Introduction: Sacral tumors are relatively rare pathology in the practice of neurosurgery. The anatomic shape and location of the S1 body makes its surgical intervention difficult. In this report, a small bony opening over the S1 pedicle was created to reach down to the S1 body for tumor removing. The tumor cavity created inside the corpus was checked with endoscopic appearance.
Methods: Prone position was used for surgery. Midline skin incision was performed over the posterior aspect L5 and S1 vertebral lamina. Unilateral paravertebral muscles were dissected and separated from the lamina of the vertebra. Under the operating microscope, diamond drill was used to reach down the body of the S1 vertebra. Tumor was identified and piece to piece removed from the body. Using curette and diamond drill created the cavity. The endoscopic telescope was used to observe the cavity of the S1 body. Following the complete removing of the tumor, the bone cement was used to full-fill the cavity.
Results: Two-dimensional fluoroscopic evaluation during surgical intervention is used for localization, direction and distance of the surgical target. Diamond drilling with high-speed drill is helpful in the creating of cavity without bleeding. Endoscope enhanced the viewing of the cavity wall. Especially the medial wall of the cavity was easily examined with the assistance of the endoscope.
Conclusions: The anatomic shape of the S1 vertebral body and the necessity of minimally invasive approach and preserving of the tiny outer wall of the vertebral body makes the necessary to using of endoscopic assistance during the removing of the vertebral body lesions. Endoscope is a helpful device in the examination of tumor remnant inside the cavity. It may be used during the cavity surgery along the vertebral body.
Patient Care: Using of endoscopic assistance during surgical intervention to removing of the S1 vertebral body tumors is helpful during surgical intervention. It may be used along the vertebral body tumors if the microscopic appearance is insufficient.
Learning Objectives: Using of endoscopic assistance during surgical intervention to removing of the S1 vertebral body tumors is helpful during surgical intervention. It may be used along the vertebral body tumors if the microscopic appearance is insufficient.