A Cross Sectional Study of Morphological & Morphometric Parameters of Sacral Hiatus and it's Importance in Caudal Epidural Block
Authors/Creators
- 1. 3rd Year Resident, Department of Anatomy, SMS Medical College, Jaipur
- 2. Senior Professor, Department of Anatomy, SMS Medical College, Jaipur
- 3. Senior Professor & HOD, Department of Anatomy, SMS Medical College, Jaipur
Description
Background: To evaluate the morphological & morphometric parameters of sacral hiatus in order to study the anatomical variations of sacral hiatus which will be useful for administering caudal epidural block and improve its reliability and success rate. Methods: After approval from Institutional Ethics Committee, this study was conducted in the Department of Anatomy, SMS Medical College and attached group of Hospitals, Jaipur, Rajasthan. Results: Most commonly sacrum is made up of five vertebrae. Present study also documented similar composition in 46 (92%) sacra whereas 2(4%) cases were made up of 4 segments. The most common shape of sacral hiatus encountered in present study was Inverted-V (48%) followed by Inverted-U (32%) cases and in rest of the cases the shape of sacral hiatus was dumbbell shape (4%) and irregular (16%). Apex of sacral hiatus was mostly seen at 4th sacral vertebra in 74% of cases, at 3rd and 2nd sacral vertebra in 24% and 24% of cases respectively. Conclusion: The opening at the caudal end of sacral canal is known as sacral hiatus. It is formed due to the failure of fusion of laminae of the fifth (occasionally 4th) sacral vertebra. The sacral hiatus transmits the fifth sacral nerve and coccygeal nerves. The dural sac ends at the level of second sacral vertebra above the sacral hiatus. Therefore, it forms a convenient region for caudal epidural anaesthesia of structures innervated by these nerves.
Abstract (English)
Background: To evaluate the morphological & morphometric parameters of sacral hiatus in order to study the anatomical variations of sacral hiatus which will be useful for administering caudal epidural block and improve its reliability and success rate. Methods: After approval from Institutional Ethics Committee, this study was conducted in the Department of Anatomy, SMS Medical College and attached group of Hospitals, Jaipur, Rajasthan. Results: Most commonly sacrum is made up of five vertebrae. Present study also documented similar composition in 46 (92%) sacra whereas 2(4%) cases were made up of 4 segments. The most common shape of sacral hiatus encountered in present study was Inverted-V (48%) followed by Inverted-U (32%) cases and in rest of the cases the shape of sacral hiatus was dumbbell shape (4%) and irregular (16%). Apex of sacral hiatus was mostly seen at 4th sacral vertebra in 74% of cases, at 3rd and 2nd sacral vertebra in 24% and 24% of cases respectively. Conclusion: The opening at the caudal end of sacral canal is known as sacral hiatus. It is formed due to the failure of fusion of laminae of the fifth (occasionally 4th) sacral vertebra. The sacral hiatus transmits the fifth sacral nerve and coccygeal nerves. The dural sac ends at the level of second sacral vertebra above the sacral hiatus. Therefore, it forms a convenient region for caudal epidural anaesthesia of structures innervated by these nerves.
Files
IJPCR,Vol15,Issue5,Article215.pdf
Files
(278.7 kB)
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Additional details
Dates
- Accepted
-
2023-05-23
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue5,Article215.pdf
- Development Status
- Active
References
- 1. Standring S. Grays Anatomy, 39th Ed, Elsevier Churchill Livingstone, London, 2005; P: 749 –754. 2. The Sacrum - The Holy Bone, Oct 2003. Available from: http://www. medicinenet.com 3. Sugar O. How the sacrum got its name. Jama and Archives. 1987; 257 (15):1. 4. Standring S. Grays Anatomy, 39th Ed, Elsevier Churchill Livingstone, London, 2005; P:731. 5. Vinod kumar et al. Morphometrical study of sacral hiatus. Journal of Anatomical society of India. 1992; 41 (1): 7 – 13. 6. Shewale SN, Laeeque M, Kulkarni PR et al. Morphological and morphometrical study of sacral hiatus. Int J Recent Trends in Sci& Tech. 2013 ;6(1):48-52. 66 7. Trotter M and Lanier PF. Hiatus canalissacralis in American whites and Negroes. Hum Biol. 1945;17:368 -81. 8. Standring S. Grays Anatomy, 39th Ed, Elsevier Churchill Livingstone, London, 2005; P: 749 –754. 53. 9. Ernest J Frazer. Anatomy of the Human skeleton. J and A Churchill ltd, London, 1914; P: 37 -42. 10. Sekiguchi M, Yabuki S, Satoh K, Kikuchi S. An Anatomical Study of the Sacral Hiatus: A Basis for Successful Caudal Epidural Block. Clinical journal of Pain. 2004; 20(1): 51 –54. 11. Lanier VS, Mcknight HE, Trotter M. Caudal analgesia: An experimental and anatomical study. American journal of Obstetrics and Gynaecology. 1944; 47 (5):633 – 641.