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Anatomical study of sacral hiatus for successful caudal epidural block


Int J Med Res Health Sci. |

Authors: Ramamurthi KS, Anilkumar Reddy Y
Int J Med Res Health Sci. 2013;2(3):496- 500 |  DOI:10.5958/j.2319-5886.2.3.086


Background: Present study determined the landmarks for caudal epidural block (CEB) after morphometric measurements of the sacral hiatus on dry sacral bones. The CEB has been widely used procedure for the diagnosis and treatment of lumbar spinal disorders. Anatomical features of the sacral hiatus and the detailed knowledge about sacral hiatus. Materials & Methods:  116 sacral bones are used for the study. Anatomical measurements were measured by using vernier caliper accuracy to 0.1 mm. 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 supero lateral sacral crests and the distance between the apex of sacral hiatus and the right and left supero 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. Conclusion: The sacral hiatus has anatomic variations. Understanding of these variations may improve the reliability of CEB.

Keywords: Sacral vertebrae, Sacral hiatus, Caudal Epidural Block (CEB)

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