The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Morphologic Diversities of Sacral Canal in Children;Three-Dimensional Computed Tomographic Study

  • Kim, Dae Wook (Zeropain Clinic) ;
  • Lee, Seung Jun (Seoul Pain Clinic) ;
  • Choi, Eun Joo (Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital) ;
  • Lee, Pyung Bok (Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital) ;
  • Jo, Young Hyun (Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital) ;
  • Nahm, Francis Sahngun (Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital)
  • Received : 2013.12.30
  • Accepted : 2014.06.05
  • Published : 2014.07.01
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Abstract

Background: Caudal block is a common technique in children for reducing postoperative pain, and there have been several reports on the variations of the sacral canal in children. However, previous studies have mainly focused on the needle trajectory for caudal block, and there is limited information on the structural variations of the sacrum in children. The purpose of this study was to analyze the anatomic variations of sacral canals in children. Methods: Three-dimensional computed tomographic images were analyzed. The data from the images included (1) fusion of the sacral vertebral laminae and the sacral intervertebral space (2) existence of the sacral cornua and (3) the types of sacral hiatus. The types of sacral hiatus were classified into 3 groups: group I (fusion of S3 or S4 vertebral laminae), group II (unfused vertebral arch with the distance of the S3 and S4 vertebral laminae < 50% of the distance between the cornua), and group III (unfused vertebral arch with the distance of the S3 or S4 vertebral laminae ${\geq}50%$ of the distance between the cornua). Results: A total of 143 children were included in this study. All of the sacral vertebral arches were not fused in 22 children (15.4%). Cornua were not identified bilaterally in 5 (3.5%) and unilaterally in 6 (4.2%) children. In the sacral hiatus, group II and group III were identified in 22 (15.4%) and 31 (21.7%) children, respectively. Conclusions: The sacral canal has various anatomical variations in children. Careful attention must be paid to identify the correct anatomic landmark.

Keywords

References

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