Surgical anatomy of the presacral area

Güvençer, Mustafa; Dalbayrak, Sedat; Tayefi, Hamid; Tetik, Süleyman; Yılmaz, Mesut; Erginoğlu, Ufuk; Baksan, Ozdil; Güran, Salih; Naderi, Sait

doi:10.1007/s00276-008-0435-1

Cited by 18 publications

(17 citation statements)

References 28 publications

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“…However, (13), (14), (15), (16) found that In fourth age group(20-40 years) of European individuals the mean Coccygeal curved length in male is 3.9± 0.7 cm , while in female is 3.6 ± 0.7 cm. This difference is significant.…”

Section: Measurements Of Coccyxmentioning

confidence: 97%

Morphometric Study of the Normal Egyptian Coccyx from (Age 1-40 Year)

Shalaby¹

2015

IJCDA

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Abstract:Background: Coccyx is named as resemblance to curved beak of the cuckoo. The coccyx is a triangular bone consisting of three to five segments: the first is the largest, it articulates with the sacrum. The last three segments are smaller and form a single bony piece. The anterior surface presents three transverse grooves indicating site of fusion of these segments. Aim of the Work: To study the normal variations of coccyx in number of segments, shape, size, curves, in different age groups by plain X-ray, MRI scan. Patients and Methods: Study was carried out on 200 normal Egyptian individuals, and were divided into 4 groups:-First group from the age of 1 up to ˂ 6 years. Second group from the age of 6 years up to ˂ 12 years. Third group from the age of 12 years up to ˂ 20 years. Fourth group from 20 years up to 40 years. Each one of these groups comprises 50 persons (25 males & 25 females). A full medical history was taken and each individual was subjected for plain X-ray on the pelvis (Anteroposterior & Lateral View) to study the variations of the coccyx, forty individuals were subjected to MRI scan as ten from each group. Results: Three coccygeal segments were present in 138 (68.3%) of individuals. Most of the subjects had coccyx type I (82; 41.0%) Fig.(

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Section: Measurements Of Coccyxmentioning

confidence: 97%

Morphometric Study of the Normal Egyptian Coccyx from (Age 1-40 Year)

Shalaby¹

2015

IJCDA

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“…The coccygeal region is principally supplied from the median and lateral sacral arteries, which run in the presacral space. The median sacral artery arises immediately above the posterior aspect of the aortic bifurcation, descends posterior to the sacral venous plexus usually to one or other side of the midline, and anastomoses with the lateral sacral arteries which send branches through the anterior sacral foramina (Esses et al,1991; Tribus and Belanger,2001; Guvencer et al,2009). The median sacral artery is about 2.3 mm wide at the coccyx (Tribus and Belanger,2001; Guvencer et al,2009).…”

Section: Resultsmentioning

confidence: 99%

“…The median sacral artery arises immediately above the posterior aspect of the aortic bifurcation, descends posterior to the sacral venous plexus usually to one or other side of the midline, and anastomoses with the lateral sacral arteries which send branches through the anterior sacral foramina (Esses et al,1991; Tribus and Belanger,2001; Guvencer et al,2009). The median sacral artery is about 2.3 mm wide at the coccyx (Tribus and Belanger,2001; Guvencer et al,2009). The coccygeal region is also supplied by a sizeable coccygeal branch from the inferior gluteal artery which is given off behind the sacrospinous ligament and passes posteriorly to perforate the sacrotuberous ligament at multiple sites before terminating in gluteus maximus (Thompson et al,1999).…”

Section: Resultsmentioning

confidence: 99%

Clinical anatomy of the coccyx: A systematic review

Woon

Stringer

2011

Clinical Anatomy

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The coccyx has been relatively neglected in anatomical research which is surprising given the population prevalence of coccydynia and our inadequate understanding of its etiology. This systematic review analyzes available information on the clinical anatomy of the coccyx. A literature search using five electronic databases and standard anatomy reference texts was conducted yielding 61 primary and 7 secondary English-language sources. This was supplemented by a manual search of selected historical foreign language articles. The coccygeal vertebrae, associated joints, ligaments and muscles, coccygeal movements, nerves, and blood supply were analyzed in detail. Although the musculoskeletal aspects of the coccyx are reasonably well described, the precise anatomy of the coccygeal plexus and its distribution, the function of the coccygeal body, and the anatomy of the sacrococcygeal zygapophyseal joints are poorly documented. Further research into the anatomy of the coccyx may clarify the etiopathogenesis of coccydynia which remains uncertain in one-third of affected patients.

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“…Consequently, the aim of this study was to describe the embryonic coccygeal body with the assumed contribution of nerves. Although the name “median sacral artery” has often been replaced by “middle sacral artery” due to the rather rare midline course in adults (Güvencer et al, ), the former or original name is used in the present embryonic study.…”

Section: Introductionmentioning

confidence: 99%

Median Sacral Artery, Sympathetic Nerves, and the Coccygeal Body: A Study Using Serial Sections of Human Embryos and Fetuses

Jin

Cho

Jang³

et al. 2016

The Anatomical Record

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To examine how the median sacral artery (MSA) is involved with the coccygeal body or glomus coccygeum, we studied serial frontal or sagittal sections of 14 embryos (approximately 5-6 weeks of gestation) and 12 fetuses (10-18 weeks). At five weeks, the caudal end of the dorsal aorta (i.e., MSA) accompanied putative sympathetic ganglion cells in front of the upper coccygeal and lower sacral vertebrae. At six weeks, a candidate for the initial coccygeal body was identified as a longitudinal arterial plexus involving nerve fibers and sympathetic ganglion cells between arteries. At 10-18 weeks, the MSA exhibited a highly tortuous course at the lower sacral and coccygeal levels, and was attached to and surrounded by veins, nerve fibers, and sympathetic ganglion cells near and between the bilateral origins of the levator ani muscle. Immunohistochemistry demonstrated expression of tyrosine hydroxylase and chromogranin A in the nerves. However, throughout the stages examined, we found no evidence suggestive of an arteriovenous anastomosis, such as well-developed smooth muscle. An acute anterior flexure of the vertebrae at the lower sacrum, as well as regression of the secondary neural tube, seemed to induce arterial plexus formation from an initial straight MSA. Nerves and ganglion cells were likely to be secondarily involved with the plexus because of the close topographical relationship. However, these nerves might play a major role in the extreme change into adult morphology. An arteriovenous anastomosis along the MSA might be an overinterAbbreviations used: BP 5 brachial plexus; Co1-4 5 coccygeal segment of vertebrae; COM 5 coccygeus muscles; CRL 5 crown-rump length; CX 5 coccyx; DRG 5 dorsal root ganglion; EAS 5 external anal sphincter; HE 5 hematoxylin and eosin; HRP 5 horseradish peroxidase; LAM 5 levator ani muscle; MN 5 mesonephros; MSA 5 median sacral artery; NC 5 notochord; PCV 5 posterior cardinal vein; S1-5 5 the first-fifth sacral vertebrae or spinal segments; SGL 5 sympathetic nerve ganglia; SMA 5 smooth muscle actin; SNT 5 secondary neural tube; TH 5 tyrosine hydroxylase.

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Surgical anatomy of the presacral area

Abstract: This study showed that there was close distance between the sacral midline and the structures anterior to it. The close relationships, as well as the potential for anatomical variations, require the use of sacral and presacral imaging before presacral approach.

Cited by 18 publications

References 28 publications

Morphometric Study of the Normal Egyptian Coccyx from (Age 1-40 Year)

Morphometric Study of the Normal Egyptian Coccyx from (Age 1-40 Year)

Clinical anatomy of the coccyx: A systematic review

Median Sacral Artery, Sympathetic Nerves, and the Coccygeal Body: A Study Using Serial Sections of Human Embryos and Fetuses

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