Digital post-mortem to evaluate sacral anatomy: Situations for a minimal invasive method to the spinal canal by the hiatus sacralis.
Surg Neurol Int. 2017;eight:290
Authors: Bodmer A, Ross S, Raabe A, Beck J, Ulrich CT, Schucht P
Background: Regardless of a number of benefits of minimally invasive strategies in spinal surgical procedure, the at the moment used approaches could result in postoperative ache and spinal instability. As a pure orifice, the hiatus sacralis presents a nontransmuscular various entry level for endoscopic approaches. On this examine, we collected knowledge concerning the complicated anatomical circumstances of the sacral canal as a foundation for the event of a sacral endoscope.
Strategies: We retrospectively evaluated 192 postmortem human cadaveric specimens with computed tomography (CT). The anatomical circumstances of the sacrum and lumbar backbone had been analyzed, together with evaluation of the lateral and anteroposterior diameters, measurement of the cross-sectional space of the sacral canal on the lumbosacral transition, hiatus sacralis, and the narrowest level of the sacral canal.
Outcomes: The narrowest anteroposterior diameter was >2.three mm in 95% of the circumstances; the width was >13 mm in 95% of the circumstances. The narrowest level was positioned on the hiatus in 72% of the circumstances. The angle of sacral kyphosis was lower than 30° and fewer than 50° in lumbar lordosis in 95% of the circumstances. A size shorter than 288 mm was measured in 95% of the circumstances. Anatomical circumstances in female and male sacra had been comparable.
Conclusions: The slender anteroposterior diameter is the important thing limiting characteristic for utilizing the canalis sacralis as a pure entry level into the spinal canal. Sacroscopy would require endoscopes with a flattened form, with parallel association of devices and adaptability to accommodate the various dorsal and ventral curvatures.
PMID: 29285406 [PubMed]