骶管注射方法（Sacral canal injection）.docVIP

骶管注射方法（Sacral canal injection） 1. meet the pain caused by lumbar sacral tail syndrome neuropathy, L: 5, S: 1 nucleus pulposus herniation, down 5, down S L 1 spinal stenosis, vascular nerve of lower limb disorders, sexual dysfunction etc.. 2. practical anatomy: The dural sac terminates at S down 1 1/4, therefore, S down 1 of the spinal canal called sacral canal. Because of the above anatomical features, when the sacral puncture is used, if the puncture needle is successful, the puncture needle does not penetrate deep into the longitudinal axis of the sacral canal, so there is no worry about the outflow of cerebrospinal fluid through the subarachnoid space. Therefore, the operation is hard, the spinal epidural puncture is simple and the technical requirement is not high, so it is beneficial to popularize and apply in the primary medical unit. S: 1 vertebral depth of 1/4, equivalent to the posterior superior iliac spine line level, sacral injection, should not exceed this level, otherwise there is still through the dura may. However, in fact, only 45% of the patients met this level, while others were at different levels above or below that level. Sacral canal puncture should pay attention to these anatomical changes. The sacral canal is injected mostly through the sacral hiatus into the sacral canal. Sacral hiatus is in fact S not down 5 vertebral fusion and the formation of pores, it became an equilateral triangle and right posterior superior iliac spine. Touch the coccygeal tip, touch along the midline when touching the coccyx, a U shaped depression is the sacral hiatus, the both sides each have a shaped protrusion that sacral angle from the tail end of ridge about 10mm (Fig. 4-23). 3. specific operations (1) the puncture site: the patient in the prone position, the lower abdomen is pillow, the head and legs are lowered and the sacral prominent, easy to find sacral hiatus by law, violet or blue painted a mark, and fixed with iodine. General skin disinfection, shop to