Variations in the Course of the Inferior Gluteal Nerve and Artery: A Case Report and Literature Review

Abstract

Variations in the course of the inferior gluteal nerve and artery were observed in Japanese cases (4/94 sides). In these variation cases, the inferior gluteal nerve exited the pelvis from the upper edge of the piriformis (suprapiriformis foramen) in 4/4 sides (4.26%). In 2/4 sides (2.13%), the normal inferior gluteal artery was not observed, except that a fine artery exited the pelvis from the inferior piriformis foramen to form an “arch” with the superior gluteal artery under the gluteal maximus in 1/4 side. Moreover, in 1/4 side, a twig of the internal pudendal artery exited pelvis from inferior piriformis foramen and distributed to the surrounding tissues. The present observations of the inferior gluteal nerve and artery course are very important and useful for surgeons and nurses.

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J. Yan, M. Takechi and J. Hitomi, "Variations in the Course of the Inferior Gluteal Nerve and Artery: A Case Report and Literature Review," Surgical Science, Vol. 4 No. 10, 2013, pp. 429-432. doi: 10.4236/ss.2013.410084.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] P. E. Celli, “Sulla Morphologie del M. Piriformis,” Anatomischer Anzeiger, Vol. 41, 1913, pp. 551-560. http://www.biodiversitylibrary.org/item/43338#page/579/mode/1up
[2] G. Gabella, “Gray’s Anatomy,” In: P. L. Williams, Ed., Pelvic Girdle and Lower Limb, 38th Edition, Churchill Livingstone, New York, 1995, pp. 1545-1564.
[3] V. Mahadevan, “Gray’s Anatomy,” In: S. Standing, Ed., Pelvic Girdle and Lower Limb, 40th Edition, Churchill Livingstone, New York, 2008, pp. 1329-1390.
[4] R. A. Bergman, S. A. Thomson, A. K. Afifi and F. A. Saadesh, “Compendium of Human Anatomic Variations,” Urban & Schwarzenberg, Baltimore, Munich, 1988, pp. 84-85.
[5] S. Chiba, “Multiple Positional Relationships of Nerves Arising from the Sacral Plexus to the Piriformis Muscle in Human,” Journal of Anatomy, Vol. 67, No. 6, 1992, pp. 691-724. (in Japanese)
[6] C. Gabrielli, E. Olave, A. Sarmento, C. Mizusaki and J. C. Prates, “Abnormal Extrapelvic Course of the Inferior Gluteal Artery,” Surgical and Radiologic Anatomy, Vol. 19, No. 3, 1997, pp. 139-142.
http://dx.doi.org/10.1007/BF01627962
[7] C. Windhofer, E. Brenner, B. Moriggl and C. Papp, “Relationship between the Descending Branch of the Inferior Gluteal Artery and the Posterior femoral Cutaneous Nerve Applicable to Flap Surgery,” Surgical and Radiologic Anatomy, Vol. 24, No. 5, 2002, pp. 253-257.
http://dx.doi.org/10.1007/s00276-002-0064-z
[8] Z. X. Ling and V. P. Kumar, “The Course of the Inferior Gluteal Nerve in the Posterior Approach to the Hip,” The Bone & Joint Journal, Vol. 88-B, No. 12, 2006, pp. 1580-1583.
http://dx.doi.org/10.1302/0301-620X.88B12.18182
[9] F. S. Anthony, F. M. Michael, W. Gary and B. Kath, “Relationship of Inferior Gluteal Nerve and Vessels: Target for Application of Stimulation Devices for the Prevention of Pressure Ulcers in Spinal Cord Injury”, Surgical and Radiologic Anatomy, Vol. 30, No. 1, 2008, pp. 41-45.
http://dx.doi.org/10.1007/s00276-007-0282-5
[10] S. Mariano and D. M. Gilda, “Exposure of the Sciatic Nerve in the Gluteal Region without Sectioning the Gluteus Maximus: Analysis of a Series of 18 Cases,” Surgical Neurology International, Vol. 3, No. 1, 2012, pp. 15-20. http://dx.doi.org/10.4103/2152-7806.92929
[11] G. C. Cormack and B. G. H. Lamberty, “The Blood Supply of Thigh Skin,” Plastic & Reconstructive Surgery, Vol. 75, No. 3, 1985, pp. 342-354. http://dx.doi.org/10.1097/00006534-198503000-00008
[12] A. Frick, R. G. H. Baumeister and B. Wiebecke, “Microvasculature of the Inferior Gluteal Flap,” European Journal of Plastic Surgery, Vol. 16, No. 1, 1993, pp. 30-32.
http://dx.doi.org/10.1007/BF00192703
[13] M. Tarek, “Superior Gluteal Artery Perforator Flap for Closure of Large Sacral Defects,” Egyptian Journal of Plastic and Reconstructive Surgery, Vol. 28, No. 2, 2004, pp. 175-179.
[14] J. A. Robert, M. L. Maria and W. G. Jay, “Inferior Gluteal Perforator Flaps for Breast Reconstruction,” Seminars in Plastic Surgery, Vol. 20, No. 2, 2006, pp. 89-94. http://dx.doi.org/10.1055/s-2006-941715
[15] B. Adachi, “Anatomische Untersuchungen an Japanern,” Zeitschrift für Morphologie und Anthropologie, Vol. 2, No. 2, 1900, pp. 198-222.
[16] C. R. Bardeen and A. W. Elting, “A Statistical Study of the Variations in the Formation and Position of the Lumbosacral Plexus in Man,” Anatomical Record, Vol. 19, No. 1, 1901, pp. 209-232.
[17] M. Hasimoto and K. Toyama, “The Relationship of the Sacral Nerve and Piriformis Muscle in Chinese,” Acta Anatomica Nipponica, Vol. 19, No. 2, 1942, pp. 171-184. (in Japanese)
[18] G. Odajima and T. Kurihara, “Supplementary Findings to the Morphology of M. Piriformis,” Journal of Showa Medical Society, Vol. 20, No. 3. 1960, pp. 1-4. (in Japanese)
[19] M. E. Tarek and H. A. Abdelghany, “Inferior Gluteal Nerve and Artery: An Anatomical Study,” Alexandria Journal of Medicine, Vol. 45, No. 2, 2009, pp. 1-17.
[20] P. S. Sharadkumar, “The Anatomical Study of Division of the Sciatic Nerve Proximal to its Exit,” Mad Science, Vol. 2, No. 1, 2013, pp. 169-171.
[21] Y. Koganei, S. Arai and S. Shikinami, “The Statistics of the Variation of the Muscles,” Journal of Tokyo Medical Society, Vol. 17, No. 2, 1903, pp. 127-131. (in Japanese)
[22] S. Igarashi, “The Relationship of the N. Ischiadicus and M. Piriformis,” Journal of Kanazawa Medical University, Vol. 19, No. 1, 1935, pp. 123-153. (in Japanese)
[23] N. Fukumoto, “The M. Piriformis and N. Ischiadicus in Japanese,” Journal of Fukuoka Medical University, Vol. 28, No. 3, pp. 756-763. (in Japanese)
[24] L. E. Beaton and B. J. Anson, “The Relation of the Sciatic Nerve and Its Subdivisions to the Piriformis Muscle,” The Anatomical Record, Vol. 70, No. 1, 1938, pp. 1-5.
http://dx.doi.org/10.1002/ar.1090700102
[25] T. Hayama, “The Relationship of Sciatic Nerve and Piriformis Muscle,” Journal of Medical University of Japan, Vol. 13, No. 3, 1954, pp. 1583-1588. (in Japanese)
[26] C. Nizankowski, J. Stociak and J. Szybejko, “Odimany Przebiegu Nerwu Kulszwogo u Cztowieka,” Folia Morphologica, Vol. 31, 1972, pp. 507-513.
[27] B. Tillmann, “Verlaufsvarianten des N. Gluteus Inferior,” Anatomical Record, Vol. 145, No. 3, 1979, pp. 293-302.
[28] T. Kusida, “The Lumbosacral Plexus in Japanese Fetus: Part III,” Acta Anatomica Nipponica, Vol. 16, No. 1, 1941, pp. 28-47. (in Japanese)
[29] J. Sugiyama, “The Relationship of the Sciatic Nerve and Piriformis Muscle in Japanese Fetal Twins,” Anatomical Study of the Fetal Twins, Vol. 4, 1943, pp. 1-26. (in Japanese)
[30] K. Kubota, I. Noguchi and T. Nakao, “Rare Types of Relation between the Sciatic Nerve and the Piriformis Muscle,” Okajimas Folia Anatomica Japonica, Vol. 36, No. 2, 1960, pp. 329-344.
[31] K. Honma, “The Anatomical Study of Sciatic Nerve in Japanese Fetus,” Journal of Tokyo Medical University, Vol. 17, No. 4, 1959, pp. 1955-1993. (in Japanese)
[32] R. Ausencia, R. V. Venkata and R. Mohandas, “Absence of Inferior Gluteal Artery: A Rare Observation,” International Journal of Morphology, Vol. 25, No. 1, 2007, pp. 95-98.

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