Morphometric Analysis Of The Sacral Hiatus In Indians: Its Clinical Importance

ABSTRACT

Introduction: Sacral hiatus (SH) is a significant landmark during caudal epidural block (CEB) which is employedfor analgesia and anaesthesia during a wide range of clinical conditions. This requires a thorough knowledge ofmorphometric characteristics of SH and surrounding landmarks, but variability in morphometric dimensionsexists among different populations.Aim: The aim of this study was to identify different anatomical landmarks to detect the location of SH andprovide a reference database for morphometric dimensions of SH in Indian population.Materials and Methods: The study was done on 108 dry adult human sacra. Linear measurements of the sacrawere taken with the help of digital vernier caliper and angular parameters were determined with a goniometer.Results: The most common shape of the sacral hiatus was inverted ’V’ shaped (59.3%) with the level of the apexat S4 in 66.7% and base at S5 in 86.1% cases. Morphometric dimensions of SH were found to be smaller in presentstudy as compared to reports by other researchers. Left crest-apex angle was observed to be significantly greaterthan the right crest-apex angle. (p 0.001).Conclusion: Multiple bony landmarks and their morphometric dimensions should be considered to locate the SHduring CEB. Values for various morphometric parameters of SH are less in Indians in comparison to otherpopulations, which should be contemplated during caudal epidural injections and trans-sacral thecaloscopy.