A Practical Access for fluoroscopically-guided percutaneous sacroplasty: Case Report.

Sacral metastases represent the lowest percentage of invasion to the spine, however, as chemotherapy treatments progress, the cancer survival rate has become higher, and the percentage of sacral metastases has increased. Treatment options for sacrum metastases are surgery, radiotherapy, and minimally invasive techniques such as sacroplasty and radiofrequency ablation. Knowing the repercussions that advancing the needle anteriorly (viscera) or medially (sacral roots) can have during the sacroplasty we are describing a technique to perform c-arm sacroplasty in coaxial vision, to identify the anterior sacral cortical bone that is in the limits of the pelvic viscera as well as the sacral foraminal line. We present a 75-year-old male patient with prostate cancer metastatic to S1, S2, S3 and iliac, with severe lumbar axial pain VAS 8/10. After the sacroplasty with the coaxial access, the patient reported VAS 1-2/10. Sacroplasty, being a recently described technique, can be a very viable option for these patients, that's why it is important to have safe and reliable techniques to complement the approach of this minimally invasive technique.