Abstract
Background: Sacrum is a triangular shaped irregular bone formed by fusion of five sacral vertebrae. Sacrum is also called ‘Hieron osteon’ meaning the holy or sacred bone.
 Methods: The present study has been carried out on 98 completely ossified undamaged dry human sacra of undetermined age and sex in the department of Anatomy in the population of Eastern Uttar Pradesh. Each sacrum is examined for the agenesis of the dorsal surface. Representative photographs of different sacrum having partial or complete agenesis on the dorsal surface are taken using a digital camera
 Result: Elongated sacral hiatus i.e. length more than 40 mm was seen in 5 (5.1%) bones. Maximum sacral hiatal length of 52.6 mm was noted. Elongated sacral hiatus were of two types i.e. inverted U and inverted V shaped. 4 (4.08%) bones showed partial dorsal agenesis of sacrum. Complete dorsal agenesis was seen in 1 sacrum. One bones with absent sacral hiatus was seen.
 Conclusion: Various anomalies on dorsal surface of sacrum were seen in Indian population. Knowledge of these variations will be of help to the Anaesthetists. We conclude that, variant anatomy on dorsal surface of sacrum make administration of caudal epidural anaesthesia difficult. So ultrasound or fluroscopic guidance leads to better patient outcome while giving caudal blocks.
 Keywords: Dorsal sacral agenesis, sacral hiatus, caudal epidural block
Highlights
Sacrum is a triangular shaped irregular bone formed by fusion of five sacral vertebrae
Representative photographs of different sacrum having partial or complete agenesis on the dorsal surface are taken using a digital camera Result: Elongated sacral hiatus i.e. length more than 40 mm was seen in 5 (5.1%) bones
Elongated sacral hiatus were of two types i.e. inverted U and inverted V shaped. 4 (4.08%) bones showed partial dorsal agenesis of sacrum
Summary
Sacrum is a triangular shaped irregular bone formed by fusion of five sacral vertebrae. Sacrum is called ‘Hieron osteon’ meaning the holy or sacred bone.[1] The dorsal surface of sacrum demonstrates a lateral sacral crest, intermediate sacral crest and median sacral crest formed by the fusion of transverse processes, articular process and spinous processes of the sacral vertebrae respectively. The lamina of the fifth and sometimes the fourth sacral vertebra don’t fuse to form the spinous process. Caudal epidural anaesthesia is administered through the sacral hiatus. Other variations like absent sacral hiatus and elongated sacral hiatus cause a problem in administering caudal epidural blocks. Other variations like absent sacral hiatus and elongated sacral hiatus cause a problem in administering caudal epidural blocks. 3
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