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Sacral Perforating Vessels

vasa perforantia sacralia

The sacral perforating vessels are branches of the lateral sacral arteries and veins that pass through the sacral foramina to supply the sacral nerve roots, the piriformis, and the overlying gluteal skin. They exit through the posterior sacral foramina as the segmental sacral vessels.

Region: Lower Back

Clinical Relevance

Clinical Notes

Sacral perforating vessels are damaged in sacral fractures producing epidural haematoma and neural compression. They are the basis for sacral perforator flaps used in pressure sore reconstruction. During sacrectomy, each sacral foramen must be controlled to prevent vessel retraction into the sacral canal where haemostasis is impossible. The vessels are identified and coagulated during posterior sacral approaches.

Pathology

Common Injuries & Conditions

Sacral Perforator Haemorrhage

Bleeding from sacral perforating vessels during sacrectomy or sacral fracture producing epidural haematoma compressing the sacral nerve roots, requiring careful vessel control at each sacral foramen during surgical decompression.