• Sanjay Konakondla, Nelson Sofoluke, Jimmy Xia, Ryan Grant, Albert E Telfeian, Christoph P Hofstetter, and Jonathan R Slotkin.
• Department of Neurosurgery, Geisinger Neuroscience Institute, Geisinger Health System, Danville, Pennsylvania, USA. Electronic address: skonakondla2@geisinger.edu.
• World Neurosurg. 2020 Sep 1; 141: 346-351.

BackgroundIdentifying the histopathological diagnosis of a spinal tumor is the necessary step prior to pursuing subsequent treatment. Both minimally invasive and open spinal procedures have been described as useful methods of obtaining tumor tissue for diagnosis but differ by their limitations. Minimally invasive techniques, such as computed tomography-guided biopsies, can expose the patient to radiation, and the tissue obtained may be nondiagnostic. Tubular and open procedures require collateral soft-tissue damage and may require bony removal leading to iatrogenic injury. Endoscopic approaches to the spine can be employed to avoid treatment delay in diagnosis, decrease length of stay, and provide adequate tissue for diagnosis.MethodsWe describe the surgical planning, tumor localization, and transforaminal endoscopic approach for tissue diagnosis of a lumbar spinal mass in a patient with a known history of Hodgkin lymphoma and non-Hodgkin lymphoma after a nondiagnostic computed tomography- guided biopsy. Final histopathological diagnosis of the lumbar spinal mass was consistent with large B-cell non-Hodgkin lymphoma.ConclusionsWe demonstrate the application of an endoscopic transforaminal approach in spine oncology. We also describe our technique on how we use a beveled working channel to obtain a large tissue core sample for definitive diagnosis.Copyright © 2020 Elsevier Inc. All rights reserved.

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