STUDY OF MORPHOLOGICAL AND MORPHOMETRIC VARIATIONS OF CLINICALLY SIGNIFICANT SACRAL HIATUS IN BOTH THE GENDERS
Abstract
One of the commonest factors for failure of caudal epidural anesthesia is anatomical variations in morphology and morphometry of sacral hiatus which occur frequently in both the genders. This route is used to create caudal anaesthesia by injecting a local anaesthetic into the epidural area. Sound knowledge of anatomy in this region will help in accurate identification of sacral hiatus and is essential to avoid procedural complications. [1, Kumar V et al].
MATERIAL AND METHODS: The study was conducted on 73 dry human sacra in the Department of Anatomy, MGMCRI, Puducherry. After the determination of gender, the sacra were classified as 40 male and 33 female sacra. Both nonmetric and metric parameters of SH were measured.
RESULTS
The most prevalent shape of SH in both the genders were inverted U shape followed by inverted V shape and less common shape were dumbbell & irregular shape, with one female sacrum having complete dorsal wall agenesis. Location of apex of SH in both the genders were seen at the level of S4 vertebra (n=43) and location of base of SH in both the genders were seen at the level of S5 vertebra (n=50). The mean length of SH in male and female were 25.19 and 22.66mm, mean width of SH at the base in male and female were 13.79 & 11.98 mm, mean depth of SH at the apex in male & female were 5.50 & 3.93mm , mean distance between apex and S2 spinous process in male and female were 29.54 mm & 28.73 mm, mean distance between two superolateral crest in male & female were 61.11mm & 62.57 mm , mean distance between left superolateral crest and apex in male and female were 64.36mm & 62.10 mm, mean distance between right superolateral crest and apex in male & female were 64.19 & 60.66 mm.
CONCLUSION The knowledge of incidences of variations of SH is crucial in clinical situations requiring CEB in both the genders to avoid complications.
KEYWORDS
Length of SH, Width of SH, Depth of SH.
