Direct Visualization of the Lumbosacral Epidural Space Through the Sacral Hiatus

Saberski, Lloyd; Kitahata, Luke M.

doi:10.1097/00000539-199504000-00035

Cited by 68 publications

(40 citation statements)

References 1 publication

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“…It is also used for three dimensional colour visualization of lumbosacral epidural space. 4 The sacral hiatus shows variations during its development. Nonfusion of laminae of fourth or the upper vertebrae results in an elongated sacral hiatus.…”

Section: Introductionmentioning

confidence: 99%

Morphometrical study of sacral hiatus in dry human sacra

Parashuram

2015

Int J Res Med Sci

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Section: Introductionmentioning

confidence: 99%

Morphometrical study of sacral hiatus in dry human sacra

Parashuram

2015

Int J Res Med Sci

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“…Dorsal agenesis of sacrum is also one of the differential diagnosis for lower back ache. 15 Saberski et al 16 in a case report of a patient for a theurapeutic steroid epidural injection for persistent radiculopathy, observed that the epidural space can be accessed safely with flexible fiberoptic catheter via the sacral hiatus with subsequent three dimensional color visualization of the contents. They opine that the straight entry allowed for easier maneuvering of the fiberoptic scope and laid the foundation for further fiberoptic guided procedures.…”

Section: Discussionmentioning

confidence: 99%

Dorsal sacral agenesis: A study on dry sacrum bones

2020

IJCAP

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Introduction: Sacral hiatus is the route for caudal epidural block. Dorsal agenesis of sacrum is a known cause for failure of caudal epidural anaesthesia. Material and Methods: 300 dry sacral bones were studied for complete dorsal agenesis, partial dorsal agenesis, elongated sacral hiatus and absent hiatus. Observations and Results: Complete dorsal agenesis was noted in 1.3% bones, elongated sacral hiatus in 3% sacrum and 0.67% bones showed absent sacral hiatus. Conclusion: Variations in the dorsal sacral wall can lead to difficulty in administering caudal blocks. Knowledge of incidence of dorsal agenesis, elongated hiatus and absent hiatus will help anaesthetists to plan for a safer approach.

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“…In 1991, Saberski and Kitahata [7] considered clinical use of these devices for the placement into the epidural space as a diagnostic tool where the caudal approach to the epidural space offer advantage over the paramedian lumbar approach. The authors reported that the caudal approach facilitated correct catheter positioning for administration of epidural steroid for the treatment of radiculopathy.…”

Section: History Of Epiduroscopymentioning

confidence: 99%

Epiduroscopy (Epidural Endoscopy)

Sayhan¹,

Beyaz²

2016

Pain Management

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Epiduroscopy is a relatively new technique used in the evaluation and treatment of low back pain via advancements in optical fiber technology. As a minimally invasive endoscopic technique, it allows for direct endoscopic imaging of the epidural space and helps the patients for the pain management who having post-lumbar surgery syndrome (PLSS) and other cases of low back pain and radiculopathy. An advanced understanding of the anatomy of epidural space and adjacent structures are also essential for positive and successful clinical outcomes. The use of epiduroscopy in the pain clinic is performed as a day procedure, and the patient is awake and can communicate with the doctor. During an epiduroscopy, thin tubes with a bright light and tiny fiberoptic camera at the end are inserted through the sacral hiatus into the epidural space around the dura and guided up toward the affected site. Anterior epiduroscopy and epiduroscopic laser neural decompression (ELND) have been recently introduced in treating herniated disc decompressions, and chronic low back pain and radicular pain, respectively. The most common complications of epiduroscopic approach are the pain in the intervention point, dural puncture, and headache.

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Direct Visualization of the Lumbosacral Epidural Space Through the Sacral Hiatus

Cited by 68 publications

References 1 publication

Morphometrical study of sacral hiatus in dry human sacra

Morphometrical study of sacral hiatus in dry human sacra

Dorsal sacral agenesis: A study on dry sacrum bones

Epiduroscopy (Epidural Endoscopy)

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