Morphological and morphometric analysis of the Sacral Hiatus using lumbosacral spine CT scans: clinical relevance in Caudal Epidural Analgesia.

IF 1.2 4区 医学 Q3 ANATOMY & MORPHOLOGY
Apurba Patra, Harmeet Kaur, Priti Chaudhary, Adil Asghar, Navneh Samagh, Jerzy Andrzej Walocha, Bartosz Rutowicz, Karolina Brzegowy-Solewska, Dariusz Lusina, Janusz Skrzat
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Abstract

Background: To conduct a morphological and morphometric analysis of the sacral hiatus (SH) using lumbosacral spine CT scans and to evaluate its clinical relevance in caudal epidural analgesia (CEA).

Materials and methods: This retrospective study analyzed 77 lumbosacral spine CT scans from a diverse patient population. The shape of the SH was classified into common types: inverted U, inverted V, irregular, and bilobed. Morphometric measurements included the length, width, and depth at the apex of the SH. The apex level of the SH was also determined in relation to the sacral vertebrae, and statistical analysis was performed to identify any correlation between the apex level and the morphometric dimensions.

Results: The most frequent SH shape was inverted U (68.83%), followed by inverted V (20.77%), irregular (9%), and a single instance of a bilobed shape (1.29%). The apex of the SH was most commonly located at the level of the S4 vertebra (75.32%), followed by the S3 vertebra (20.77%), S5 in two (2.59) and S2 in one (1.29%). No significant correlation was found between the level of the apex and the length, width, or depth of the SH. These findings indicate a high degree of anatomical variability in the SH, independent of the apex level.

Conclusions: The anatomical variability of the SH, as observed in this study, underscores the need for individualized assessment during CEA. The lack of correlation between the apex level and the morphometric dimensions of the SH highlights the importance of imaging modalities such as ultrasound or fluoroscopy to ensure precise localization and effective analgesia administration. These insights can improve clinical outcomes by enhancing the accuracy and safety of caudal epidural procedures.

利用腰骶椎 CT 扫描对骶骨间隙进行形态学和形态计量学分析:与尾硬膜外镇痛的临床相关性。
背景:利用腰骶椎 CT 扫描对骶骨裂隙(SH)进行形态学和形态计量学分析,并评估其在尾硬膜外镇痛(CEA)中的临床意义:这项回顾性研究分析了来自不同患者群体的 77 例腰骶部脊柱 CT 扫描结果。SH的形状分为常见类型:倒U形、倒V形、不规则形和双叶形。形态测量包括 SH 的长度、宽度和顶点深度。此外,还根据骶椎的关系确定了SH的顶点水平,并进行了统计分析,以确定顶点水平与形态测量尺寸之间的相关性:最常见的骶骨形状是倒 U 形(68.83%),其次是倒 V 形(20.77%)、不规则形(9%)和单一的双叶形(1.29%)。SH的顶点最常位于S4椎体水平(75.32%),其次是S3椎体(20.77%),S5有2例(2.59%),S2有1例(1.29%)。在顶点水平与 SH 的长度、宽度或深度之间没有发现明显的相关性。这些结果表明,SH的解剖变异性很大,与心尖水平无关:本研究观察到的 SH 解剖学变异性强调了在 CEA 期间进行个体化评估的必要性。心尖水平与 SH 形态计量尺寸之间缺乏相关性,这凸显了超声或透视等成像模式对确保精确定位和有效镇痛的重要性。这些见解可以提高尾硬膜外手术的准确性和安全性,从而改善临床效果。
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来源期刊
Folia morphologica
Folia morphologica ANATOMY & MORPHOLOGY-
CiteScore
2.40
自引率
0.00%
发文量
218
审稿时长
6-12 weeks
期刊介绍: "Folia Morphologica" is an official journal of the Polish Anatomical Society (a Constituent Member of European Federation for Experimental Morphology - EFEM). It contains original articles and reviews on morphology in the broadest sense (descriptive, experimental, and methodological). Papers dealing with practical application of morphological research to clinical problems may also be considered. Full-length papers as well as short research notes can be submitted. Descriptive papers dealing with non-mammals, cannot be accepted for publication with some exception.
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