A study of the anatomy of the caudal space using magnetic resonance imaging

We have studied, in 37 adult patients, the anatomy of the sacral extradural (caudal) space using magnetic resonance imaging The sacrococcygeal membrane (SCM) could not be detected in 10.8% of patients. The maximum depth of the caudal space adjacent to the SCM was beneath the upper third of the SCM in more than 90% of patients (mean depth 4.6 mm; range 1.0-8.0 mm). The shortest linear distance from the dura to the upper limit of the SCM varied considerably (60.5 mm; 34-80 mm) as did the volume of the caudal space excluding the foraminae and dural sac (14.4 cm(3); 9.5-26.6 cm(3)). The dimensions of the caudal space and their variability have implications for clinical practice and a knowledge of these dimensions may increase both the reliability and safety of caudal techniques in adult patients.