Kosin Med J.  2024 Jun;39(2):132-137. 10.7180/kmj.23.153.

Interpedicular approach in percutaneous sacroplasty for treating pain due to direct invasion of rectal cancer into the S3 body: a case report

• Yeo J
• Kim S
• Lee CS

• KMID: 2556811
• DOI: http://doi.org/10.7180/kmj.23.153

Abstract

Percutaneous sacroplasty is mainly used as an intervention for pain associated with sacral insufficiency fractures or sacral metastatic tumors. However, sacroplasty for managing the pain associated with direct sacral invasion of rectal cancer has been rarely reported. We present a case of a 74-year-old patient who underwent sacroplasty via the interpedicular approach under fluoroscopic guidance to relieve pain resulting from direct tumor invasion into the S3 body. After the procedure, the patient experienced immediate pain relief and did not feel worse pain with ambulation. Aside from peritumoral vascular leakage, no other significant complications occurred immediately post-procedure. Our results suggest that fluoroscopically guided interpedicular sacroplasty is a safe and effective option for relieving the pain associated with direct sacral invasion by rectal cancer.

Keyword

Cancer pain; Case report; Interventional radiology; Neoplasm invasion; Rectal neoplasms

Figure

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  Fig. 1. (A) Axial computed tomography image showing direct sacral invasion of rectal cancer. (B) Sagittal magnetic resonance image showing direct tumor invasion into the S3 vertebral body. Open arrows indicate rectal cancer invasion.

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  Fig. 2. (A) Fluoroscopic image showing precise needle placement using the interpedicular approach, with the needle tip positioned within the S3 body. Posttreatment frontal (B) and lateral (C) images show the presence of polymethyl methacrylate cement within the S3 body, accompanied by minimal presacral extravasation.

Reference

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