Difficulties Encountered in Epiduroscopy due to Narrowness of the Sacral Canal: Two Case Reports.

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  • 仙骨管の狭小により硬膜外内視鏡を断念した２症例

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Flexible fiber optic epiduroscopy (FEE) from the sacral hiatus into a saline-expanded lumbar epidural space is a new technique to permit diagnostic and theraptic interventions in the lumbar spine.We treated thirty-eight patients with FEE. Unfortunately, in two cases (5.2%), FEE was impossible due to the overt narrowness of the sacral canal. Because caudal block was successful by performed before FEE, we were not able to envisage the narrowness of the sacral canal. The anteroposterior diameter of the sacral canal at the level of the apex of the hiatus must be sufficiently large to admit a FEE guidecatheter (diameter=2.7mm). Trotter found that there were approximately 5.0% with a diameter of 2.0mm or less. We recommend that the diameter of the hiatus be assessed by x-ray or MRI examination before FEE.

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