Each of the four paired sacral foramina transmits a sacral spinal nerve and associated vessels, forming short fibro-osseous canals through the sacral bone between the anterior and posterior sacral surfaces. These spaces are the target for sacral nerve root blocks and sacral neuromodulation lead placement.
The sacral foramina are the access points for sacral nerve root blocks at S1-S4 for diagnostic and therapeutic nerve blockade in pelvic pain, bladder dysfunction, and sciatica. Fluoroscopic-guided sacral foramen injection places steroid adjacent to the sacral nerve root within the foraminal canal. S3 foramen is the standard placement site for sacral neuromodulation (Interstim) leads for urinary incontinence and bowel dysfunction.
Sacral nerve root compression within the sacral foraminal canal from sacral fracture fragment, tumour infiltration, or tarlov cyst producing unilateral sacral radiculopathy with perineal pain and bladder/bowel dysfunction.
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