A definitive tissue diagnosis of a vertebral lesion can be made with a minimally invasive, safe, and accurate method called CT-guided percutaneous vertebral biopsy. The most effective substitute for a surgical biopsy is frequently a CT-guided vertebral biopsy. The identification of spinal lesions is mostly dependent on magnetic resonance imaging (MRI). Even while recent advances in MRI now make it possible to recognize and suspect the nature of vertebral lesions and positron emission tomography-computed tomography (PET-CT) provides data on lesion metabolism, a biopsy is still required in the majority of instances.