Morphologic diversities of sacral canal in children; three-dimensional computed tomographic study

Area of Science:

• Pediatric Anesthesiology
• Anatomical Imaging
• Skeletal Morphology

Background:

• Caudal block is a standard pediatric pain management technique.
• Previous research focused on needle trajectory, not sacral structure variations.
• Limited data exists on the anatomical variations of the sacrum in children.

Purpose of the Study:

• To investigate and analyze the anatomical variations of sacral canals in pediatric patients.
• To provide a detailed understanding of sacral structural differences in children.

Main Methods:

• Analysis of 3D computed tomographic (CT) images from 143 children.
• Evaluation of sacral vertebral lamina fusion and intervertebral spaces.
• Classification of sacral hiatus types based on cornua presence and vertebral arch characteristics.

Main Results:

• 15.4% of children showed unfused sacral vertebral arches.
• Sacral cornua were absent in 3.5% (bilaterally) and 4.2% (unilaterally).
• Sacral hiatus types II and III were observed in 15.4% and 21.7% of cases, respectively.

Conclusions:

• Significant anatomical variations exist within the pediatric sacral canal.
• Accurate identification of anatomical landmarks is essential for successful procedures.
• Findings highlight the need for individualized approaches in pediatric caudal blocks.