Anatomy and Clinical Significance of Sacral Hiatus
DOI:
https://doi.org/10.51985/JBUMDC2019127Abstract
The sacral hiatus is a gap on the dorsal surface of the sacrum formed by the non-fusion of the lamina of the fourth and
fifth sacral vertebrae. A multitude of anatomical alternations of hiatus have been reported involving metric and non-metric
parameters. These have been identified during radiological investigations, surgical procedures or discovered in anatomical
and anthropological research studies. For successful outcomes in the clinical setting, it is vital that awareness of identified
and newly discovered anatomical variations is achieved through review of literature. Objective of this article is to provide
a systematic review of the reported anatomical variations of sacral hiatus with its clinical significance.
References
Standring S. Gray’s Anatomy. 41st ed. London: Elsevier Churchill Livingstone; 2016. p. 726-9.
Sinnatamby CS. Last’s Anatomy Regional and Applied. 12th ed. London: Churchill Livingstone; 2011: p 665-70.
Kujur B, Gaikwad MR. A Study of Variations in Sacral Hiatus and Its Clinical Significance. IJIMS 2017; 4(2): 204-12.
Singh A, Gupta R, Singh A. Morphological and Morphometrical Study of Sacral Hiatus of Human Sacrum. Natl J Integr Res Med2018; 9(4):65-73.
Mustafa MS, Mahmoud OM, El Raouf HHA, Atef HM. Morphometric Study Of Sacral Hiatus In Adult Human Egyptian Sacra: Their Significance In Caudal Epidural Anesthesia. Saudi J Anaesth 2012; 6(4):330-57.
Osuwoke EA, Oladipo GS, Allison TA, Orlu E. A Study of Sacral Hiatus in Dry Human Sacra in Southern Nigeria. JHMN 2014; 3:51-5.
Lakshmi TA, Azrajabeen. Surgically Relevant Morphometry of Sacral Hiatus. Anatomica Karnataka, 2013;7(1): 52-6.
Bhatacharya S, Majumdar S, Chakraborty P, Mazumdar S, Mazumdar A. A Morphometric Study of Sacral Hiatus for Caudal Epidural Block among the Population of West Bengal. Indian Journal of Basic and Applied Medical Research 2013; 7(2):660-67.
Woon J, Stringer MD. The Anatomy of the Sacrococcygeal Cornual Region and Its Clinical Relevance. Anat Sci Int 2013; 89(4):207-14.
Kao SC, Lin CS. Caudal Epidural Block: An Updated Review of Anatomy and Techniques. Biomed Research International 2017: 1-5.
Ahmm K, Ara S, Ashrafuzzaman M, Khatun K, Islam MS. Morphometry of Sacral Hiatus and its Clinical Relevance in Caudal Epidural Block. J. Dhaka Med Coll 2014; 23(1):31- 6.
Vasuki AK, Sundaram KK, Nirmaladevi M, Jamuna M, Hezibkah DJ, Fenn TKA. Anatomical Study of the Sacrum and its Clinical Significance. Int J Anat Res 2016; 2(3):123- 7.
Bagheri H, Govsa F. Anatomy of the Sacral Hiatus and Its Clinical Relevance in Caudal Epidural Block. Surg Radiol Anat 2017; 39:943-51.
Prasad N, Prasad M. A Study Of Hiatal Level In Sacrum: Is This The Cause of Back Problems In Indians. Journal of Evidence Based Medicine Healthcare 2016; 3(47):2318-21.
Secer M, Muradov JW, Dalgi A. Evaluation of Congenital Lumbosacral Malformations and Neurological Findings in Patients with Low Back Pain. Turkish Neurosurgery 2009; 19(2):145-8.
Elumalai G, Thangamani M, Sanyal S, Kanagarajan P. Deficient Sacral Hiatus Cause Mechanical Low Back Pain: A Radiological Study. International Journal of Anatomy and Research 2016; 4(1):1758-64.
Kumar V, Nayak SR, Potu BK, Pulakunta T. Sacral Hiatus in Relation to Low Back Pain in South Indian Population. Bratisl Lek Listy 2009; 110(7):436-41.
Bhadra RC, Saha D. Relation of Low Back Pain with Level of Sacral Hiatus in West Bengal Population-An Osteo- radiological Study. Indian Journal of Basic and Applied Medical Research 2017; 6(3):140-7.
Nastoulis E, Karakasi MV, Pavlidis P, Thomaidis V, Fiska A. Anatomy and Clinical Significance Of Sacral Variations: A Systematic Review. Folia Morphologica 2019: 1-45.
Moore KL, Dalley AF, Agur AMR. Clinically Oriented Anatomy. 18th ed. Philadelphia: Lippincott Williams and Wilkins; 2018. p. 270-4.
Aggarwal A, Kaur H, Batra YK, Aggarwal AK, Rajeev S, Sahni D. Anatomic Consideration of Caudal Epidural Space: A Cadaver Study. Clin Anat 2009; 22:730–7.
Ali S, Azeemi AA, Shoukat S. The Prevalence of Spina Bifida Occulta in Pakistani Population: A Study of Dry Human Sacra. Anesthesia Pain and Intensive Care 2014; 18(2):157-61.
Kilicaslan A, Keskin F, Babaoglu O, Gok F, Erdi MF, Karya B, et al. Morphometric Analysis of the Sacral Canal and Hiatus Using Multidetector Computed Tomography for Interventional Procedures. Turk Neurosurgery 2015; 25(4):566- 73.
Park G, Kwon DR, Cho HK. Anatomic Differences in the Sacral Hiatus During Caudal Epidural Injection Using Ultrasound Guidance. J Ultrasound Medicine 2015; 34:2143- 8.
Nasr AY. Clinical Relevance of Conus Medullaris and Dural Sac Termination Level with Special Reference to Sacral Hiatus Apex: Anatomical and MRI Radiologic Study. Anat Sci Int 2017; 92:456–67.
Bagheri H, Govsa F. Anatomy of the Sacral Hiatus and Its Clinical Relevance in Caudal Epidural Block. Surgical Radiological Anatomy 2017; 39:943-51.
Pal DR, Rahman A, Fatema K. Morphometric Study of Sacral Hiatus: A Basis for Successful Caudal Epidural Block. Bangladesh Journal of Anatomy 2012; 10(1):5-10.
Senoglu N, Senoglu M, Oksuz H, et al. Landmarks of the Sacral Hiatus for Caudal Epidural Block: An Anatomical Study. Br J Anaesth 2005; 95:662-95.
Nadeem G. Importance of Knowing the Level of Sacral Hiatus for Caudal Epidural Anesthesia. J Morphol Sci 2014; 31(1):9- 13.
Trotter M. Variations Of The Sacral Canal: Their Significance In The Administration Of Caudal Analgesia.ÊAnesth Analg.Ê1947;26: 192–202.
Mayuri J, Vijay G, Vasudha N, Anita G, Asha P. Anatomical Study of Sacral Hiatus in Dry Isolated Sacra. J Res Med Dent Sci 2014; 2(2): 43-6.
Sekuguchi M, Yabuki S, Satoh K, Kikuchi S. An Anatomic Study of the Sacral Hiatus: A Basis for Successful Caudal Epidural Block. Clin J Pain 2004; 20(1):51-4.
Jaffer Al-sa’adi MH. Assessment of Surgeon Performed Caudal Block for Anorectal Surgery. Asian J Surg 2018;42(1):240-3.
Canakci E, Yagan O, Tas N, Mutlu T, Cirakoglu A, Benli E. Comparison of Preventive Analgesia Techniques In Circumcision Cases: Dorsal Penile Nerve Block, Caudal Block or Subcutaneous Morphine? J Pak Med Assoc 2017; 67(2): 159-65.
Mourgela S, Sakellaropoulos, Anagnostopolou S, Warnke JP. The Dimensions of Sacral Spinal Canal in Thecaloscopy: A Morphometric MRI Study. Neuroanat 2009; 8:1-3.
Pradhan A, Yadav S. Assessing the Dimension of Sacral Spinal Canal for Thecaloscopy Using MRI. Int J Pharm Bio Sci 2016; 7(1): 588-592.
ElSawy NA, Mahran HG and Alkushi AG. Impact of Therapeutic Electrical Stimulation of Sacral Surface Considering Individual Anatomical Sacral Variations on Early Recovery Urinary Incontinence after Radical Prostatectomy. FMAR 2017; 5:1-13.
Yilmaz S, Tokpinar A, Acer N, Dogan S. Morphometric Investigation of the Sacral Bone in MR Images. J US China Med Sci 2019; 16:179-85.
Domingo T, Bong DA, Mayoral V, Ortega R, Perez MM, Sabate A. Ultrasound-Guided Pain Interventions In The Pelvis And Sacral Spine. Tech Reg Anesth Pain Manag 2013; 17:107- 130.
Kim DH, Park HJ, Lee SC. Ultrasonographic Evaluation of Anatomic Variations of Sacral Hiatus: Implications for Caudal Epidural Injections. Spine 2016;41(13):759-63.
Nakahashi M, Uei H, Hashino M, Omori K, Igarashi H, Tokuhashi Y. Anatomical Evaluation of Sacral Hiatus Using Ultrasound Imaging: Factors That Inhibit Needle Insertion During Caudal Epidural Block Procedures. Pain Prac 2013; 1(7):11-18.
Shinde VK, Shirbadgi SA. Study of Variations in Levels of Sacral Hiatus. Int J Anat Res 2016; 4(1):1882-85.
Chauhan R, Nagar M. Anatomical Profile and Morphometric Evaluation of Human Sacral Hiatus in Northern Indians. J Surg Acad 2015; 5(2):8-12.
Duncan MA, Sherriff M, O’Keeffe D, Dangerfield PH. A Radiographic Assessment of the Distances from Sacral Hiatus To The Lower Lumbar Spinous Processes. Eur J Anat 2009; 13(1): 19-22.
Ali S, Qureshi I, Ali A. Anatomical Variations of Sacral Hiatus in Dry Human Sacra. JIMC 2015; 10(1):121-3
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