COMPARATIVE ASSESSMENT OF GENDER-ASSOCIATED ANATOMICAL VARIATIONS IN SACRAL HIATUS: A CASE-CONTROL STUDY
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Keywords
Sacral hiatus, anatomical variations, gender differences, caudal epidural anesthesia, sacral canal dimensions
Abstract
Background: The sacral hiatus exhibits significant anatomical variations, which can affect the success of caudal epidural anesthesia. Understanding these variations, particularly gender-based differences, is crucial for improving procedural outcomes.
Objectives: To assess and compare gender-associated anatomical variations in the sacral hiatus in a case-control study.
Study Setting: This case-control study was conducted at Nowshera Medical College, Nowshera.
Methods: A total of 135 patients (68 males, 67 females) were included. Demographic data, sacral hiatus dimensions (length, anteroposterior diameter, and transverse width), and shape variations were analyzed. Measurements were performed using radiographic imaging. Gender-based differences in sacral hiatus dimensions were evaluated, and the correlation between age and sacral hiatus dimensions was also assessed. Statistical analysis was conducted using SPSS version 25.0, with results reported as mean ± standard deviation.
Results: The mean sacral hiatus length was 26.5 ± 4.5 mm, with males having a slightly longer hiatus than females. The transverse width was 17.5 ± 2.3 mm in males and 16.8 ± 2.1 mm in females. Inverted-U shape was the most common (45%), followed by the inverted-V shape (30%). A significant correlation between sacral hiatus dimensions and age was observed. Gender-based variations were statistically significant for both length and width (p < 0.05).
Conclusion: Our study found significant gender-associated anatomical variations in the sacral hiatus, which are important for improving caudal epidural anesthesia techniques and reducing procedural failure rates.
References
2. Punja R, Sumalatha S, Afrah F, Hosapatna M. Clinically Relevant Morphometry of Sacral Hiatus and Morphology of Sacrum. Turk Neurosurg. 2023 Jan 1;33(3):373-8.
3. Patra A, Kaur H, Chaudhary P, Asghar A, Samagh N, Walocha JA, Rutowicz B, Brzegowy-Solewska K, Lusina D, Skrzat J. Morphological and morphometric analysis of the Sacral Hiatus using lumbosacral spine CT scans: clinical relevance in Caudal Epidural Analgesia. Folia Morphologica. 2024 Aug 19.
4. Mahato NK. Implications of structural variations in the human sacrum: why is an anatomical classification crucial?. Surgical and Radiologic Anatomy. 2016 Oct;38:947-54.
5. Diel J, Ortiz O, Losada RA, Price DB, Hayt MW, Katz DS. The sacrum: pathologic spectrum, multimodality imaging, and subspecialty approach. Radiographics. 2001 Jan;21(1):83-104.
6. Nasr AY. Clinical relevance of conus medullaris and dural sac termination level with special reference to sacral hiatus apex: anatomical and MRI radiologic study. Anatomical science international. 2017 Sep;92:456-67.
7. Bothsa V, Thaduri N. Morphological And Morphometrical Study Of Sacrum: A Comparative Study Between South And Central Indian Population. Journal of Pharmaceutical Negative Results. 2023 Jan 2:6658-68.
8. Saluja S, Agarwal S, Tuli A, Raheja S, Tigga SR. Morphological Variations of Sacrum in Adult Indian Population. Int J Anat Res. 2022;10(1):8230-37.
9. Shehata MA. Significance of Different Sacral Measurements in Sex Identification and Its Correlation with Caudal Epidural Block; An Egyptian Anatomical Study. Zagazig University Medical Journal. 2023 Jan 1;29(1.1):190-9.
10. Naznin RA, Moniruzzaman M, Sumi SA, Benzir M, Jahan I, Ahmad R, Haque M. Sacralization of Coccygeal Vertebra: A Descriptive Observational Study in Bangladesh. Cureus. 2022 Jul;14(7).
11. Guler A, Senol YC, Akpinar AE, Gunerhan G, Dalgic A. Comparison of the Particulate Steroids, Betamethasone and Methylprednisolone, in Caudal Steroid Injection Under Ultrasound Guidance. World Neurosurgery. 2023 Oct 1;178:e421-6.
12. Bagoji IB, Bharatha A, Prakash KG, Hadimani GA, Desai V, Bulgoud RS. A morphometric and radiological study of sacral hiatus in human adult sacra and its clinical relevance in caudal epidural anaesthesia. Maedica. 2020 Dec;15(4):468.
13. Singh R. Anatomical variations of sacral hiatus and associated clinical relevance-A review. Int J Anat Var. 2017 Dec;4(10):96-8.
14. Jyoti C Nayak, R V Dave. Study of sacral hiatus and its anatomical variation. MedPulse – International Journal of Anatomy. November 2019; 12(2): 42-44.
15. Khokhar SK, Qamar A, Khaliq S, Mehwish A, Ali A, Zehra S. Anatomical variations of sacral hiatus and its associations. The Professional Medical Journal. 2022 Sep 1;29(09):1320-5.
16. Surti A, Khokhar SK, Qamar A, Khaliq S. Radiographic assessment of sacral hiatus anatomy with backache. Pakistan Journal of Medical Sciences. 2023 Nov;39(6):1757.
17. Kujur B, Gaikwad MR. A study of variations in sacral hiatus and its clinical significance. IJIMS 2017; 4(2): 204-12.
18. 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
19. Gökçek E, Kaydu A. Determination of the optimal angle for needle insertion during caudal epidural steroid injection in adults using ultrasound imaging.Iran. Red Crescent Med J 2018; 20(8):876-81.
20. Park GY, Kwon DR, Cho HK. Anatomic differences in the sacral hiatus during caudal epidural injection using ultrasoundguidance. J Ultrasound Med 2015; 34: 2143-8
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Afsheen Khan
Assistant Professor Department of Anatomy, Shaheed Mohtarma Benazir Bhutto Medical College, Liyari
Khalida Moeed
Associate Professor Department of Anatomy, Quetta Institute of medical Sciences
Muhammad Haris
Associate Professor Department of Anatomy, Nowshera Medical College, Nowshera
Saadia Muzadar
Associate Professor Department of Anatomy, Watim Medical & Dental College Rawat, Rawalpindi
Faiza Irshad
Associate Professor of Anatomy Azra Naheed Medical College, Lahore
Aftab Alam Tanoli
Associate Professor of Forensic Medicine and Toxicology Loralai Medical College, Loralai