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A Novel Transforaminal Approach to Presacral Abscess.

Qi-Jun An1, De-An Qin1, Ji Ma1

  • 1Department of Orthopedics, Shanxi Provincial People's Hospital, Taiyuan Shanxi, China.

World Neurosurgery
|July 13, 2021
PubMed
Summary
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A novel trans-sacral-foramen approach offers a safer and easier method for draining presacral abscesses. This minimally invasive technique provides the shortest path to the abscess, improving patient outcomes.

Area of Science:

  • Minimally invasive surgery
  • Interventional radiology
  • Infectious disease management

Background:

  • Presacral abscesses are common in developing countries, often requiring drainage.
  • Computed tomography (CT)-guided percutaneous drainage is a recommended alternative to surgery.
  • The presacral space presents anatomical challenges for accessing abscesses.

Observation:

  • A novel trans-sacral-foramen approach was used to drain a residual presacral abscess in a 47-year-old woman.
  • The procedure involved CT guidance and catheter insertion through the sacral foramen.
  • The patient was positioned prone, and a one-step technique was applied.

Findings:

  • Magnetic resonance imaging (MRI) after 2 weeks showed significant abscess reduction.
Keywords:
CT guidancePercutaneous drainagePresacral abscessTransforaminal approach

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  • Catheters were removed, and 18-month follow-up MRI indicated intervertebral fusion.
  • The trans-sacral-foramen approach proved to be the shortest and safest route.

    • Implications:

    • This approach simplifies drainage of difficult-to-access presacral abscesses.
    • It offers a potentially safer and more effective alternative to existing methods.
    • Further research may establish this as a standard treatment for presacral abscesses.