Back to Search
Start Over
Anatomic Differences in the Sacral Hiatus During Caudal Epidural Injection Using Ultrasound Guidance
- Source :
- Journal of Ultrasound in Medicine. 34:2143-2148
- Publication Year :
- 2015
- Publisher :
- Wiley, 2015.
-
Abstract
- OBJECTIVES The aim of this study was to clarify differences in the anatomic structure of the sacral hiatus and angle of needle insertion during caudal epidural steroid injection using ultrasound guidance in patients according to sex and age. METHODS A total of 237 patients with low back pain with or without sciatica were included. Sonograms of the sacral hiatus were obtained, and caudal epidural steroid injection using ultrasound guidance was performed in all patients. The intercornual distance, diameter of the sacral canal, thickness of the sacrococcygeal ligament, optimal angle for needle insertion, and actual angle of needle insertion were measured. RESULTS Between men and women, significant differences were observed for the intercornual distance (17.7 versus 16.5 mm; P< .01) and thickness of the sacrococcygeal ligament (4.3 versus 3.9 mm; P = .02). In all patients, the thickness of the sacrococcygeal ligament (r= 0.28) and diameter of the sacral canal (r= 0.40) were positively correlated with the optimal angle for needle insertion (P < .01). In women, the thickness of the sacrococcygeal ligament (r = -0.24), diameter of the sacral canal (r = -0.27), optimal angle for needle insertion (r = -0.29), and actual angle of needle insertion (r = -0.18) were negatively correlated with age. In men, only the diameter of the sacral canal was negatively correlated with age (r = -0.30). CONCLUSIONS We found that the sacral hiatus has anatomic differences between patients of different sexes and ages. Understanding these differences, especially in women, may improve the safety and reliability of caudal epidural steroid injection.
- Subjects :
- Adult
Male
Sacrum
Sensitivity and Specificity
Sciatica
Age Distribution
Prevalence
medicine
Humans
Radiology, Nuclear Medicine and imaging
Sex Distribution
Ultrasonography, Interventional
Aged
Retrospective Studies
Aged, 80 and over
Sex Characteristics
Radiological and Ultrasound Technology
Sacral canal
business.industry
Reproducibility of Results
Anatomy
Middle Aged
musculoskeletal system
Low back pain
Ultrasound guidance
Treatment Outcome
medicine.anatomical_structure
Ligament
Female
Steroids
Caudal epidural
medicine.symptom
business
Anesthesia, Caudal
Sacral hiatus
Subjects
Details
- ISSN :
- 02784297
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- Journal of Ultrasound in Medicine
- Accession number :
- edsair.doi.dedup.....1032215e67f2e02f333af90bf8204aa0