Journals / Ağrı / 2020 / Cilt: 32 - Sayı: 1

Anatomical differences in sacral hiatus during caudal epidural injection with ultrasonography guidance and its effects on success rate

Ultrasonografi rehberliğinde uygulanan kaudal epidural enjeksiyon sırasında sakral hiatusdaki anatomik farklılıklar ve başarı oranına etkisi

Journal
Ağrı
Pages
19–24
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

According to current evidence, the success rate of caudal epidural steroid injection increased when the anatomical structures of sacral hiatus are shown correctly in USG guided.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objectives: To investigate the anatomical differences of sacral hiatus, pain levels and success rates during caudal epidural steroid injection (CESE) using ultrasonography.
📊
Key Findings & Data:Methods: In the study, 255 patients (148 male and 107 female) with lower lumbar back pain and sciatica were included.
💡
Conclusion & Impact:According to current evidence, the success rate of caudal epidural steroid injection increased when the anatomical structures of sacral hiatus are shown correctly in USG guided.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objectives: To investigate the anatomical differences of sacral hiatus, pain levels and success rates during caudal epidural steroid injection (CESE) using ultrasonography. Methods: In the study, 255 patients (148 male and 107 female) with lower lumbar back pain and sciatica were included. These patients were applied caudal epidural steroid injection by ultrasonography. Sonograms were obtained by ultrasonography (USG) guideline. Patients’ pain levels were assessed by the Visual Analogue Scale (VAS) during the CESE procedure performed on USG guided, and success rates were saved. The intercornual distance, sacral distance and sacrococcygeal ligament thickness were measured. Results: There was no statistically significant difference between the demographic data of the patients (p>0.05). There was a significant difference between male and female patients concerning intercornual distance (15.8 versus 16.6 mm; p=0.004) and sacrococcygeal ligament thickness (4.1 mm vs. 3.7 mm; p=0.018). There was no significant difference between patients about KESE success rate, VAS values and sacral distance (p>0.05). Conclusion: We found that sacral hiatus has anatomical differences between male and female patients. According to current evidence, the success rate of caudal epidural steroid injection increased when the anatomical structures of sacral hiatus are shown correctly in USG guided.

Özet

Amaç: Bu çalışmada kaudal epidural steroid enjeksiyonu (KESE) işlemi sırasında sakral hiatusun anatomik yapısındaki farklılıkları ultrasonografi (USG) eşliğinde incelemeyi, KESE sırasında ağrı düzeylerini ve başarı oranını değerlendirmeyi amaçladık. Gereç ve Yöntem: USG eşliğinde KESE uygulanan alt lomber bel ağrısı ve siyatik ağrısı olan 255 (148’i erkek, 107’i kadın) hasta çalışmaya dahil edildi. Tüm hastaların USG kılavuzluğunda sonogramları elde edildi. KESE işlemi esnasında hastaların ağrı düzeyleri vizüel analog skala (VAS) ile değerlendirildi ve başarı oranları kaydedildi. Anatomik hesaplamalarda interkornual mesafe, sakral mesafe ve sakrokoksigeal ligament kalınlığı ölçümü yapıldı. Bulgular: Hastaların demografik verileri arasında istatistiksel açıdan anlamlı bir fark saptanmadı (p>0.05). Erkeklerle kadınlar arasında, interkornual mesafe (16.6 mm’ye karşı 15.8; p=0.004) ve sakrokoksigeal ligament kalınlığı (4.1 mm’ye karşı 3.7 mm; p=0.018) açısından anlamlı bir fark vardı. KESE başarı oranı, VAS değerleri ve sakral mesafe açısından hastalar arasında anlamlı bir fark yoktu (p>0.05). Sonuç: Sakral hiatusun erkek ve kadın hastalar arasında anatomik farklılıklara sahip olduğunu tespit ettik. Mevcut kanıtlara göre USG eşliğinde sakral hiatusun anatomik yapıları doğru bir şekilde gösterildiğinde KESE’nin başarı oranı artmaktadır

🔖

Cite This Article

GÖKÇEK, E., KAYDU, A. (2020). Anatomical differences in sacral hiatus during caudal epidural injection with ultrasonography guidance and its effects on success rate. Ağrı, Cilt: 32 - Sayı: 1, 19–24. https://ajindex.com/articles/139249

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (13)

  1. Karppinen J, Ohinmaa A, Malmivaara A, Kurunlahti M, Kyllönen E, Pienimäki T, et al. Cost effectiveness of periradicular infiltration for sciatica: subgroup analysis of a randomized controlled trial. Spine (Phila Pa 1976) 2001;26(23):2587–95
  2. Riew KD, Yin Y, Gilula L, Bridwell KH, Lenke LG, Lauryssen C, et al. The effect of nerve-root injections on the need for operative treatment of lumbar radicular pain. A prospective, randomized, controlled, double-blind study. J Bone Joint Surg Am 2000;82(11):1589–93
  3. Vad VB, Bhat AL, Lutz GE, Cammisa F. Transforaminal epidural steroid injections in lumbosacral radiculopathy: a prospective randomized study. Spine (Phila Pa 1976) 2002;27(1):11–6
  4. White AH, Derby R, Wynne G. Epidural injections for the diagnosis and treatment of low-back pain. Spine (Phila Pa 1976) 1980;5(1):78–86
  5. Price CM, Rogers PD, Prosser AS, Arden NK. Comparison of the caudal and lumbar approaches to the epidural space. Ann Rheum Dis 2000;59(11):879–82
  6. Sekiguchi M, Yabuki S, Satoh K, Kikuchi S. An anatomic study of the sacral hiatus: a basis for successful caudal epidural block. Clin J Pain 2004;20(1):51–4
  7. Aggarwal A, Kaur H, Batra YK, Aggarwal AK, Rajeev S, Sahni D. Anatomic consideration of caudal epidural space: A cadaver study. Clin Anat 2009;22(6):730–7
  8. Crighton IM, Barry BP, Hobbs GJ. A study of the anatomy of the caudal space using magnetic resonance imaging. Br J Anaesth 1997;78(4):391–5
  9. Park JH, Koo BN, Kim JY, Cho JE, Kim WO, Kil HK. Determination of the optimal angle for needle insertion during caudal block in children using ultrasound imaging. Anaesthesia 2006;61(10):946–9
  10. Chen CP, Tang SF, Hsu TC, Tsai WC, Liu HP, Chen MJ, et al. Ultrasound guidance in caudal epidural needle placement. Anesthesiology 2004;101(1):181–4
  11. Manchikanti L, Singh V, Cash KA, Pampati V, Damron KS, Boswell MV. Effect of fluoroscopically guided caudal epidural steroid or local anesthetic injections in the treatment of lumbar disc herniation and radiculitis: a randomized, controlled, double blind trial with a two-year follow-up. Pain Physician 2012;15(4):273–86
  12. Senoglu N, Senoglu M, Oksuz H, Gumusalan Y, Yuksel KZ, Zencirci B, et al. Landmarks of the sacral hiatus for caudal epidural block: An anatomical study. Br J Anaesth 2005;95(5):692–5
  13. Chen CP, Wong AM, Hsu CC, Tsai WC, Chang CN, Lin SC, et al. Ultrasound as a screening tool for proceeding with caudal epidural injections. Arch Phys Med Rehab 2010;91(3):358–63.