Feasibility of percutaneous dural sac puncture via a posterior trans-sacral foraminal conduit approach: a CT morphometric analysis.

Autor: Dhawan SS; Department of Bioengineering, Stanford University Schools of Engineering and Medicine, Stanford, USA., Necker FN; Stanford IMMERS (Incubator for Medical Mixed and Extended Reality), Department of Radiology, Stanford University School of Medicine, Stanford, USA.; Institute of Functional and Clinical Anatomy, Digital Anatomy Laboratory, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany., Massoud TF; Division of Neuroimaging and Neurointervention, and Stanford Initiative for Multimodality Neuro-Imaging in Translational Anatomy Research (SIMITAR), Department of Radiology, Stanford University School of Medicine, Stanford, USA. tmassoud@stanford.edu.; Department of Radiology, Stanford University Center for Academic Medicine, Radiology, MC: 5659; 453 Quarry Road, Palo Alto, CA, 94304, USA. tmassoud@stanford.edu.
Jazyk: angličtina
Zdroj: Neuroradiology [Neuroradiology] 2023 Oct; Vol. 65 (10), pp. 1555-1559. Date of Electronic Publication: 2023 Apr 06.
DOI: 10.1007/s00234-023-03147-4
Abstrakt: We assess the theoretical feasibility of percutaneous posterior sacral foramen (pSF) needle puncture of the sacral dural sac (DS) by studying the three-dimensional imaging anatomy of pSFs relative to the sacral canal (SC). On CT images of 40 healthy subjects, we retrospectively studied sacral alae passageways from SC to pSFs in all three planes to determine if an imaginary spinal needle could theoretically traverse S1 or S2 pSFs in a straight path toward DS. If not straight, we measured multiplane angulations and morphometrics of this route. We found no straight connections between S1 or S2 pSFs and SC. Instead, there were bilateral spatially complex dorsoventral M-shaped "foraminal conduits" (FCs; common, ventral, and dorsal) from SC to anterior SFs and pSFs that would prevent percutaneous straight needle puncture of the DS. This detailed knowledge of the sacral FCs will be useful for accurate imaging interpretation and interventional procedures on the sacrum.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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