Welcome to International Journal of Anatomy and Research

 

 

Type of Article : Original

Year: 2015 | Volume 3 | Issue 1 | Page No. 848-855

Date of Publication: 28-02-2015

DOI: http://dx.doi.org/10.16965/ijar.2014.527

STUDY OF SACRAL HIATUS IN DRY HUMAN SACRA IN NEPAL, PARSA REGION

Malarvani T *¹, Ganesh E ¹, Nirmala P ².

^*1 Department of Anatomy, Tribhuvan University, National Medical College, Birgunj, Nepal.
² Department of Anatomy, Kathmandu University, Nobel Medical College & Teaching Hospital, Biratnagar, Nepal.

Address: Malarvani T, Assistant Professor, Department of Anatomy, Tribhuvan University, National Medical College, Birgunj, Nepal.
E-Mail: malardewdrop@gmail.com

Abstract

Introduction: The sacrum is a large triangular bone, formed by the fusion of five sacral vertebrae. The opening at the caudal end of sacral canal is known as sacral hiatus. It is formed due to the failure of fusion of laminae of the fifth (occasionally fourth) sacral vertebra. Sacrum is one of the bones which exhibit variations and the variation of sacral hiatus is of great clinical significance because it may also leads to mechanical low back pain. Previous works on the morphometrical study on the sacral hiatus is limited, especially in Nepal, Parsa population. The present study was undertaken to help in filling this gap at least to a certain extent and also made an attempt to find out the variations of sacrum.
Materials: One hundred dry human sacra were collected from the Department of Anatomy of National medical college & Teaching Hospital, Nepal.
Methods & Observations: The morphometrical studies were done, and the parameters (Shape, length, Transverse width & Antero-posterior width of sacral hiatus and level of apex & base of sacral hiatus) were measured with the help of divider, the observations were recorded, tabulated & analyzed.
Result: The study showed a significant co-relation between anatomical variations of sacral hiatus with the previous studies.
KEYWORDS: Sacral hiatus, Epidural anaesthesia, Caudal analgesia, Sacral canal.

References

1. Standring S. Gray’s Anatomy, 39th Ed, Elsevier Churchill Livingstone, London, 2005; 731 & 749 – 754.
2. Sugar O. How the sacrum got its name. Jama and Archives 1987; 257(15):1.
3. The Sacrum – The Holy Bone, Oct 2003.
4. Ernest J Frazer. Anatomy of the Human skeleton. J and A Churchill ltd, London, 1914; 37 -42.
5. Brailsford JF. Deformities of lumbosacral region of spine. British Journal of Surgery 1929; 16: 562 – 570.
6. Edwards WB, Hingson RA. Continuous caudal anaesthesia in obstetrics. American Journal of Surgery 1942; 57: 459 – 464.
7. Nagar SK. A study of sacral hiatus in dry human sacra. Journal of Anatomical Society of India 2004; 53(2): 18 – 21.
8. Vishal kumar et al. Sacral hiatus in relation to low back pain in South Indian population: Anatomico – Radiological study. Bratisl Lek Listy 2009; 110(7): 436 – 441.
9. Vinod kumar et al. Morphometrical study of sacral hiatus. Journal of Anatomical society of India 1992; 41(1): 7 – 13.
10. Sekiguchi M, Yabuki S, Satoh K, Kikuchi S. An Anatomical study of the sacral hiatus: A basis for successful caudal epidural block. Clinical journal of pain 2004; 20(1): 51 -54.
11. Trotter M. and Letterman GS. Variations of the female sacrum: Their significance in continuous caudal anaesthesia. Surg. Gynecol. Obstet 1944; 78(4): 419 -424.
12. Rajapur parashuram. Morphometrical study of sacral hiatus using isolated dry human sacra: Dissertation 2008.
13. Lanier VS, Mcknight HE, Trotter M. Caudal analgesia: An experimental and anatomical study. American journal of Obstetrics and Gynaecology 1944; 47(5): 633 – 641.
14. Hollinshead WH. Anatomy for Surgeons. 2nd Ed, Harper and Row publishers, Philadelphia, 1969; 176 – 180.
15. Chen PC, Tang STF, Hsu, et al. Ultrasound guidance in caudal epidural needle placement. Anaesthesiology 2004; 101: 181 – 184.
16. Datta AK. Essentials of human osteology, 1st Ed, Current Books International, Calcutta, 1997: 53.
17. David L Brown. Regional Anaesthesia and Analgesia, Saunders and Company, 1986; 346 -347.
18. Esses SI, Botsford DJ, Huler RJ, et al: Surgical anatomy of the sacrum. A guide for rational screw fixation. Spine 1991; 16(suppl 6):283 – 288.
19. Esses SE, Botsford DJ: Surgical Anatomy and Operative Approaches to the sacrum,in Frymoyer JW, Ducker TB, Hadler NM et al(eds): The Adult Spine: principles and practise, 2nd Ed. Philadelphia: Lippincott-Raven, 1997;2:2329 – 2341.
20. Estin D, Cohen AR. Caudal agenesis and associated caudal spinal cord malformations. Neurosurg Clin N Am 1995; 6: 377 – 391.
21.   Letterman GS, Trotter M. Variations of the male sacrum: Their significance in caudal analgesia. Surg. Gynecol. Obstet 1944; 78(5):551 – 555.
22. Marina Baptist et al. Sex differences in sacra in the Punjab region: E:/Biomedica vol.24, Jul. – Dec. 2008/ Bio – 23. Doc (WC) :152 – 157.
23. Mishra et al. Identification of sex of sacrum of Agra region: J Anat. Soc. India 2003; 52(2):132 -136.
24. N.Senoglu, et al. Landmarks of the sacral hiatus for caudal epidural block: An Anatomical study. British Journal of Anaesthesia 2005;95(5): 692 – 695.
25. Saberski L, Kitahata L. Direct visualization of lumbosacral epidural space through the sacral hiatus. Anaesth Analg 1995; 80: 839 – 840.
26. Siddiqui A. Variations in sacral hiatus. Journal of Anatomical Society of India 2003; 52(1):113.
27. Tapan kumar jana et al. Variations in sacral hiatus and significance of hiatal index in sexing of sacrum. Journal of Anatomical society of India 1986; 42
28. Thompson JE. An Anatomical and Experimental study of sacral anaesthesia. Ann. Surg 1917; 66:718 – 727.
29. Trotter M. Variations of the sacral canal: Their significance in the administration of caudal analgesia. Anaesth. Analg 1947; 26(5):192 – 202.
30. Bernard Rosner. Fundamentals of Biostatistics, 5th Ed, Duxbury, 2000.
31. Venkataswamy Reddy. Statistics fir mental health care research, NIMHANS publication, India, 2002.
    

 

Malarvani T, Ganesh E, Nirmala P. STUDY OF SACRAL HIATUS IN DRY HUMAN SACRA IN NEPAL, PARSA REGION. Int J Anat Res 2015;3(1):848-855. DOI: 10.16965/ijar.2014.527