Sacral Intervertebral Approach for Caudal Block in Infant Corpses

Abstract

Due to the difficulties arising from anatomic variations of the sacral hiatus and concerns about the risk of infection in injections through the sacral hiatus, an alternative approach to the sacral canal could be via the sacral intervertebral space. To evaluate this approach in 34 infant corpses, 1 cc of methylene blue was injected through tne midpoint of a line drawn between the posterior sperior iliac spines. One to three days later, the lumbo-sacral area was dissected. The relationship between the spinal cord and dural sac with injection site and the correct placement of the injections was evaluated. It was found that in 88.24% of the cases, injections were correct (in the sacral canal) and actually made through S2-S3 interspace. The spinal cord was found to end at the upper border of the L3 vertebra in 85% of the cases, and the dural sac at S2 level in all. It was concluded that an injection through the point described above could be an alternative and safe approach to the caudal canal in the new-born.