Dorsal Approach to Presacral Biopsy: Technical Case Report

Abstract

Biopsy of the presacral space is often awkward, technically difficult, and unrewarding when the sacrum is intact and the procedure is performed either by open operation or with computed tomographic guidance through the abdomen or perineum. We describe a patient with metastatic adenocarcinoma who presented with leg pain and computed tomographic evidence of a high, small mass anterior to an intact sacrum. By drilling a hole through the sacrum lateral to the canal and between the roots, a biopsy of such a mass may be performed easily, safely, and quickly. A dorsal approach to presacral biopsy may be easily performed with readily available technology.