Landmarks of the sacral hiatus for caudal epidural block: an anatomical study

Şenoğlu, Nimet; Şenoğlu, Mehmet; Öksüz, Hafize; Gümüşalan, Yakup; Yüksel, Kasım Zafer; Zencirci, Beyazit; Ezberci, Meral; Kızılkanat, Emine

doi:10.1093/bja/aei236

Cited by 113 publications

(119 citation statements)

References 9 publications

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“…The data obtained in our study was in accordance to the study of Phalgun and Baskaran 6 who conducted their study on the sacra of Southern origin suggesting that the sacra of South Indians is quite similar to that of North Indians. On the contrary, the present study was not consistent with the studies of Senoglu et al and Bhattacharya et al 7,8 Regional and ethnic variation could be a possible explanation for this difference (Table 3). Phalgun and Baskaran, 6 Senoglu et al 7 and Bhattacharya et al 8 found the mean distance between the right and left lateral sacral crest and the apex of SH to be greater in their studies as compared to the data obtained in the current study.…”

Section: Discussioncontrasting

confidence: 99%

Dorsal sacral dimensional anatomy-revisited

Chauhan

Nagar

2015

Int J Res Med Sci

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Section: Discussioncontrasting

confidence: 99%

Dorsal sacral dimensional anatomy-revisited

Chauhan

Nagar

2015

Int J Res Med Sci

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“…In Senoglu's study [8] of 96 dry sacral bones eight had abnormalities of the sacral hiatus (2 with posterior closure defect and six with agensis of the sacral hiatus).…”

Section: Discussionmentioning

confidence: 99%

Caudal epidurals: the accuracy of blind needle placement and the value of a confirmatory epidurogram

Barham

Hilton

2010

Eur Spine J

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The objective of this study was to assess the accuracy of blind placement of caudal epidural needles and the usefulness of the radio-contrast epidurogram. The study involves a prospective case series of 147 consecutive patients with radiological assessment of blind needle placement and epidurogram assessing the accuracy of blind needle placement in caudal epidurals. When the surgical miss rate (26%) and failure of flow of the therapeutic agents (6%) are combined, it can be deduced that up to 32% of nonradiologically guided caudal epidurals may fail to deliver the therapeutic agents to the site of pathology. There was no significant difference in the accuracy of needle placement in adequately trained and experienced middle grade surgeons when compared with consultant surgeons performing these procedures regularly. In conclusion, we recommend radiological guidance and use of epidurogram as the gold standard for the administration of caudal epidurals to increase the likelihood of successful delivery of the therapeutic agents to the site of pathology during the procedure.

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“…Study by Dipali Rani Pal [8] et al observed that the distance between S2 and apex of sacral hiatus was 31.33 mm on an average (range 5 -60 mm) and the distance to the base of sacral hiatus was 54.88 mm (range 37 -39 mm). Study done by Senoglu N [12] et al stated that the distance between S2 foramen and apex of sacral hiatus was 35.37 mm on an average (range 11-62 mm) and the distance to the base of the sacral hiatus was 65.25 mm (range 39-85 mm). The distance between S2 foramen and apex of Sacral hiatus was 34.6 mm on an average (range 6 -52 mm ) and the distance to the base of the Sacral hiatus was 51.2 mm (range 15 -58 mm) was observed in our study which was similar to the previous studies.…”

Section: Median Distance In Millimetrementioning

confidence: 99%

Anatomical Study of Sacrum and its Clinical Significance

2016

AIMDR

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Background: Sacrum is formed by the fusion of five sacral vertebrae and forms the lower part of Vertebral column. The opening present at the lower end of sacral canal is known as sacral hiatus. Methods: This study was carried out on 75 dry human sacra of unknown sex to study the variations of sacral hiatus. Various shapes of sacral hiatus were observed which included inverted u, inverted v, irregular, dumbbell and bifid. The apex of sacral hiatus was commonly found at the level of 4th sacral vertebra. The mean length of sacral hiatus, the mean anteroposterior diameter of sacral canal was measured. The narrowing of sacral canal at the apex of sacral hiatus was measured. Results: We observed length of Sacral hiatus from apex to midpoint of base -maximum length was found to be 11 -20 mm in 32 dry sacra. Anteroposterior diameter at the sacral hiatus was found to be 0 -3 mm. in 35 dry sacra. Base (Transverse diameter) was found to be 11 -15 mm in 36 dry sacra. Median distance between the level of lower margin of S2 and apex of sacral hiatus was 21 -30 mm in 25(33%) Sacra. Distance between midpoint of Base to S2 foramen was found to be >40 mm in 52 Sacra and that accounts for 69 %. Conclusion:The knowledge of anatomical variations of sacral hiatus is clinically important for caudal epidural block in Pediatric, Obstetric, Orthopedic, Urologic and Surgical practice. The reliability and success of caudal epidural block depends upon Knowledge of Variations of Sacral hiatus.

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Landmarks of the sacral hiatus for caudal epidural block: an anatomical study

Cited by 113 publications

References 9 publications

Dorsal sacral dimensional anatomy-revisited

Dorsal sacral dimensional anatomy-revisited

Caudal epidurals: the accuracy of blind needle placement and the value of a confirmatory epidurogram

Anatomical Study of Sacrum and its Clinical Significance

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