Variations of the sciatic nerve anatomy and blood supply in the gluteal region: a review of the literature

Abstract

Variations of the sciatic nerve anatomy and blood supply are complex and largely not dealt with in common anatomy texts. Variations of the sciatic nerve anatomy can be divided into the height of division of its branches, relation of the branches to the piriformis muscle, and its blood supply. These variations should be well known to any surgeon operating in this anatomical region. It is unknown whether these variations increase the risk of surgical injury and consequent morbidity. This paper will review the current knowledge regarding anatomical variations of the sciatic nerve and its blood supply.

Lumbar artery branches coursing vertically over the intervertebral discs of the lower lumbar spine: an anatomic study

“…Although the anatomy and blood supply of the sciatic nerve have been described in detail [13], there have been no detailed anatomic studies of the branches of the lumbar artery and blood supply to the lumbar plexus. Arslan et al observed that the anastomotic arteries ran vertically approximately 4 mm anterior to the base of the transverse process [12].…”

Siyatik sinirin varyasyon anatomisi ve klinik yansımaları

“…The variations of sciatic nerve in gluteal region contribute to nerve palsy during the posterior approach total hip arthroplasty since this surgical approach involves detaching the piriformis tendon and the other short external rotators of the hip from the trochanter and upper thigh. Retraction of piriformis muscle may be responsible of stretching and damage to the nerve (3,24,25). Smoll (2010) mentioned that if type B, D or E variations were present, all or a part of sciatic nerve pierced the piriformis muscle and retraction can cause sciatic nerve compression as the muscle retracts medially, pulling on the nerve (5).…”

“…During this route, the anatomy of the sciatic nerve and its branches have several anatomical variations. The variations of piriformis muscle, sciatic nerve and its branches have clinical importance during surgical interventions and some other clinical approaches (1)(2)(3)(4)(5)(6).…”

“…The cause of sciatica is piriformis syndrome approximately 6-8% of patients (1,5). It is still a poorly understood clinical syndrome relating to the proper diagnosis and most effective form of treatment (1,2,3,9,10). Sciatic nerve variants were considered as a possible unrecognized etiology in the piriformis syndrome by some authors (7,8,(11)(12)(13).…”

Repensar a Ciatalgia Perante Variação Anatómica Bilateral do Nervo Isquiático, com Origem Baixa e Divisão Alta: Importância Histórica, Anatómica e Clínica

“…A síndrome do piriforme, como causa do quadro clínico de ciatalgia, continua actualmente a suscitar estudos internacionais e tentativas de modernização da abordagem clínica. 40,41,42 A hipótese de maior frequência de agenésia ou trajecto curto do tronco do nervo isquiático pode colocar importantes ilações clínicas e cirúrgicas, 39 como no caso de bloqueios anestésicos, 37,44 na terapêutica conservadora da ciatalgia, 45 e também sobretudo nos procedimentos técnicos e seguimento clínico de casos de artroplastia da anca, 36,39,[43][44][45] cujo número crescente se deve ao envelhecimento gradual da população, para além do crescimento da cobertura populacional mundial em termos de cuidados de saúde.…”