scholarly journals A study of variations of sacral hiatus of dry human sacra in north interior Karnataka region

2014 ◽  
Vol 03 (04) ◽  
pp. 215-219 ◽  
Author(s):  
Vijaykumar Shinde ◽  
P S Bhusaraddi
Keyword(s):  
Spina Bifida ◽  
Success Rate ◽  
Epidural Anaesthesia ◽  
Anatomical Variations ◽  
The Other ◽  
Caudal Anaesthesia ◽  
Anatomical Knowledge ◽  
Sacral Hiatus ◽  
Caudal Epidural

Abstract Background and aims: The shape of sacral hiatus is known to show a number of anatomical variations. The shape and extent of sacral hiatus is important because in caudal epidural anaesthesia, the approach is made through sacral hiatus. The detailed anatomical knowledge of variations of sacral hiatus is very helpful to the anaesthetists to increase the success rate of caudal anaesthesia. The present study is an attempt to find out variations of sacral hiatus in north interior Karnataka region. Materials and methods: For the present study, one hundred dry human sacra obtained from north interior Karnataka region were used. Results: The inverted U shaped sacral hiatus was most common (56%). Inverted V shaped sacral hiatus was found in 24% of sacra. The other variations like irregular shaped hiatus (10%), bifid hiatus (2%), dumbbell shaped hiatus (5%), complete spina bifida (1%) and absent hiatus (2%) were also found. Conclusion: Abnormal shapes of sacral hiatus like irregular, bifid, dumbbell, completespina bifida and absent hiatus were seen in 20%of total 100 sacra belonging to north interior Karnataka.

scholarly journals Anatomical study of sacral hiatus in South Indian population and its clinical significance in caudal epidural anaesthesia

2014 ◽  
Vol 03 (03) ◽  
pp. 128-136
Author(s):  
A. Anupriya ◽  
M. Mahima Sophia
Keyword(s):  
Epidural Anaesthesia ◽  
Average Length ◽  
Anatomical Study ◽  
South Indian Population ◽  
South Indian ◽  
Caudal Anaesthesia ◽  
Anatomical Knowledge ◽  
Sacral Hiatus ◽  
Sacral Canal ◽  
Caudal Epidural

Abstract Background: Caudal anaesthesia is administered into the epidural space through Sacral Hiatus(SH). Hence reliability and success of caudal epidural anaesthesia depends upon the anatomical knowledge of sacral hiatus. Aim: The aim is to study the morphological measurements and variations of structures around the sacral hiatus and to identify possible anatomical reasons for failure of caudal epidural anaesthesia (CEA). Materials and methods: Fifty three dry adult sacral bones of both sexes were measured using Vernier Caliper, scale and divider. The shape of sacral hiatus (SH) was observed and its length and breadth were measured. The measurements were focused on sacral hiatus and its relation with surrounding bony projections. Results: The shape of the sacral hiatus showed a maximum occurrence of inverted 'V' and 'U' shapes with 35.85% and 26.42% respectively. The level of apex of SH was maximum at S4 foramen level in 68.63% cases followed by S5 and S3 level. In 62.26%, the level of base was observed at S5 level . The average length of the sacral hiatus was 23.02(± 8.95 mm), APdiameter was 5.49 (±l.44 mm) and base of SH was 14.6 (± 3.99 mm). The distance from apex and base of SH to S2 foramen level was 31.07 mm and 52.86 mm respectively. Conclusion: The anatomical knowledge of SH is very much necessary to increase the reliability and success of CEA. Surrounding bony irregularity, different shapes of hiatus and defect in dorsal wall of sacral canal should be taken into consideration before undertaking CEA so as to avoid its failure.

scholarly journals Sacral Hiatus Study in Dry Human Sacra

2014 ◽  
Vol 2 (1) ◽  
pp. 17-22
Author(s):  
M Mishra ◽  
AK Singh ◽  
P Satyavathi ◽  
N Sah
Keyword(s):  
Epidural Anaesthesia ◽  
Andhra Pradesh ◽  
Medical Science ◽  
Anatomical Variations ◽  
South Indian Population ◽  
South Indian ◽  
Caudal Anaesthesia ◽  
Sacral Hiatus ◽  
Sacral Canal ◽  
Caudal Epidural

Background and objectives: The sacral hiatus is the site for caudal epidural anaesthesia during perineal surgery and also for a painless delivery. It is also used for three dimensional colour visualization of lumbosacral epidural space in orthopaedic practice for diagnosis and treatment. Work on the morphometrical study of the sacral hiatus is limited, especially in south indian population. So this study is carried to examine, measure and record the morphometry of sacral hiatus in order to study the anatomical variations which will be useful for caudal epidural anaesthesia. Material and Methods: The study was conducted in the Department of Anatomy, Prathima Institute of Medical Science, Naganur, Andhra Pradesh. 93 dry sacra with complete sacral hiatus were taken for the study. The shape of the sacral hiatus was noted by naked eye. Level of the apex and base of the sacral hiatus was noted with respect to the sacral vertebra. The length of sacral hiatus was measured from apex to the midpoint of base, the anteroposterior depth of sacral hiatus at the apex was measured with the help of vernier calipers. The transverse width of sacral hiatus at the base was measured between the inner aspects of inferior limit of the sacral cornu with the help of divider and then adjusted, and calculated with vernier caliper. Results: In 47 (50.53 %) sacra the shape was Inverted-U and in 25 (26.9 %) sacra Inverted-V. The irregular shaped of sacral hiatus was observed in 11 (11.8 %) cases. A “Dumbbell” shaped sacral hiatus was observed in 5 (5.4%) cases with a nodular bony growth projecting medially from both margins. The dorsal wall of sacral canal was entirely absence in 4 (4.3%) cases. Absence of sacral hiatus, a rare phenomenon, was observed in 1 (1%) specimens only. Conclusion: In the present study, elongated hiatus and narrowing of the sacral canal at apex of sacral hiatus was found in a significant percentage, which should be kept in mind while giving the caudal anaesthesia in Andhra Pradesh region. DOI: http://dx.doi.org/10.3126/jmcjms.v2i1.11391 Janaki Medical College Journal of Medical Sciences (2014) Vol. 2 (1): 17-22

scholarly journals Importance of knowing the level of sacral hiatus for caudal epidural anesthesia

2014 ◽  
Vol 31 (01) ◽  
pp. 009-013 ◽  
Author(s):  
G. Nadeem
Keyword(s):  
Success Rate ◽  
Failure Rate ◽  
Epidural Anesthesia ◽  
Anatomical Variations ◽  
Bony Landmarks ◽  
Sacral Hiatus ◽  
Different Shapes ◽  
The Mean ◽  
Sacral Canal ◽  
Caudal Epidural

Abstract Introduction and Materials and Methods: The Study was carried out on 100 dry human sacra to know the Anatomical variations of sacral hiatus. Results: Different shapes of sacral hiatus were observed which included- Inverted U (56%), Inverted V (14%), Irregular (16%), Dumb-bell (10%), Bifid (2%) and Elongated (2%). The apex of the sacral hiatus was most commonly found at the level of 3rd sacral vertebrae in 62%. The mean length of sacral hiatus was 25.2mm, the mean anteroposterior diameter of sacral canal at the apex of sacral hiatus was 5.53mm. The mean distance between sacral cornu at the base of sacral hiatus was observed to be 19.5mm. Conclusion: This study was done to clarify the anatomical variations of sacral hiatus using bony landmarks of sacrum for improving the reliability of caudal epidural anesthesia and to improve its success rate and reduce the complications and failure rate.

scholarly journals STUDY OF DORSAL SACRAL TRIANGLE IN HUMAN SACRA

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Manoj Bhavanidatta Joshi
Keyword(s):  
Epidural Anesthesia ◽  
Preoperative Assessment ◽  
Anatomical Variations ◽  
Cross Sectional Study ◽  
Pelvic Bone ◽  
Sacral Vertebra ◽  
Cross Sectional ◽  
Sacral Hiatus ◽  
Sacral Canal ◽  
Caudal Epidural

Introduction: Sacrum is a triangular bone shaped by combination of five sacral vertebrae. It is embedded as a wedge between the two innominate bones at the upper and back portion of pelvic bone. The opening show at the caudal conclusion of sacral canal is known as sacral rest. It is shaped due to the disappointment of combination of laminae of the fifth (every so often 4th) sacral vertebra. It is situated inferior to the 4th (or 3rd) fused sacral spines or lower end of median sacral crest. Sacrum is a vital bone for recognizable proof of sex in human skeletal framework. Since it may be a component of hub skeleton and and pelvic support, it has an applied significance in deciding sexual orientation with the assistance of estimation carried upon it. The well- known strategy for assurance of male and female sacra has been the Sacral file (SI). The varieties within the structure of dorsal divider of sacral canal are various. It may be open all through its whole length or there may be moo lying lamina of to begin with sacral vertebra. Other varieties incorporate lacks between its predominant and second rate limits, pulverization of lumen of sacral canal and hard abundance annihilating the break. The nearness of any gaps may allow the needle to elude the canal coming about in subcutaneous statement of anesthetic operator. The sacral hiatus has been used for administration of caudal epidural anesthesia in obstetrics as well as orthopedic practice for treatment and diagnosis. The foremost visit issue experienced in caudal epidural square is needle situation as in some cases it is troublesome to decide the anatomical area of sacral rest particularly in grown-ups. Clinical assessment of needle arrangement can be done with ultrasonography or fluoroscopy. In any case, it isn't continuously doable to do so since of time and cost limitations. Varieties have been found within the shape and level of sacral break. Anatomical points of interest and the information of real shape and size of sacral rest and its varieties play a major part within the victory of needle situation.  Aim: The main of this study is to find out the anatomical variations of sacral hiatus of the cadaver in human. Material and Methods: This is a Cross-sectional study carried out on dry human sacra to study the anatomical variations of sacral hiatus. Total 80 human sacra were collected from Department of Anatomy. Only dry sacra with complete sacral hiatus were included in this study. Damaged sacra were excluded in this study. For the study various parameters and measurement were used for the study. With the help of naked eye the shape of the sacral hiatus was noted. The length of sacral hiatus was measured from apex to the midpoint of base; the antero-posterior depth of sacral hiatus at the apex was measured with the help of vernier calipers and recorded as data. With the help of vernier caliper the transverse width of sacral hiatus at the base was also measured between the inner aspects of inferior limit of the sacral cornu with the help of divider and then adjusted and calculated. Result: In this all the sacrum studied was composed of five segments in 80 cases. There were many variations in the shape of sacral hiatus. In 38 (47.5%) sacra the shape was Inverted-U whereas sacra Inverted V was seen in 21(26.3%).  Both the over sorts were considered as ordinary and the sacral break was show against 4th and 5th sacral sections. The irregular shaped of sacral hiatus was observed in 12(15%) cases. A “Dumbbell” shaped sacral hiatus was observed in 5(6.3%) cases with a nodular bony growth projecting medially from both margins. The dorsal wall of sacral canal was entirely absence in 3(3.8%) cases. a rare phenomenon, absence of sacral hiatus was observed in 1(1.3%) only. Conclusion: There was variability in the anatomical structure of the sacral hiatus. The inverted U shape of sacral hiatus was most commonly seen. Apex and base of the hiatus were most commonly seen at the level of S4 and S5 respectively. These estimations will be of colossal esteem in administration of caudal epidural anesthesia and variations in shape and estimate of sacral rest will help in preoperative assessment of patients. There are anatomical varieties within the sacral break, which may relate to the complication to caudal epidural anesthesia. Understanding of these varieties may progress the victory rate of caudal epidural anesthesia. Keywords: Sacrum, Sacral hiatus, apex, base, caudal epidural anaesthesia

scholarly journals EFFECTIVENESS OF CAUDAL EPIDURAL ANAESTHESIA IN ANORECTAL SURGERY.

2019 ◽  
Vol 26 (07) ◽  
pp. 1121-1124
Author(s):  
Sajid Malik ◽  
Shahid Hussain Mirani ◽  
Dileep Kumar
Keyword(s):  
Epidural Anaesthesia ◽  
Randomized Study ◽  
Caudal Block ◽  
Anorectal Surgery ◽  
Postoperative Pain Control ◽  
Caudal Anaesthesia ◽  
Surgical Conditions ◽  
Study Setting ◽  
Surgical Condition ◽  
Caudal Epidural

Objectives: To assess the effectiveness of caudal epidural anaesthesia in patients with anorectal surgical condition. Study Design: Prospective randomized study. Setting: Department of Surgery, Jinnah Hospital, Lahore. Period: 1st August 2016 to 31st July 2017. Materials and Methods: One hundred and eighty patients with general anorectal surgical conditions were recruited in this study with their consent. Patients were subject to surgery planned beneath caudal block. Results: One hundred and fifty eight patients (87%) satisfy with the technique of anaesthesia and one hundred sixty six (92.22%) patients demonstrate satisfaction with the postoperative pain control. One hundred and fifty two patients (84.44%) were resisted with pre-operative information and 158 (87%) patients show their consent to select this kind of anaesthesia if needed again. In 20 patients there was block failure caused about 11.11% failure rate. Conclusion: Satisfactory anaesthesia, minimal requirements, cost effectiveness and high patients acceptability make caudal anaesthesia a suitable choice for trivial and surgery.

scholarly journals Secondary Myelitis in Dermal Sinus Causing Paraplegia in a Child with Previously Normal Neurological Function

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Sakina Rashid ◽  
Grace Kinabo ◽  
Marissa Kellogg ◽  
William P. Howlett ◽  
Marieke C. J. Dekker
Keyword(s):  
Congenital Anomaly ◽  
Spina Bifida ◽  
Neural Tube ◽  
Clinical Course ◽  
Acute Infection ◽  
Early Embryogenesis ◽  
The Other ◽  
Neurological Deficits ◽  
Dermal Sinus ◽  
Neurological Development

Neural tube defects result from failure of neural tube fusion during early embryogenesis, the fourth week after conception. The spectrum of severity is not uniform across the various forms of this congenital anomaly as certain presentations are not compatible with extrauterine life (anencephaly) while, on the other hand, other defects may remain undiagnosed as they are entirely asymptomatic (occult spina bifida). We report a child with previously normal neurological development, a devastating clinical course following superinfection of a subtle spina bifida defect which resulted in a flaccid paralysis below the level of the lesion and permanent neurological deficits following resolution of the acute infection and a back closure surgery.

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