A Semi-quantitative Evaluation of Out-to-Out Agenesis of Posterior Wall in a Dry Human Sacrum in Bangladesh

Background: Each vertebra is formed by combining the distal portion of one somite and the cranial half of its proximate part. HOX genes regulate the patterning of the shapes of the non-identical spinal column. In the sacral area, anatomical dissimilarity is on account of the distinct shape of the sacral hiatus and the outright non-subsistence of the posticous embankment of the sacral neural tube, which is a consequence of the non-fulfillment of bonding of lamina of all sacral vertebrae. After that, the meninges and the spinal nerve are unprotected and undiagnosable without an X-ray examination. Therefore, it is difficult to detect the reasons for caudal block failure, low back pain, etc. The current research aimed to improve the proficiency of anatomical and developmental errors of the dorsal wall of the sacrum. Methods: This study was conducted on 60 dried adult sacra of unknown sexes from the stock wing of Anatomy, Sylhet MAG Osmani Medical College, Bangladesh, from 2017 to 2018. The undefined gender of the sacrum was identified. Results: Out of 60 sacra, 30 (50.0%) were found to be that of males and 30 (50.0%) of females. Among the study samples, only three (5%) samples presented a complete absence of the sacrum's dorsal wall and and incidence among males was higher than females. Conclusion: This type of sacral aberration has paramount clinical importance. Thereby avoiding caudal epidural block-connected sufferings and backbone operative procedures. The expertise regarding the anatomical variation of sacral hiatus is necessary to reduce the failure rate during caudal epidural anesthesia, helps orthopedic surgeons diagnose the cause of low back pain or in surgical situations, and helps pediatricians deal with congenital anomalies such as meningocele and myelomeningocele.