DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20204910

Incidence of complete agenesis of dorsal wall of sacral canal: study of dry human sacra

Mritunjay Pandey

Abstract


Background: The human sacrum is a large, triangular shield-shaped bone formed by the fusion of five separate vertebrae along with the inter-vertebral discs. Gross morphology of sacrum shows a concave ventral surface, a convex dorsal surface and a triangular sacral canal. The sacral canal consists of an anterior wall formed by the fusion of the posterior aspect of the bodies of sacral vertebrae and the dorsal wall is formed by the fused laminae, spines and ossified ligamentum flava. Spina bifida is a developmental defect of sacral vertebrae, where the dorsal wall of sacral canal is partially or completely absent. The present study is an attempt to verify the incidence of complete agenesis of dorsal wall of sacral canal.

Methods: Eighty six dry human sacra were collected from the undergraduate students and department of anatomy of three different medical colleges of Uttar Pradesh for the study of dorsal wall of sacral canal.

Results: Out of eighty six bones studied, two (2.33%) of the bones showed complete absence of the dorsal wall of the sacral canal.

Conclusions: Complete agenesis of dorsal wall of sacral canal may lead to partial or complete failure of caudal epidural anaesthesia. Association between dorsal sacral agenesis and some other congenital malformations have also been reported by few authors. Anatomical knowledge of these variations of dorsal wall of sacral canal is important for anaesthetists, radiologists and spine surgeons.


Keywords


Sacrum, Sacral agenesis, Spina bifida, Caudal epidural anaesthesia

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References


Standring S. Gray’s anatomy: the anatomical basis of clinical practice. 41st ed. London: Elsivier; 2016: 726-729.

Moore K, Persaud T, Torchia M. Before we are born: essentials of embryology and birth defects. 9th ed. Philadelphia: Elsivier; 2016.

Sadler TW. Langman's medical embryology. 13th ed. Philadelphia: Wolters Kluwer; 2015.

Singh R. Classification, causes and clinical implications of sacral spina bifida occulta in Indians. Basic Sci Med. 2013;2(1):14-20.

Shinde A, Manikar P, Bharambe V. Dorsal sacral agenesis: a study on dry sacrum bones. Indian J Clin Anat Physiol. 2018;5(2):157-60.

Nagendrappa RB, Jayanthi KS. Study of dorsal wall of sacrum. Int J Res Med Sci. 2014;2(4):1325-8.

Saha D, Bhadra RC. A morphometric study of complete agenesis of dorsal wall in dry human sacrum in West Bengal population. Indian J Basic Appl Med Res. 2016;6(1):226-30.

Banerjee A, Shrivastava T, Kumar S. Agenesis of dorsal wall of sacrum: a case report. Sch Int J Anat Physiol. 2018;1(3):84-6.

Poornima SC. Complete dorsal wall defect in a dry human sacrum: a case report. Int J Med Res Health Sci. 2013;2(2):290.

Vanitha V, Fatima T, Kadlimatti H. Complete dorsal wall agenesis of sacrum: a case report. J Dent Med Sci. 2014;13(4):80-1.

Gaikwad M, Kujur B, Jain M, Das S, Behera S. Complete agenesis of dorsal wall of sacral canal: a case report. Cureus. 2019;11(9):e5720.

Qi BQ, Beasley SW, Frizelle FA. Evidence that the notochord may be pivotal in the development of sacral and anorectal malformations. J Pediatr Surg. 2003;38:1310-6.

Aragão J, Oliveira O, Filho J, Aragão I, Aragão F, Reis F. Occurence of complete agenesis of the sacral canal dorsal wall. Acta Sci Anat. 2019;1(3):164-8.