PMC6197695_01
Transverse ultrasound image of the sacrum at the level of the sacrococcygeal ligament showing the ligament and the sacral cornu.
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Ultrasound imaging (GE 12L-RS linear transducer, GE Medical Systems Co., Jiangsu, People's Republic of China) of the sacral hiatus was performed in the transverse and longitudinal views (Figures 1 and 2).
Longitudinal image of the sacrum showing the sacrococcygeal ligament, the base of the sacrum, and the caudal epidural space.
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Ultrasound imaging (GE 12L-RS linear transducer, GE Medical Systems Co., Jiangsu, People's Republic of China) of the sacral hiatus was performed in the transverse and longitudinal views (Figures 1 and 2).
Longitudinal image of the sacrum showing the advancement of the Tuohy needle toward the sacrococcygeal ligament.
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On the first attempt, a 3.5 inch, 17-gauge Tuohy needle (Epimed Spirol  Epidural Set, Epimed International Inc., Dallas, TX, USA) was advanced under ultrasound guidance toward and through the sacrococcygeal ligament into the caudal epidural space (Figure 3).