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Title: Anatomical variations of sacral hiatus and its associations.
Authors: Samia Khalid Khokhar, Aisha Qamar, Saneed Khaliq, Ayesha Mehwish, Ahmed Ali, Shabih Zehra
Journal: The Professional Medical Journal (TPMJ)
Publisher: Independent Medical College, Faisalabad- Pakistan
Country: Pakistan
Year: 2022
Volume: 29
Issue: 9
Language: English
DOI: 10.29309/TPMJ/2022.29.09.6995
Keywords: BackacheAnatomical VariationsSacral Hiatus
Objective: To compare anatomy of sacral hiatus between the genders of case and control groups. To determine significance of hiatal variations between the genders of cases and controls. Study Design: Case-control study. Setting: PNS Shifa Hospital Karachi. Period: January 2020 to June 2020. Material & Methods: Total of 178 participants aged 18-65 years were enrolled in the study. Approval was taken from Ethical Review Committee of Bahria University Medical and Dental College (BUMDC). Participants were arranged into case and control groups. The hiatus and its dimensions were identified on lumbosacral spine radiographs inferior to the sacral spine using spinous and alar processes. Data was recorded in subject evaluation proforma and analyzed using SPSS version 23.0. Results: The V shaped hiatus was more prevalent in males, whereas in females it was U. The most common variant was the irregular shape. The hiatal apex in males was at S3. In females it was at S2. The base was seen at S5 in both genders. The mean length, anteroposterior diameter and transverse width of the hiatus was more in males as compared to females. The mean values of all parameters were less in cases as compared to controls. Conclusion: The V shaped sacral hiatus were most prevalent in males, whereas U shape in females. The hiatal apex was at a lower level in males, whereas the level of base was similar in both genders. The hiatus was shorter in cases of backache in both genders as compared to controls. The anteroposterior diameter and width were also less in cases as compared to the healthy controls.
To compare the anatomy of the sacral hiatus between genders in case and control groups and to determine the significance of hiatal variations between these groups.
A case-control study was conducted at PNS Shifa Hospital Karachi from January 2020 to June 2020, involving 178 participants aged 18-65 years. Participants were divided into case (backache) and control (asymptomatic) groups. Sacral hiatus and its dimensions were identified on lumbosacral spine radiographs. Data was analyzed using SPSS version 23.0.
graph TD;
A["Participant Recruitment 178 adults, 18-65 yrs"] --> B["Ethical Approval"];
B --> C["Group Allocation Cases: Backache, Controls: Asymptomatic"];
C --> D["Lumbosacral Spine Radiographs"];
D --> E["Identification of Sacral Hiatus and Dimensions"];
E --> F["Data Recording in Proforma"];
F --> G["Data Analysis SPSS v23.0"];
G --> H["Comparison of Hiatal Parameters Gender, Case/Control"];
H --> I["Conclusion"];
The study found significant differences in sacral hiatus shapes between genders in the control group, with V-shape more common in males and U-shape in females. While hiatal apex levels differed between genders in cases, the base level was similar. Hiatal dimensions (length, width, depth) were generally smaller in individuals with backache compared to controls, suggesting an association between these variations and back pain. The knowledge of these variations is crucial for procedures like caudal epidural anesthesia.
- V-shaped hiatus was more prevalent in males, while U-shaped was more prevalent in females.
- The most common variant shape was irregular.
- The hiatal apex was at S3 in males and S2 in females.
- The base of the hiatus was at S5 in both genders.
- Mean length, anteroposterior diameter, and transverse width of the hiatus were greater in males compared to females.
- Mean values of all parameters were less in cases (backache) compared to controls.
Anatomical variations of the sacral hiatus are common and differ between genders. Smaller hiatal dimensions (length, width, depth) in cases with backache compared to controls indicate a strong association with this condition. Understanding these variations is essential for successful clinical interventions, particularly caudal epidural anesthesia.
- The study involved 178 participants aged 18-65 years.
- The study period was from January 2020 to June 2020.
- The V-shaped hiatus was more prevalent in males, and the U-shaped hiatus was more prevalent in females.
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