Abstract: Objective: To assess the value of C-arm imaging guided transpedicular biopsy in vertebral body lesions.Methods: Thirty-six patients with vertebral body lesions underwent percutaneous biopsy with kyphoplasties under C-arm imaging guiding.Results: Thirty-six patients had successful pathologic tissue biopsy.The overall positive rate of biopsy was 97.2%.Sixteen patients underwent surgical operation,with the preoperative and postoperative pathologic diagnostic coincidence rate at 100.0%.No complications occurred in the group.Conclusions: C-arm imaging guided transpedicular biopsy is a minimally invasive and trusty method in the diagnosis of spinal disease with high accuracy.