A Morphological Study Of Sacral Hiatus In Dry Human Sacra And Its Clinical Importance
A Morphological Study Of Sacral Hiatus In Dry Human Sacra And Its Clinical Importance
DOI:
https://doi.org/10.70284/njirm.v7i5.1144Keywords:
sacrum, sacral hiatus, caudal epidural block (CEB)Abstract
Background & objectives: The opening at the inferior end of sacral canal is known as sacral hiatus.It formed due to the failure of fusion of laminae of the fifth (occasionally fourth) sacral vertebra. Sacrum is one of the bones which exhibit variations and the variation of sacral hiatus is of great clinical significance. Present study determined the landmarks for caudal epidural block (CEB) after morphometric measurements of the sacral hiatus on dry sacra bones .Methods: 120 sacral bones are used for the study. Anatomical measurements were measured by using Vernier caliper accuracy to 0.1mm. Results: Agenesis of sacral hiatus was detected in two sacral bones. Various shapes of sacral hiatus were observed which included inverted U (31%), inverted V (25.8%), irregular (20.6%), Elongated (17.2%) and dumbbell (5%). Apex of sacral hiatus was commonly found at the level of 4th sacral vertebra in 50.8%. The distance between the two superolateral sacral crests and the distance between the apex of sacral hiatus and the right and left super lateral crests were 69.5 (5.8) mm, 61.4 (11.2) mm, 57.4 (9.7) mm respectively, on average. The mean, mode, SD is calculated for all the measurements. Interpretation & conclusion: The sacral hiatus has anatomic variations. Understanding of these variations may improve the reliability of, caudal epidural block (CEB). [Satish P NJIRM 2016; 7(5):69-72]
References
2. Senoglu N, Senoglu M, Oksuz H, Gumusalan of the sacral hiatus for caudal epidural block an anatomical study. British journal of Anaesthesia 2005; 95 (5): 692-95 Y, Yuksel KZ, Zencirci Bet al., Landmarks
3. Ernest J Frazer. Anatomy of the Human skeleton. J and A Churchill ltd, London, 1914; 37 -42.
4. Patil Dhannaja S Jadav Hrishikesh R, Binod kumar, Mehta CD, Patel Vipul D.Anatomical study of Sacral Hiatus for CaudalEpidural Block. National Journal of Medical Research. Sept 2012;2(3) 1-6
5. Brailsford JF. Deformities of lumbosacral region of spine. British Journal of Surgery 1929; 16: 562 –570.
6. Peter L William et al. Gray’s anatomy 38th edition. Churchill Livingston 2000;592-31,673- 74.
7. Trotter M, Letterman GS. Variations of the female sacrum; their significance in continuous caudal analgesia. Surg. Gynaecol.Obstet. 1944; 78(4):419 – 24.
8. Ramamurthi KS, Anatomical Study of sacral hiatus in dry human sacra for successful caudal epidural block, Int J Med Res Health Sci. 2013;2(3):496-500.
9. Vishal kumar et al. Sacral hiatus in relation to low back pain in South Indian population: Anatomico –Radiological study. Bratisl Lek Listy 2009; 110(7):436 – 441.
10. William R. Meeker, Sacral nerve block aneshesia,The anatomy involved, technic and clinical application . Annals of Surgery,vol.80, issue 5 ,Nov1924;739-772.
11. Rajapur parashuram. Morphometrical study of sacral hiatus using isolated dry human sacra: Dissertation 2008