The sacral cornua are two small horn-like projections at the lower end of the back of the sacrum, one on each side of the sacral hiatus. They are the remnants of the inferior articular processes of the fifth sacral vertebra. Each joins the matching coccygeal cornu by ligament.
| Articulations |
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| Landmarks |
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| Ossification | Develop from the vertebral arch ossification centres of the fifth sacral vertebra, which fail to fuse in the midline, leaving the hiatus between them. |
The sacral cornua are the main palpable landmark for caudal epidural injection, used for chronic back pain and for anaesthesia in children: the needle enters the sacral hiatus between the two cornua. Their size and the shape of the hiatus between them vary, which partly explains failed caudal blocks. Injury to the sacrococcygeal region from falls can cause pain over the cornua and coccyx.
Difficulty entering the sacral hiatus because of variation in the shape of the sacral cornua and hiatus, leading to an ineffective caudal epidural injection.
Pain at the tip of the spine after a fall onto the buttocks or childbirth, often tender over the sacrococcygeal junction and cornua.
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