Carrying forward our series on sacral and L5/S1 biopsies, the posterolateral transsacral approach is a simple technique to target L5/S1 lesions or lesions along the inferior aspect of the L5 body or inferior endplate. Sometimes, gantry angulation may be needed to align the needle, but otherwise, the wide sacral ala affords easy passage of the needle.

This 49-years old presented with L5/S1 discitis. Unfortunately, even though adequate material was obtained, as often happens in such circumstances, we did not get definite evidence of infection, either on histology or on microbiology.

The video explains the rest.