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

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 p...

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Publicado en:Neuroradiology Vol. 65; no. 10; pp. 1555 - 1560
Autores principales: Dhawan, Siddhant S., Necker, Fabian N., Massoud, Tarik F.
Formato: diagnostic images pictorial tables/charts Journal Article
Publicado: Springer Nature Oct2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2023
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00234-023-03147-4
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        atl: Feasibility of percutaneous dural sac puncture via a posterior trans-sacral foraminal conduit approach: a CT morphometric analysis.
      aug:
        au:
          Dhawan, Siddhant S.
          Necker, Fabian N.
          Massoud, Tarik F.
        affil: Department of Bioengineering, Stanford University Schools of Engineering and Medicine, Stanford, USA
      sug:
        subj:
          Sacrum
          Spinal Puncture Methods
          Needles Utilization
          Imaging, Three-Dimensional Methods
          Human
          Retrospective Design
          Descriptive Statistics
          Data Analysis Software
          Tomography, X-Ray Computed Methods
          Fluoroscopy Methods
          Male
          Female
          Adult
          Middle Age
          Aged
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: 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.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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