Morphometric analysis and clinical anatomy of sacrum and sacral hiatus in Turkish healthy adults

Year 2020, Volume: 45 Issue: 2, 672 - 679, 30.06.2020

Sema Özandaç Polat , Ayşe Gül Kabakcı , Fatma Yasemin Öksüzler Mahmut Öksüzler Ahmet Hilmi Yücel

https://doi.org/10.17826/cumj.651175

Cited By: 1

Abstract

Purpose: This study is carried out to evaluate the anatomy and clinical significance of the sacrum which forms the posterior wall of pelvis and hiatus sacralis shapes.
Materials and Methods: One hundred twenty three (60 females and 63 males) of Turkish healthy subjects aged between 18 and 70 having brain CT with various reason in the Radiology Department in this retrospective study. The sacrum maximum length, sacrum maximum breadth, sacral index obtained from the ratio of the sacrum breadth to sacrum length multiplied by 100 were measured and calculated. Additionally, the hiatus sacralis shapes were evaluated and classify.
Results: Sacrum maximum length, 106.70±12.88mm; sacrum maximum width, 127.67±14.72mm; and sacral index 120.11±14.64 were calculated in females, respectively. The same parameters were 118.87±14.03mm, 126.45±12.77mm, and 108.48±16.50 in males, respectively. Also, the most frequent type of sacral hiatus were inverted U in females and inverted V in males, respectively. Moreover, there were a significant difference between sacrum length and sacral index and gender.
Conclusion: Knowing the anatomy of the sacrum, and sacral hiatus shapes and making of morphometric measurements of it, is of clinical importance in terms of preventing the complications and the surgical intervention which will practice to this area in the pathologies of the area by orthopaedic surgeons, obstretricians, paediatricians, anaesthecians and anatomists.

Keywords

Sacrum index, sacral hiatus, gender and age related changes

Sağlıklı Türk yetişkinlerinde os sacrum’un ve hiatus sacralis’in klinik anatomisi ve morfometrik analizi

Abstract

Amaç: Bu çalışma, pelvis arka duvarını oluşturan os sacrum’un anatomisini ve klinik önemini değerlendirmek ve hiatus sacralis şekillerini ortaya koymak için yapıldı.
Gereç ve Yöntem: Bu retrospektif çalışmaya yaşları 18 ile 70 arasında değişen ve çeşitli nedenlerle Radyoloji bölümünde Bilgisayarlı Tomografi çektiren yüz yirmi üç (60 kadın; 63 erkek) sağlıklı Türk popülasyonu dahil edildi. Os sacrum’un maksimum uzunluğu, os sacrum’un maksimum genişliği, os sacrum genişliğinin os sacrum maksimum uzunluğuna bölünüp 100 ile çarpılmasıyla elde edilen sakral indeks değeri ölçüldü. Ayrıca, hiatus sacralis şekilleri değerlendirilerek sınıflandırma yapıldı.
Bulgular: Kadınlarda sırasıyla os sacrum’un maksimum uzunluğu 106,70±12,88 mm os sacrum’un maksimum genişliği 127,67±14,72 mm, ve sakral indeks 120,11±14,64 olarak bulunurken, aynı parametreler sırasıyla erkeklerde 118,87±14,03 mm, 126,45±12,77 mm, ve 108,48±16,50 olarak ölçüldü. Ayrıca, en sık görülen hiatus sacralis şekli kadınlarda U şekilli hiatus sacralis iken erkeklerde V şekilli hiatus sacralis olarak belirlendi. Aynı zamanda, os sacrum uzunluğu ve sakral indeks değerleri ve cinsiyet arasında anlamlı farklılık bulundu.
Sonuç: Os sacrum’un anatomisinin bilinmesi ve morfometrik ölçümlerinin yapılması os sacrum’u ilgilendiren patolojilerde bu bölgeye uygulanacak girişimlerde ve oluşabilecek komplikasyonların önlenmesi açısından ortopedi uzmanı, kadın doğum uzmanı, pediatrist, anestezist ve anatomistler açısından kinik öneme sahiptir.

Keywords

sacrum indeksi, hiatus sacralis, yaş ve cinsiyete bağlı değişkenler

References

• Taner D. Fonksiyonel Anatomi Ekstremiteler ve Sırt Bölgesi. 4. Baskı, Ankara: HYB Basım Yayın, 2009, 218-9.
• Simriti NS, Ashwani Sharma RM. Morphological and Morphometric Study of Dry Human Sacra in Jammu Region. JK Science. 2017;19(3):154-6.
• Arıncı K. Elhan A. Anatomi. 3.Baskı, Ankara: Güneş Kitabevi, 2001.
• Stranding S. Gray’s Anatomy. The Anatomical Basis of Clinical Practice. 41th Ed. London: Elsevier, 2016.
• Hansen JT. Netter’s Clinical Anatomy. 4th Ed. Newyork: Elsevier, 2018.
• Cheng JS, Song JK. Anatomy of the sacrum. Neurosurg Focus. 2003; 15 (2):1-4.
• Duman T. Yetişkinlerde os sacrum’un çok kesitli bilgisayarlı tomografi ile morfometrik incelenmesi (Yüksek lisans tezi). Konya. Selçuk Üniversitesi, 2009:63.
• Ozan H. Ozan Anatomi. 3. Baskı. Ankara: Klinisyen Tıp Kitabevleri, 2014, 38-40.
• Nastoulis E, Karakasi MV, Pavlidis P, Thomaidis V, Fiska A. Anatomy and clinical significance of sacral variations: a systematic review. Folia Morphologica. 2019;1-45.
• Bagheri H, Govsa F. 2017. Anatomy of the sacral hiatus and its clinical relevance in caudal epidural block. Surg Radiol Anat. 39(9):943-951. doi: 10.1007/s00276-017-18231.
• Osunwoke EA, Oladipo G.S, Alison T.A, et al. 2014. A study of sacral hiatus in dry human sacra in Southern Nigeria. Journal of Biology, Agriculture Healthcare (JBAH). 4(5): 43-48.
• Phalgunan V, Baskaran S. 2013. Morphometric analysis of sacral hiatus and its clinical significance. Health Agenda. 1:10-15.
• Suwanlikhid N, Lakchayapakorn K, Mahakkanukrauh P. 2013. The position and size of sacral size of sacral hiatus in Thai dry human sacra. Thammasat Medical Journal. 13(3):313-319.
• Başaloğlu H, Turgut M, Taşer FA, Ceylan T, Başaloğlu HK, Ceylan AA. Morphometry of the sacrum for clinical use. Surgical Radiol Anat. 2005;27:467-71.
• Kothapalli J, Velichety SD, Desai V, Zameer MR. Morphometric study of sexual dimorphism in adult sacra of South Indian population. Int J of Biol Med Res. 2012;3(3):2076-81.
• Janipati P, Kothapalli J, Shamsunder RV. Study of sacral ındex: comparison between different regional populations of India and abroad. Int J Anat Res. 2014;2(4):640-44.
• Wagner D, Kamer L, Sawaguchi T, Richards RG, Noser H, Hofmann A, Rommens PM. Morphometry of the sacrum and its implication on trans-sacral corridors using a computed tomography data-based three-dimensional statistical model. The spine Journal. 2017;17:1141-7.
• Vasuki AKM, Sundaram KK, Nirmaladevi M, Jamuna M, Hepzibah DJ, Fenn TKA. Anatomical variations of sacrum and its clinical significance. International Journal of Anatomy and Research. 2016;4(1):1859-63.
• Laishram D, Ghosh A, Shastri D. A study on the variations of sacrum and its clinical significance. IOSR. 2016;15(6):8-14.
• Singh R. Anatomical variations of sacral hiatus and associated clinical relevance - A review. International J ournal of Anatomical Variations. 2017;4(10):96-8.
• Mustafa MS, Mahmoud OM, El Raouf HHA, Atef HM. Morphometric study of sacral hiatus in adult human Egyptian sacra: Their significiance in caudal epidural anesthesia. Saudi J Anaesth. 2012; 6(4): 350-7.
• Koç T, Ertekin T, Acer N, Çınar Ş. Os sacrum kemiğinin morfometrik değerlendirilmesi ve eklem yüzey alanlarının hesaplanması. Erciyes Üniversitesi Sağlık Bilimleri Dergisi. 2014; 23(2): 67-73.
• Patel S, Nigam M, Mishra P, Waghmare CS. A study of sacral index and its interpretation in sex determination in Madhya Pradesh. J Indian Acad Forensic Med. 2014;36(2):146:9.
• Kumar A, Wishwakarma N. An anthropometric analysis of dry human sacrum:gender discrimination. IJSR. 2015;4(4):1305-10.
• Sachdeva K, Singla RK, Kalsey G, Sharma G. Role of sacrum in sexual dimorphisim A morphometric study. J Indian Acad Forensic Med. 2011;33(3):206-10.
• Sinha MB, Rathore M, Trivedi S, Siddiqui AU. Morphometry of first pedicle of sacrum and its clinical relevance. Int J of Healthcare & Biomedical Research. 2013; 1(4):234-240.
• Acar M, Alkan ŞB, Durmaz MS, Seçkin E, Öztemel K, Sezgin Z, Akbaba A. Sakrum’un Multidedektör Bilgisayarlı Tomografi Yöntemi İle Morfometrik Analizi. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 2018;20(2):125-30.
• Comas J, Charles C. Manual of Physical Anthropology. Thomas Springfield Illionois, USA, 1961; 41.
• Isaac UE, Ekanem TB, Igiri AO. Gender Differentiation in the adult Human sacrum and the subpubic angle among indigenes of cross river and Akwa Ibom States of Nigeria using radiographic films. Anatomy Journal of Africa, 2014; 3 (1): 294- 307.
• McGrath MC, Stringer MD. Bony landmarks in the sacral region: the posterior superior iliac spine and the second dorsal sacral foramina: a potential guide for sonography. Surg Radiol Anat (2011) 33:279–286.
• Seema SM, Mahajan A. An Anatomical Study of Variations of Sacral Hiatus in Sacra of North Indian Origin and Its Clinical Significance. Int. J. Morphol., 31(1):110-114, 2013.
• Rajeev D, Surekha J, Medha D, Manoj A, Ashwini D. Variatıons in anatomical features of the sacral hiatus in Indian dry sacra. International Journal of Medical Research Health Sciences. 2014;3(3):634-8.