Anatomical Relationships of the Sciatic Nerve and Pudendal Nerve to the Ischial Spine as They Exit the Greater Sciatic Foramen.

Autor: Hanna AS; Department of Neurological Surgery, University of Wisconsin - Madison, Madison, Wisconsin, USA; Department of Biomedical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA. Electronic address: ah2904@yahoo.com., Staniszewski TM; Department of Neurological Surgery, University of Wisconsin - Madison, Madison, Wisconsin, USA., Omar AH; Department of Neurological Surgery, University of Wisconsin - Madison, Madison, Wisconsin, USA; Department of Neurosurgery, Cairo University, Giza, Egypt., Guevara-Moriones N; Department of Medicine, Universidad Juan N. Corpas, Bogotá, Colombia., Moscote-Salazar LR; Department of Neurological Surgery, University of Wisconsin - Madison, Madison, Wisconsin, USA., Hilger KH; Department of Neurological Surgery, University of Wisconsin - Madison, Madison, Wisconsin, USA., Hellebrand DJ; Department of Neurological Surgery, University of Wisconsin - Madison, Madison, Wisconsin, USA; Department of Biomedical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2024 Mar; Vol. 183, pp. e564-e570. Date of Electronic Publication: 2024 Jan 03.
DOI: 10.1016/j.wneu.2023.12.147
Abstrakt: Objective: Deep gluteal syndrome is a clinical condition in which discomfort may arise due to the pathoanatomy of the subgluteal space. We conducted an anatomical exploration to categorize the relationship of the piriformis muscle, sciatic nerve (SN), and pudendal nerve (PN) to the ischial spine (IS) and sacrospinous ligament.
Methods: We analyzed 22 cadavers. The piriformis muscle, SN, and PN were exposed through either a transgluteal approach or a gluteal flap. The relationship of the neural structures to the IS, sacrospinous ligament, and ischial bone as they exit the greater sciatic foramen was observed, and the exit zones were classified as zone A, medial to the IS (entirely on sacrospinous ligament); zone B, on the IS; and zone C, lateral to the IS (entirely on ischial bone).
Results: The SN was observed either in zone B or zone C in all specimens. The PN was found to be in either zone A or zone B in 97.6% of specimens. The most common combinations were SN in zone B and PN in zone A (type I), and SN in zone C and PN in zone B (type II).
Conclusions: The results from this study show clear anatomical differences in the SN-PN relationship, which may play a role in pain seen in deep gluteal syndrome. Moreover, classification of the SN-IS and PN-IS relationships described in this article will help describe different pathologies affecting the deep gluteal area.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: