RESULTS: The number of immediate adverse events was significantly higher in the ioxaglate group (p < .02). The more frequent events were digestive disorders and skin rashes; 13 of these events were reported in the ioxaglate group, but none were reported in the iohexol group (p < .001). The other parameters were not significantly different in the two groups. CONCLUSION: We found a similar efficacy and a better tolerance of iohexol-300 than ioxaglate-320 in lower limb phlebography.

Place of intravenous arteriography with non-numerized processing in vascular pathology and surgery. Results of 424 investigations.

424 intra-venous arteriographies with non-numerized photographic subtraction have been carried out in 304 patients. Exploration concerned supra-aortic trunks in 204 cases, abdominal aorta in 107 cases, arteries of the lower limbs in 89 cases, thoracic aorta in 19 cases and arteries of the upper limbs in 5 cases. Technique is described, indications, results, complications and limits of the method are discussed for each explored area. This method is an interesting contribution as a morphological, slightly invasive evaluation of arterial lesions when computerized systems are not available.

Erythromycin elicits opposite effects on antro-bulbar and duodenal motility: analysis in diabetics by cineradiography.

We have previously demonstrated by cineradiography analysis that erythromycin (Ery) increases antral contractility and antropyloric coordination in diabetics. The aim of this study was to further characterize antro-bulbar and duodenal motility after Ery i.v. administration. Fourteen diabetic patients (mean age 61.2 years) were randomly allocated to receive either 100 or 500 mg of Ery intravenously 4 hours after a standard solid liquid meal. After ingestion of a barium sulfate suspension, a series of 15 fluorographic plates (one every two seconds) was performed. the same procedure was repeated twice for each subject with a delay of 3 days once before and once after Ery. Antral, bulbar and duodenal areas and evolution diagrams were calculated in baseline conditions and after Ery administration using a graphic table connected to a microcomputer. No differences were found between the two doses of the drug. Ery significantly decreased antral (1284 +/- 268 mm2 vs 704 +/- 181 mm2; P < 0.01) and bulbar areas (127 +/- 26 mm2 vs 73 +/- 21 mm2; P < 0.01). In contrast, duodenal areas were significantly increased after Ery (875 +/- 112 mm2 vs 575 +/- 112 mm2; P < 0.01). This study suggests that the known prokinetic effect of Ery on gastric emptying seen in diabetic patients could be related to an increase of motility in the antrum and in the bulb simultaneously with a relaxation in the duodenum.

[Simplified measurement of colonic transit time by one radiography of the abdomen and a single type of marker. Normal values in 82 volunteers related to the sexes]. / Mesure simplifiée du temps de transit colique par une seule radiographie de l'abdomen et un seul type de marqueur. Normes chez 82 témoins en fonction du sexe.

Assessment of total and segmental colonic transit times (CTT) in man using a single type of radiopaque marker and one abdominal X-ray has been validated but not extensively studied. The aims of our prospective study were to establish normal values of this method as a function of age, gender and fiber intake in healthy subjects. Eighty-two healthy volunteers (51 men, 31 women, mean age 38 yr, range 21-61) with normal stool frequency (between 3/day and 3/week) and no history of gastrointestinal disease or medication were enrolled and ingested 10 small (3 mm edge) radiopaque markers every morning for 6 consecutive days. On the 7th day, an abdominal X-ray was performed to calculate total and segmental (right, left, rectosigmoid) CTT according to Arhan's method (CCT = 2.4 N; N = number of markers in the considered zone). During the study the number of stools was recorded and fiber intake estimated on a questionnaire. Stool frequency, total and segmental CTT were evaluated for differences due to age, gender and/or fiber intake. In volunteers, total, left and rectosigmoid CTT were closely related to stool frequency (P = 0.0001) being longer in women than in men (P < 0.02). In contrast, right CTT was independent of gender or stool frequency. Finally, in this group CTT were independent of age and fiber intake. This study confirms the influence of gender on CTT and demonstrate the ability of this simple and non-invasive method (0.08 mrad surface exposure) to assess CTT. Its use as a diagnostic tool in self-defined constipated patients would be of interest in clinical practice.

[Gastric peristalsis and dyspepsia: value of cineradiographic analysis in men]. / Péristaltisme gastrique et dyspepsie: intérêt de l'analyse cinéradiographique chez l'homme.

Gastric peristalsis has not been studied extensively in patients with dyspepsia. The aim of our study was to further characterize gastric peristalsis in such patients using a newly described fluorographic method. Thirty-two patients with dyspepsia and 18 healthy volunteers were included in our study. Four hours after a standard solid-liquid meal, the subject swallowed 250 ml of a baryum sulfate solution and (100 mm x 100 mm) fluoroscopy of the stomach was performed every 2 s during 30 s. Spot films were analyzed using a graphic table and a amateur microcomputer program. For each subject, the instant velocity, vi, and mean velocity, V, of gastric peristalsis were calculated and used to generate a time-space diagram of contractions, a velocity histogram and an index of propagation, Ip. These parameters were compared to normal values (V = 2.2 +/- 0.2 mm/s; Ip = 2.2 +/- 0.4). When compared with normal values, 3 different motility patterns appeared in dyspeptic patients with a high correlation between V and Ip (P less than 0.01): normoperistalsis (n = 8; 1.8 less than V less than 2.6 mm/s); 1.4 less than Ip less than 30); hypoperistalsis (n = 7; V less than 1.8 mm/s; Ip greater than 3.0) and hyperperistalsis (n = 7; V greater than 2.6 mm/s; Ip less than 1.4). In a 4th group (n = 5), a retroperistalsis was effect observed with Ip less than 0. For 5 other patients, Ip or V was abnormal with atypical motor activity detected on the time-space diagram.(ABSTRACT TRUNCATED AT 250 WORDS)

[Propagation of the gastric peristalsis in normal subjects and duodenal ulcer patients]. / Propagation du péristaltisme gastrique chez l'homme normal et chez l'ulcéreux duodénal.

The velocities of gastric peristaltic waves were measured on fluorographic series made in normal subjects and patients with duodenal ulcer. After an overnight fast, the subjects drank 250 ml of barium suspension. Sequential radiograms were taken every 2 s during 30 s after two pyloric ejections. Peristaltic waves were located and their displacements measured with an Apple Graphic Tablet. Wave progression diagrams and velocity histograms were drawn for each subject. The velocities were calculated every 2 s. A "spread index" Ip was determined for each subject, characterizing the irregularity of propagation. Mean frequency and mean velocity were greater in duodenal ulcer patients (3.6 c/min; 3.7 mm/s) than in normal subjects (2.9 c/min; 2.4 mm/s; p less than 0.001). Nevertheless, no significant difference was found between proximal or midcorpus and antral velocities, in ulcer patients as well as in normal subjects, contrarily to classical data. However, the velocities were not uniform along the stomach. The contractions spread unevenly and displayed transient slopes. The irregularities of propagation were more pronounced in normal subjects, ranging from 0 to 14 mm/s with 28 p. 100 of velocities less than 1 mm/s, then in ulcer patients (0 to 13 mm/s with 12 p. 100 of low velocities). The spread index Ip was greater in normal (ranged from 0.54 to 2.62) than in ulcer patients (ranged from 0.16 to 0.48; p less than 0.001). This study showed that the propagation velocity of the peristaltic waves and its regularity were different in normal subjects and in duodenal ulcer patients.

[Antro-pyloro-bulbar contractibility in diabetics studied by cineradiography. Effect of erythromycin]. / Etude de la contractilité antro-pyloro-bulbaire chez le diabétique par analyse de cinéradiographies. Effet de l'érythromycine.

We studied antropyloroduodenal contractility in diabetics and the effect of erythromycin IV (100-500 mg) using the non invasive Boiron cineradiographic method analysis. Fourteen diabetics and 22 controls were examined. Four hours after a standard liquid-solid meal, patients drank 250 mL baryum solution. Fluorographic plates (10 x 10 cm) were taken every 2 s during 30 s. Semi-automatic data processing analysis allowed to measure motility parameters including antral (CA) and bulbar (CB) contractility indexes; pyloric opening index (OP), gastric (FG) and bulbar (FB) frequencies. Three types of pylorus behaviour patterns were define: A and B related to antropyloric and antropyloroduodenal coordination respectively and N without coordination. In diabetics, CA, OP and FG were decreased vs controls (P < 0.01) (CA: 65.5 +/- 6.8 vs 83.1 +/- 2.4%; OP: 60.9 +/- 8.7 vs 84.8 +/- 1.9%; FG: 2.42 +/- 0.14 vs 3.08 +/- 0.04 c/min) and antropylorbulbar coordination altered (N was predominant; no bulbar cycles at 3/min). Antral hypocontractility was correlated with autonomic neuropathy. After erythromycin, radiological parameters returned to normal values (CA = 83.0 +/- 2.4%; OP = 86.0 +/- 4.7%; FG = 3.0 +/- 0.16 c/min) and coordination improved type N disappeared and FB = 3 c/min (58%). Cineradiographic analysis is simple, able to show antropylorobulbar contractile abnormalities, to study pharmacological effects, and in diabetics is capable of studying improvement of motility parameters with erythromycin.

[Staging and follow-up of renal cell carcinoma]. / Bilan d'extension et surveillance des tumeurs malignes du rein.

Surgery is the only curative treatment of renal cell carcinoma (RCC). Preoperative staging is aimed at evaluating surgical possibilities and optimal surgical technique. Thoracic and abdominal CT is the best way to routinely evaluate locoregional and metastatic extension of the tumor. However, there is no consensus concerning which laboratory and imaging studies should be obtained to assess patients after radical nephrectomy or conservative surgery. Objectives of this review

[Sonographic evaluation of human male infertility]. / Evaluation échographique de l'infertilité masculine.

The male partner is responsible for 50% of infertility in couples. Assessment of male infertility should include clinical examination, laboratory tests (semen analysis, dosage of gonadal and gonadotropic hormones) and sonographic examination of the urogenital tract. Male infertility is related to diverse abnormalities including testis lesions (infertility of secretory type) and obstructive disorders of the genital tract (infertility of excretory type). Sonographic examination with abdominal, scrotal and transrectal probes has become the major imaging modality to evaluate male infertility and especially to analyze infertility of excretory type related to inflammatory lesions, congenital agenesis of vas deferens and congenital cyst of the distal genital tract. The main purpose of this paper is to illustrate with sonography the normal anatomy of the male genital tract and to detail sonographic features of current pathologies responsible for human male infertility.

[Color Doppler ultrasonography of local recurrent breast cancer]. / Echo-Doppler couleur des récidives locales du cancer du sein.

Local lesions occurring after conservative surgery for breast neoplasms require diagnostic means capable of detecting and assessing the recurrence of such cancers. In the present color-coded Doppler was used in 20 women who had under gone conservative surgery (mean 4 years before) to screen all suspect lesions. Among the 14 malignant lesions assessed histologically, one or more arterial vessels were detected inside or beside the lesion in 13. Among the 6 benign lesions, only of one arterial vessel was detected, in all cases far from the lesion (12.5 to 3.3 mm). No significant difference was observed for systolic velocities and resistance index. These results indicate high accuracy of color coded Doppler examination associated with echotomography and mammography for positive diagnosis of recurrent lesions in post-conservative follow-up of breast cancer.

[Rupture of the rotator cuff. Quantification of indirect signs in standard radiology and the Leclercq maneuver]. / Rupture de la coiffe des rotateurs. Quantification des signes indirects en radiologie standard et manoeuvre de Leclercq.

The roentgenograms and the "Leclercq's manoeuvre" of 105 patients who had a shoulder arthrography were reviewed. We differentiated two groups: One with a rotator cuff tear. The other without a rotator cuff tear. The space between the acromion and the head of the humerus was measured on rotation zero degree and external rotational roentgenograms. When the acromio-humeral space was less than 8 mm, it was always correlated with a rotator cuff tear (specificity = 1). If at least tow of the following signs were present, there was in most cases a rotator cuff tear (specificity = 0.96): Sclerosed acromion. Spur of the acromion. Cystic changes around the greater tuberosity. Rounded tuberosities. Inferior gleno-humeral spur. The "Leclercq's manoeuvre" was considered positive either when there was an acromio-humeral space narrowing compared with the other side, or when there was an upward subluxation of the head of the humerus. When positive there was always a rotator cuff tear (sensibility = 0.7; specificity = 1).

[MRI diagnosis of sinus cavernous invasion by pituitary adenomas]. / Diagnostic en IRM de l'envahissement du sinus caverneux par les adénomes hypophysaires.

PURPOSE: To evaluate the preoperative MRI criteria of a sinus cavernous invasion by a pituitary adenoma. MATERIAL AND METHODS: Study of 102 cavernous sinuses among 51 patients who had had a surgical cure of pituitary adenoma. Thirteen patients had a surgical invasion of the cavernous sinus. RESULTS: A certain number of signs eliminated cavernous sinus invasion. The best means consisted in not crossing the intercarotid line (Sensitivity-Se = 100%, Specificity-Sp = 85% and Negative Predictive Value-NPV = 100%). The others means implied: not going past twelve o'clock on the internal carotid artery-ICA (NPV = 97.1%), symmetrical size of the cavernous sinus (NPV = 92.5%), non-convexity of the lateral wall (NPV = 90.2%), visualization of at least two venous groups of the laterosellar space (NPV = 90.2%) and finally, non-displacement of the ICA (NPV = 89.2%). The best criteria for diagnosis were passing by the intra and supracavernous ICA lateral tangent (Se = 84.6%, Sp = 95%) and the percentage of ICA encasement by the adenoma exceeding 25% (Se = 92.3%, Sp = 85%). CONCLUSION: Except the total encasement of the intracavernous ICA, the cavernous sinus can be invaded when the lateral tangent of the supra and the intracavernous ICA is crossed, and also when the percentage of ICA encasement exceeds 25%.

[Does renal transplantation increase the risk of breast diseases?]. / La transplantation rénale accroît-elle le risque de pathologie mammaire?

PURPOSE: To evaluate the risk of breast pathology occurrence in a group of kidney transplanted patients. MATERIAL: and methods. In the last five years, 30 kidney-transplanted women underwent systematic breast evaluation in our institution and were included in this retrospective study (exposed-group). To compare with this exposed-group, 90 non transplanted women undergoing breast evaluation in the same period at our institution (non-exposed group), were retrospectively randomized. In both groups, results of breast evaluation were classified in two categories (normal and abnormal) and distribution of benign and malignant breast pathologies were evaluated. The mean exposition-time was determined in months in the exposed-group. Comparative analysis of both groups included a comparison of mean patients age and evaluation of the relative risk (RR) of breast pathology occurrence. RESULTS: Mean exposition time was 72.7+/-66.6 months. The percentages of benign breast pathology were 93.7% in the exposed-group and 83.3% in the non-exposed group. Percentages of cancer were respectively 6.3 and 16.7%. Mean patient age was quite similar in the exposed-group (50.7+/-10 years) and in the non-exposed group (50.6+/-10.5 years). The relative risk of breast pathology occurrence was 1.70 (0.99

[Percutaneous bone puncture biopsy with trocar. Apropos of 60 cases]. / Ponction biopsie osseuse percutanée au trocart. A propos de 60 observations.

Deep bone biopsies were performed in 58 patients over the last 2 years, in a radiology department in Tours, France, under television screen control. Data obtained included pathologic, cytologic and bacteriologic features in the 60 biopsies conducted, localization being the spine in 52 cases (12 dorsal, 36 lumbar, 4 sacroiliac) and the pelvis 8 times. Etiology was a tumoral process in 15 cases (14 metastases and 1 reticulosarcoma), 7 infectious processes including 2 cases of tuberculosis, 26 cases of decalcifying degenerative osteopathies, 1 Paget's disease, 1 ankylosing spondylitis and 1 bone infarct. Biopsy was unsuccessful in 9 cases, the success rate being an overall 85%. Complications were not observed. Conducted under local anesthesia, deep bone biopsy provides a rapid diagnosis and allows a shortened hospital stay. Surgery is generally avoided and appropriate treatment instituted more rapidly.