Sacral Index Research Articles

Use of computed tomography to evaluate pelvic canal in cats.

The objective of this study was to establish an evaluation technique for the feline pelvic cavity using computed tomography (CT). Client-owned cats with a normal pelvis (n = 50) or pelvic stenosis (n = 3) were included. We categorized pelvic CT images in the normal pelvis group into two types according to pelvic cavity shape, then calculated the sacral index (SI), pelvic canal area (PCA), and PCA/sacral width index (PSI). The reference intervals of these variables were determined based on the results in the normal pelvis group. In the normal pelvis group, the PSI, unlike the SI and PCA, was not affected by body weight. In addition to high intraobserver and interobserver reproducibilities, the PSI showed no significant differences according to pelvic cavity shape. However, the SI exhibited significant differences among pelvic cavity shapes. In the stenosis group, the postoperative PSI in all cats was within the reference interval. However, the postoperative SI in one case was lower than the reference interval. The PSI may become a new method for evaluation of the pelvic cavity, including the pelvic floor.

Results of transanal irrigation in intestinal dysfunction associated with anorectal malformations.

There are multiple tools available to optimize defecation in patients with anorectal malformation (ARM), such as habits, laxatives, and retrograde or anterograde irrigations, which are usually adapted in a progressive and combined fashion. The objective of this study was to assess the incorporation of transanal irrigation (TAI) to constipation and fecal incontinence treatment in patients with ARM. A retrospective study of ARM patients with indication of TAI according to the colorectal pathology unit's intestinal management protocol from 2015 to 2022 was carried out. Following use for over 3 months, patients or their guardians completed a phone survey of our own approved by the ethics committee. 39 ARM patients participated in the study. Pathologies included 11 rectourethral fistulas, 6 rectovesical fistulas, 16 cloacae, 2 rectovaginal fistulas, 2 perineal fistulas, and 2 vestibular fistulas. 44% of them had a sacral index <0.4. 62% had constipation, and 38% had incontinence. Thanks to TAI, confidence and safety improved in a very high and a high degree in 89% of the patients, whereas time devoted to intestinal management decreased a lot in 68% of them. 79% reported a 9- and 10-point quality-of-life improvement. 92% rated overall satisfaction with TAI with a score of 8, 9, and 10 - 10 meaning "completely satisfied." 100% recommend TAI. TAI is a good alternative for the intestinal management of fecal incontinence and constipation.

Determination of Sexual Dimorphism of the Human Sacrum Based on Receiver Operating Characteristic Curve Analysis of Morphometric Parameters.

Background Sex estimation of unidentified incomplete skeletons poses a challenge to paleoanthropologists and forensic experts. The sacrum is a part of the axial skeleton and contributes to the formation of the pelvic girdle. It is a significant bone for the identification of the sex in the human skeletal system due to associated functional differences of the pelvic bones in males and females. However, there is a lack of cognizance of different morphometric parameters of the sacrum which may be crucial for determining sex, particularly when a part of the bone is available. This study aimed to recognize the best morphometric parameters for the identification of the sex of the sacrum even when fragmented bones were available and compare the various parameters for sexual dimorphism in different populations. Methodology The study was conducted on 110 dry adult human sacra in the anatomy department. Out of these, 42 sacra were female and 68 were male. Morphometric measurements were performed with the help of a digital vernier caliper. Statistical analysis was performed using SPSS version 17.0 (SPSS Inc., Chicago, IL, USA). Morphometric measurements of male and female sacra were compared using Student's t-test. The receiver operating characteristic (ROC) curve analysis was performed to establish the most appropriate cut-off values for each parameter. Results The mean sacral length measured from the promontory to the apex of the sacrum was higher in males compared to females (p < 0.001), whereas the sacral index was higher in female sacra in comparison to male sacra (p < 0.001). Furthermore, the mean height of the first posterior sacral foramina (PSF) was higher in male sacra bilaterally (p < 0.05). On ROC analysis, the area under the curve was 0.994 for the sacral index and 0.862 for the sacral length. Conclusions In this study, the sacral index was noted to be the most important morphometric parameter for the identification of the sex of the sacra. Additionally, the height of the S2 body, the height of the first anterior sacral foramina, and the height of the first PSF can be contemplated with an accuracy of 60-70% if only a part of the sacrum is available for determining the sex. Hence, this study emphasizes the significance of morphometric parameters of the sacrum in the determination of sex, especially in forensic cases when the skull and pelvis are fragmented or unavailable.

Determination of Sex of Sacrum in Adult Bangladeshi People by Morphometric Study

Background: Sex determination from bones is of vital importance in anthropological studies and medico-legal cases. Sacrum is one of the bones, which exhibits sex differences. Literature available on this bone shows that not much study has been done in the population of Bangladesh. In the present study, an attempt has been made to test the validity of the parameters that are useful in differentiating male and female sacra. The present study was conducted to see the sexual dimorphism and morphometry of sacrum in adult Bangladeshi people. This study will be useful for anatomists, experts in forensic medicine and physical anthropologist for more accurate sexing of sacra.&#x0D; Materials and methods: Descriptive, cross-sectional study was conducted in the Department of Anatomy, Chittagong Medical College, Chattogram on 100 dry human sacra of known (Male-46, female-56) sex during January 2014 to December 2014. The measurements included for the study were maximum length, maximum width, mid ventral curved length, transverse diameter of first sacral vertebra, length of ala, maximum length of auricular surface and indices like curvature index, sacral index, corporo-basal index, alar index, index of body of S1, auricular index were calculated and statistically analyzed.&#x0D; Results: In the present study the male sacrum showed significantly higher values for ventral straight length, ventral curved length, transverse diameter of S1 and antero-posterior diameter of S1 than the female sacrum, while the female sacral index showed higher value compared with the values of male.&#x0D; Conclusion: From the above parameters and indices in the present study revealed demarking points for each have statistical significant role in determining the male and female sacrum.&#x0D; IAHS Medical Journal Vol 4(2), June 2021; 2-4

Morphometric study of sacrum and its clinical implications in population in Bihar

The sacrum is a large triangular bone formed by fusion of five sacral vertebrae and wedged between two hip bones. Dimension of sacrum varies from region to region therefore morphometric study of sacrum in population of Bihar is important for proper fixation during orthopedic procedure in trauma patients. : The objectives of this study was to evaluate the morphometric parameters of sacrum so that a data can be generated from local population. M: The present study was done on 110 human sacra of known sex (62 male and 48 female) collected from department of Anatomy, IGIMS, Patna and also from other medical colleges of Bihar. Maximum length of sacrum, curved length of sacrum, maximum breadth of sacrum, antero-posterior diameter of the body of first sacral vertebra, transverse diameter of the body of first sacral vertebra and maximum length of articular surface of sacrum were measured. Mean value of sacral straight length were 104.55 cm in male and 94.66 cm in female, Curve length 112.03 cm in male and 103.98 cm in female, Width of sacrum 101.53 cm in male and 105.67 cm in female. Transverse diameter of body of 1st sacral vertebra were 46.53 cm and 40.85 cm in male and female respectively, antero-posterior diameter of body of 1st sacral vertebra were 29.89 cm and 27.73 cm in male and female respectively, Length of auricular surface were 56.08 cm and 54.77 cm respectively. Sacral index, curvature index, index of body of first sacral vertebra, corpora-basal index and auricular index were calculated. Morphometric study of sacrum in population of Bihar is important because dimension of sacrum varies from region to region and this is important for proper fixation during orthopedic procedure in trauma patients.

Anorectal malformation in children

The lecture presents modern information about embryogenesis, associated anomalies, diagnosis, and treatment of various forms of anorectal malformations (ARM) in children. During the initial examination of ARM children the authors recommend the following sequence of actions for a neonatologist and a surgeon: catheterization the esophagus in order to exclude combined esophageal atresia; survey radiography of the abdominal organs in direct or lateral projections to exclude concomitant duodenal atresia, dilated intestinal loops and primary assessment of the condition of the spine and sacrum; echocardiography to detect concomitant heart and large vessel defects (occur in 30% of ARM newborns), Ultrasound of the kidneys and bladder. A special X-ray study to determine the location of the intestine al atresia is carried out by a pediatric surgeon no earlier than 18-24 hours after birth in newborns without an anus on the perineum. It is believed that after this period of time, the gas will fill the atresized part of the intestine, which is determined on the side image at the level of the coccyx or sacrum or in the abdominal cavity, depending on the type of pathology. To determine the prognosis of the functional state of the pelvic organs before surgery, it is recommended to determine the sacral index, since a visual assessment of the state of the sacrum and coccyx (counting the number of vertebrae) in most cases does not allow a quantitative assessment of the detected changes. The bowel management program provides training for the patient’s parent or child on how to empty the bowel in order to achieve a “clean” period (without constipation and fecal smearing) during the day. The schedule is developed individually for each patient, usually within one week. The issues of postoperative rehabilitation of patients at the stage of treatment in the clinic are discussed.

Sacrum morphometry and spinopelvic parameters among the Indonesian population using computed tomography scans.

This is a cross-sectional study. This study aims to describe the characteristics of sacrum vertebrae and spinopelvic parameters among the Indonesian population and compare them with studies from other populations. This study also intends to determine the sexual dimorphism of sacrum vertebrae and find the correlations between spinopelvic parameters.Morphometry of the sacrum is necessary for designing sacral prosthesis and instrumentations. Knowledge of spinopelvic parameters further supports the prosthesis installation procedure to restore the physiological spinal alignment of the patients. However, previous studies showed varied results among different populations. This is the first study to be conducted among the Indonesian population.Morphometric dimensions of sacrum vertebrae and the spinopelvic parameters (pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis) were analyzed using thin-cut (1 mm) computed tomography images in 150 males and 150 females, aged 25 to 50 years without any spinal pathology.Generally, the size of the sacrum vertebrae was greater in males (P < .05). The sacral index, curvature index, and corporo-basal index were statistically different between genders (P < .001). Lumbar lordosis was the only spinopelvic parameter found significantly greater in females (P < .001). Significant positive correlations between all spinopelvic parameters, except for lumbar lordosis and pelvic tilt, were found in the present study (P < .001).The study serves as the first large series database of sacrum morphometric characteristics and spinopelvic parameters of the Indonesian population. There was significant gender-associated differences in various dimensions of sacrum vertebrae. The sacral index was found to be the most useful parameter for sex determination. There were strong significant positive correlations between various spinopelvic parameters. A comparison of populations revealed morphometric characteristic differences, which is proved to be critical in surgical implications.

Results of treatment of fifty children with persistent cloaca in one center

BACKGROUND: The preserved cloaca is a particular type of anorectal anomaly. The combination of urological, genital, and rectal abnormalities makes radical reconstruction difficult. MATERIALS AND METHODS: This study examined operations performed in 50 patients with persistent cloaca treated from 2010 to 2021. Two groups are presented: the first with 35 children and a short canal (3 cm), and the second with 15 children and a long canal (3 cm). We examined the prognosis for bowel control, the type of operation, the need for vaginal reconstruction, complications after surgery, and the days of hospital stay. RESULTS: Anomalies of the Mllerian ducts in the second group (94%) were higher than in the first (36%) (p 0.001). The sacral index and myelodysplasia did not differ in both groups. The sacral index in the first group was 0.62 0.14, and in the second group, it was 0.58 0.14 (p = 0.520). Myelodysplasia in the first group was 33%, and in the second group, it was 38% (p = 0.744). Total urogenital mobilization (51%) was used in the first group, and abdominal reconstruction (54%) was used in the second group. Vaginal reconstruction was required in 28% of patients in the first group and 60% in the second group. Complications were 3.5 times more likely in the first group (60% versus 17% in the second) (p = 0.003). The length of hospital stay in patients in the second group was longer than that of patients in the first group. CONCLUSION: Our study data demonstrate that the reconstruction of a persistent cloaca requires individual planning of the operation, considering the length of the canal and the state of all structures forming the cloaca.

Comparison of the sacral ratio between children with Hirschsprung disease and non-Hirschsprung

Background: Hirschsprung's disease is a congenital gastrointestinal disorder that is the most common cause of intestinal obstruction in children. One of the factors that influence gastrointestinal disorders is the sacrum bone. The sacral index can review the evaluation of the sacral bone, an instrument that can evaluate the development of the sacral bone in different clinical conditions. This study assessed the value of the sacral ratio in children with Hirschsprung's disease and non-Hirschsprung's disease at Dr. Hospital. Hasan Sadikin Bandung.Methods: This study was a descriptive-analytic study with a case-control design. Sampling was done retrospectively by collecting medical record data and the enema barium readings from October 2019 to July 2020. The study was conducted at the Department of Radiology Hospital Dr. Hasan Sadikin Bandung from September to October 2020. Data processing uses an unpaired T-test.Results: The total sample was 58 objects, consisting of 29 with Hirschsprung’s disease and 29 non-Hirschsprung, with an average age of Hirschsprung’s disease was 3.14±3.905 years. In the Hirschsprung’s disease group, the mean sacral ratio value was 0,62 and, and the mean sacral ratio in the non-Hirschsprung group was 0,74. Statistical test results with unpaired T-test showed significant mean differences in the case and control groups (p=0.0001).Conclusion: The sacral ratio value in children with Hirschsprung’s disease compared to non-Hirschsprung were different significantly.

Comparison of Single versus Double Lateral Plating in Treatment of Feline Ilial Fractures Using Veterinary Cuttable Plates.

The aim of this study was to compare the frequency of implant failure and the extent of pelvic canal narrowing associated with the fixation of ilial fractures in cats with a single veterinary cuttable plate (SLP) or double veterinary cuttable plates (DLP) applied to the lateral surface of the ilium. Radiographic evaluation of feline ilial fractures plated laterally using SLP or DLP. Pelvic canal narrowing directly postoperatively and at 6 weeks follow-up was objectively measured using the sacral index (SI). Radiographs were evaluated for implant failure and fracture healing. Seventy-seven cats satisfied the inclusion criteria. Twenty-nine fractures were treated with a SLP and 48 with DLP. Implant failure occurred significantly more (p = 0.001) in the SLP group (14/29) compared with the DLP group (6/48). Follow-up SI was significantly different between the two groups (p = 0.048, SLP median: 1.0 range: 0.83-2.4, DLP median: 0.98; range: 0.76-1.45). Median change in SI was -0.04 (range: -1.4 to 0.05) in the SLP group and 0.0 (range: -0.23 to 0.23) in the DLP group. This difference was significantly different (p = 0.031). DLP leads to significantly less implant failure and significantly less pelvic canal narrowing compared with SLP. This difference in pelvic canal narrowing was small and the clinical relevance remains unclear.

Determination of Sex by Sacral Index in South Indian Population

Determination of Sex by Sacral Index in South Indian Population

Sex Determination from Radiological Assessment of the Sacrum in Nepalese Population: A Cross-sectional Study

Introduction: Human skeleton shows variable degree of sexual dimorphism, but definitive inference can be obtained from only a few bones, sacrum being one of them. The morphometric differences of the bone will be helpful to obstetricians, as it shows special adaptations in females for child bearing. It is also important for physical anthropologists and forensic scientists for sex determination. The aim of this study was to find out whether sex could be determined by using sacral parameters from X-ray images of pelvis. Methods: The study included antero-posterior X-ray images of pelvis with clearly visible 680 sacra (311 of males and 369 of females) obtained by computer generated random numbers from records in the Department of Radiodiagnosis of a medical college in Nepal. X-ray images with the sacrum suspected for fractures and pathological diseases were excluded. Inbuilt software “CR Konica Minolta Aero DR/CR CS7” was used for measurements. Results: The mean sacral length and mean transverse diameter of S1 vertebra were higher in males; whereas, mean sacral breadth, mean left ala length, mean right ala length, mean ala length, mean sacral index and mean alar index were higher in females. These differences in sacral parameters between the two sexes were statistically significant (p&lt;0.05). The percentage of bones identified by demarking points of sacral index was 15.17% and 0.32% respectively in the males and the females. Conclusion: The result of the present study supported determination of sex of an individual from radiological assessment of sacrum.

Sacral index and its clinical importance in human dry sacral bones - Morphometric study

Sacral Index is the most important parameter in assessing the sexual dimorphism. A total of 42 dry adult human sacral bones of known sex (19 – female sacra; 23-male sacra) collected from Anatomy Department, Santhiram Medical College, Nandyal. The sacral length measured from the promontory to the middle of antero-inferior margin of last sacral vertebra. The sacral breadth measured from the lateral most points of ale of sacrum. The sacral index (SI) is calculated and statistically analyzed. We noted the mean sacral index 101.142+2.148 in male sacra, and 103.668+2.271 in female sacra with significantly higher sacral index in female sacra than male sacra in the present study. Our study acknowledges the importance of sacral index and its significance can be useful in sexual dimorphism.

A study on sacral index and its uses in sex determination

The human sacrum is a complex structure and provides accommodation for spinal nerves which stabilises the pelvis. Morphometric measurements of sacrum determine the sex of the individual. The measurement of sacral index using the sacrum bone is considered as one of the best methods for determination of sex. The aim of this study is to find out the importance of sacral index in sexual dimorphism and to compare the findings with various age groups. 100 fully ossified sacral bones were collected from department of Anatomy. Average sacral length and breadth were taken by using sliding Vernier caliper and sacral index was calculated. The obtained values were tabulated against their respective parameters and then interpreted for the study. Avergae sacral index in females (109) is significantly greater than males (94). As per present study sacral index can reliably identify 58% of male sacrum and 42% of female sacrum. It is therefore a quite reliable and significant criteria for sex determination of sacrum. Thus, regional and racial differences in sacrum along with sacral index can be used for anatomical, medico-legal and anthropological purposes.

Identification of Sex of Sacrum in Karnataka Population

35 male and 35 females adult, non pathological dried sacra were studied. The height and width was measured with vernier caliper. In comparison of height of sacrum, the mean value of male was 106.4(SD±0.30) and female 90.1(SD±0.16), ‘t’ test was 395, and P value was highly significant (P<0.01). In the comparative study of width of the sacrum mean value of males was 99.3 (SD±0.44) and female was 112 (SD±0.08) ‘t’ test was 122.65 and P value was highly significant (P<0.01). The sacral Index of male was 93.3 and female was 124.27. This significant value to differentiate the male and female genders will be quite useful to medico legal expert anthropologist and anatomist because these obtained value represent the regional or ethnic study of sacra. Moreover morphometric values of mesodermal derivatives are un-certain.

Significance of Different Sacral Measurements in Sex Identification and Its Correlation with Caudal Epidural Block; An Egyptian Anatomical Study

Background: Sacrum is an important bone of the human skeleton. It contributes in the formation of the pelvic girdle. It has many clinical applications. So this study was performed to demonstrate the different dimensions and measurements of the sacrum to make it easy for identifying sex and performing caudal epidural block.Material and Methods: An anatomical study on 50 adult Egyptian dry complete undamaged sacra was performed in the Human Anatomy and Embryology department, Faculty of Medicine, Zagazig University, Egypt. The parameters used in this study were the different dimensions of the sacrum including the morphology of the sacral hiatus, the extensions of the auricular surface, the sacral index and the auricular index. All the measurements were performed by using a Vernier digital caliper with accuracy of 0.1mm. The measurements were recorded and their mean and standard deviations were calculated.Results: It was found that the mean values of sacrum width and height, transverse diameter of the wing and the base of sacrum were more in males than females. While auricular surface length, sacral and auricular indices were higher in females than in males. Also the mean values of width and height of the sacral hiatus were more in males than females.Conclusions: The sacral index and the maximal sacral length and width were the most significant of all the parameters used for sex identification. Also, the determination of the anatomical variations of the sacral hiatus may be helpful in increasing the success rate of caudal epidural anaesthesia.

SIGNIFICANCE OF SACRAL INDEX IN ESTIMATION OF SEX IN NORTH INDIAN POPULATION

Introduction: For the assessment of sexual dimorphism of human skeleton, pelvis has been used with great accuracy by anthropologists and forensic experts. Sacrum, being an integral part of pelvis, has therefore gained importance. Among the various parameters of sacrum, sacral index is the most reliable one, calculated by the formula: Sacral index=max breadth x100/max length of sacrum. This study aimed to determine the significance of sacral index in estimation of sex in north Indian population. Materials and methods: For the present study, 35 dry human sacrum bones were obtained from the Department of Anatomy, KGMU, Lucknow, out of which 32, free of deformity, were used in study. The bones were first separated as male and female on the basis of their gross features. Maximum length and breadth of sacra were measured using digital sliding Vernier calliper and sacral index was calculated. Results: Mean sacral index was significantly higher in females (109.52) as compared to males (92.37). Sex determination done on the basis of gross features were comparable to that done by calculation of sacral index, except in sacrum no. 5,13,14,15 &amp;16. Sacrum no. 5,13,14 &amp;15 were more curved forwards (female feature) while their sacral indices were much lesser (male feature). Sacrum no. 16 had a uniform curvature (male feature) while its sacral index was&gt;105 (female feature). Sacrum no. 16 also had only 3 dorsal and ventral foramina, which was a variation. Conclusions: Sacral index is a reliable criterion for sex determination, useful for anatomical, medicolegal and anthropological purposes.

ROLE OF SACRUM IN SEX DETERMINATION IN WEST BENGAL POPULATION

Background: Sex classification of a bone is possible with a degree of certainty only if it can be compared to a series of bones of known sexual dimorphism. Different parameters and indices are available based on which the sex can be determined using sacrum. Thus, it always attracted the attention of the medico-legal experts for establishing the sex, because of its contribution to pelvic girdle and associated functional sex differences. Objective: Study the sexual dimorphism and regional differences of the varied features of the sacrum in West Bengal population and compare the significant anthropometric indices with similar observations across India. Material and method: The study comprised of 50 adult sacra (35 male and 15 female), obtained from the department of anatomy and department of forensic medicine of ICARE Institute of Medical Sciences and Research and Haldia Institute of Dental Sciences and Research, Haldia, West Bengal. Different parameters viz. mid ventral straight length, mid ventral curved length, ventral straight breadth, transverse diameter of base, transverse diameter of body of S1, antero-posterior diameter of body of S1, breadth of alae were measured and indices viz. sacral index, longitudinal curvature index and corporobasal index were calculated and statistically analyzed. Result: Sacral index was found to be the most useful criterion for identification of sex followed by breadth of alae, corporobasal index and the ventral straight breadth. Conclusion: In the present study, out of the eleven parameters of the sacrum, seven parameters yielded statistical significance between the two sexes. Therefore, it can be concluded that sex determination of the sacrum with 100% accuracy may possible only when maximum number of parameters are taken into consideration.&#x0D; Keywords: Sacrum, sexual dimorphism, sacral parameters, sacral index

Conservative management of sacroiliac luxation fracture in cats: medium- to long-term functional outcome.

The aim of this study was to determine the functional medium- to long-term outcome for cats with a conservatively managed sacroiliac luxation fracture (SILF). Inclusion criteria were conservative management of SILF in cats with no other concurrent fractures of the pelvic weightbearing axis and availability of radiographs for review. Radiographic measurements of percentage displacement of the sacroiliac joint and the sacral index were obtained and fracture configuration was assessed. A specific owner questionnaire was completed a minimum of 6 months after the injury. The questionnaire assessed the ability of the cat to perform normal activities, the time to recovery, any behavioural changes and any requirement for long-term analgesia. Seventeen cats met the inclusion criteria, and 13 owners completed the questionnaire. Twelve cats had an excellent outcome, with no difficulty performing normal activities. One cat had a good outcome, with slight or occasional difficulty performing normal activities. Our study provides evidence to support the current guidelines of conservative management of SILF. The inherent bias of case selection in our population implies that this treatment cannot be recommended for all cases of SILF.

Study of Sacral Index: Comparison between Different Study

Study of Sacral Index: Comparison between Different Study