Full-endoscopic interlaminar approach for nerve root decompression of sacral metastatic tumor.

Full-endoscopic interlaminar approach for nerve root decompression of sacral metastatic tumor.

World Neurosurg. 2018 Jan 17;:

Authors: Tsai SH, Wu HH, Cheng CY, Chen CM

Abstract
BACKGROUND: Endoscopic surgery has been successfully applied in the treatment of degenerative spinal disease, but few studies have assessed its use in treating sacral metastasis. Herein, a successful full endoscopic interlaminar approach for sacral nerve root decompression of a sacral metastatic tumor was presented.
CASE DESCRIPTION: An 80-year-old man with history of hepatocellular carcinoma suffered from buttock pain with radiation to the right lower leg for one week. There was also decreased muscle power of the right lower extremity. The lumbosacral magnetic resonance imaging (MRI) scan revealed metastasis of the sacral spine and right iliac bone with S1 exiting nerve root compression. S1 nerve root decompression via the full-endoscopic interlaminar approach under local anesthesia was performed. Under the guidance of fluorescence, a working sleeve with a beveled opening was placed in the interlaminar space of L5-S1. We entered the sacral canal and identified the S1 exiting nerve root. A laminotomy was performed from the internal edge of the right sacral laminae toward the lateral recess. During the decompression of the nerve root, the buttock and leg pain improved gradually. After the operation, there was almost complete resolution of leg pain and the patient recovered the ability to walk. The visual analogue scales for pain decreased from 8 to 2 after 3 months' follow-up.
CONCLUSIONS: For patients with sacral metastasis, without spinal instability or difficulty lying in prone position under local anesthesia, the full-endoscopic interlaminar approach for nerve root decompression of sacral metastasis may be an available method.

PMID: 29355803 [PubMed - as supplied by publisher]

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