Anatomy and Cell Biology

Korean Association of Anatomists (대한해부학회)
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Morphometric analysis of sacral corridor in the upper three sacral segments to prevent neurovascular injury

  • Binita Chaudhary (Department of Anatomy, All India Institute of Medical Sciences Patna) ;
  • Prem Kumar (Department of Radiodiagnosis, All India Institute of Medical Sciences Patna) ;
  • Ruchika Narayan (Department of Radiodiagnosis, All India Institute of Medical Sciences Patna) ;
  • Adil Asghar (Department of Anatomy, All India Institute of Medical Sciences Patna) ;
  • Padamjeet Panchal (Department of Anatomy, All India Institute of Medical Sciences Patna) ;
  • Neelam Kumari (Department of Anatomy, All India Institute of Medical Sciences Patna)
  • Received : 2023.10.26
  • Accepted : 2024.02.17
  • Published : 2024.06.30
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Abstract

Although studies of the sacral corridor dimension have been reported in the European population, little attention has been paid to this issue in the Asian population. The purpose of the study is to estimate the safe dimension of the corridor to avoid neurovascular damage during the fixation of the sacral fracture. The study aimed to examine the cephalocaudal (vertical) and the anteroposterior diameter of the bony passage in the upper three sacral segments. The study further examines the effect of age and sex on corridor dimensions at different sacral levels. Three-dimensionally reconstructed sacra from computed tomography of normal subjects were included in the study. Cephalocaudal and anteroposterior diameters were measured in coronal and axial sections using Geomagic Freeform Plus software. Anteroposterior diameter of the sacral corridor at the first, second, and third sacral segments are significantly higher in males (P=0.013, 0.0011, and <0.0001, respectively). The length of the sacrum also revealed sexual dimorphism (P<0.00016). The anteroposterior diameter of the second sacral segment (ap-S2c) correlated moderately with the first sacral anteroposterior diameter (ap-S1c) (R=0.519, P<0.001). The ap-S2c exhibited a moderate correlation to the third sacral segment (ap-S3c) (R=0.677, P<0.001). The sacral corridor at the level of S1 has the largest cephalocaudal (18.25 mm) and anteroposterior diameter (17.11 mm). Placement of the screw in the first sacral corridor may avoid damage to the neurovascular bundle during the fixation of the sacral fracture.

Keywords

Acknowledgement

The authors acknowledge Md Shamshad Ansari, a 3D artist, and Mr. Ravikant, a 3D Lab application engineer, for reconstructing the sacra.

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