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Arterial Supply of Sciatic Nerve and Its Impact on Clinical Practice

Received: 17 August 2015     Accepted: 3 September 2015     Published: 9 September 2015
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Abstract

Sciatic nerve is the nerve of the posterior compartment of thigh; it is formed in the pelvis from the ventral rami of L4 to S3 spinal nerves. It leaves the pelvis via the greater sciatic foramen below piriformis and divides into common peroneal nerve and tibial nerve at the level of the upper angle of the popliteal fossa. The vasculature of peripheral nerves is adapted specifically to their structure and function. Arterial vessels that reach main nerve trunks originate from the adjacent main arteries or their muscular or cutaneous branches. Although variability in arterial supply of sciatic nerve was discussed by some authors it is still deficient. To minimize sciatic nerve ischemia and its concomitant problems, an understanding of the origin and course of the arteries supplying it in the gluteal region and the posterior compartment of thigh is important. The present study aimed to detect the different arteries supplying the sciatic nerve in the gluteal and posterior thigh regions and to study the importance of this in clinical practice. Three cases subjected to vascular surgery and twenty lower limbs of ten formalin preserved male cadavers were used. Higher division of sciatic nerve was observed in all specimens. In 6 specimens (30%), arterial supply of sciatic nerve originated from the inferior gluteal artery, 6 specimens (30%)from first, second and third perforating arteries, 5 specimens (25%)from the lateral circumflex femoral artery and 3 specimens (15%)from internal pudendal artery. Anastomosis between internal iliac artery through its internal pudendal branch and external iliac artery through perforating arteries was observed. It was concluded that there is a good anastomosis between internal iliac and profunda femoris artery on the same side but cross pelvic anastomosis is absent or deficient and in case of profunda femoris occlusion we should preserve internal pudendal artery and the reverse.

Published in International Journal of Clinical and Developmental Anatomy (Volume 1, Issue 3)
DOI 10.11648/j.ijcda.20150103.14
Page(s) 79-84
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Sciatic Nerve, Ischemia, Gluteal Artery, Pudendal Artery, Perforating Artery

References
[1] Prathiba K, Seema M, Udaya KP and Dharmendar PN. A cadaveric study on anatomical variations of sciatic nerve in relation to pyriformis muscle in andhra pradesh region. IJCRR 2013; 5(21): 56-60.
[2] Pokorny D, Jahoda D, Veigl D, Pinskerova V and Sosna A. Topographic variations of the relationship of the sciatic nerve and the piriformis muscle and its relevance to palsy after total hip arthroplasty. Surg Radiol Anat 2006; 28:88–91.
[3] Ugrenovic SZ, Jovanovic ID, Kovacevic P, Petrovic S,and Simic T. Similarities and dissimilarities of the blood supplies of the human Sciatic, tibial, and common peroneal nerves. Clin. Anat. 2013; 26(7): 875–82.
[4] Latarjet A. 1929. Testut’s Traite D’Anatomie Humaine. 8th Ed. Paris: Tome Deuxieme, Angeiologie, Systeme Nerveux, Central, Gaston, Doin and Cfe. p 349.
[5] Romanes GJ. 1981. Cunningham’s Textbook of Anatomy. 12th Ed. Oxford: Oxford University Press. p 1376.
[6] Johnston TB, Whillis J. 1946. Gray’s Anatomy. 29th Ed. London:Longmans Green. p 799.
[7] Standring S 2008. Gray’s Anatomy. 40th Ed. Edinburgh: Churchill Livingstone. p 1562.
[8] Schafer EA, Thane GD. 1892. Quain’s Anatomy, Vol. 2, Part II: Arthrology, Myology, Angeiology. London: Longmans Green. p 481.
[9] Karmanska W, Mikusek J, Karmanski A. Nutrient arteries of the human sciatic nerve. Folia Morphol (Warsz) 1993;52:209–15.
[10] Austin MS, Klein GR, Sharkey PF, Hozack WJ, Rothman RH. Late sciatic nerve palsy caused by hematoma after primary total hip arthroplasty. J Arthroplasty2004; 19:790–2.
[11] Weil Y, Mattan Y, Goldman V, Liebergall M. Sciatic nerve palsy due to hematoma after thrombolysis therapy for acute pulmonary embolism after total hip arthroplasty. J Arthroplasty 2006; 21: 456–9.
[12] Teare J, Evans E, Belli A, Wendler R. Sciatic nerve ischaemia after iliac artery occlusion balloon catheter placement for placenta percreta. International Journal of Obstetric Anesthesia 2014: 23(2):178-81.
[13] Eguchi K and Majima M. Sciatic neuropathy caused by disorder of a nutrient artery: A case report of thromboembolism secondary to profunda femoral artery aneurysm. Archives of physical medicine and rehabilitation 2001;82 (2):253-5.
[14] Andrew JK. Variations of the sciatic nerve anatomy and blood supply in the gluteal region: a review of the literature. ANZ Journal of Surgery 2014; 84(11): 816-9.
[15] Georgakis E and Soames R. Arterial supply to the sciatic nerve in the gluteal region. Clin Anat. 2008; 21(1):62-5.
[16] Mikusek J1, Karamńska W and Karmański A. Vascularization of the human sciatic nerve fasciculi. Folia Morphol.1997;56(3):175-81.
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    El Sayed Aly Mohamed Metwally, Nancy Mohamed Aly El-Sekily, Naguib Abd El Karim Ramadan. (2015). Arterial Supply of Sciatic Nerve and Its Impact on Clinical Practice. International Journal of Clinical and Developmental Anatomy, 1(3), 79-84. https://doi.org/10.11648/j.ijcda.20150103.14

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    ACS Style

    El Sayed Aly Mohamed Metwally; Nancy Mohamed Aly El-Sekily; Naguib Abd El Karim Ramadan. Arterial Supply of Sciatic Nerve and Its Impact on Clinical Practice. Int. J. Clin. Dev. Anat. 2015, 1(3), 79-84. doi: 10.11648/j.ijcda.20150103.14

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    AMA Style

    El Sayed Aly Mohamed Metwally, Nancy Mohamed Aly El-Sekily, Naguib Abd El Karim Ramadan. Arterial Supply of Sciatic Nerve and Its Impact on Clinical Practice. Int J Clin Dev Anat. 2015;1(3):79-84. doi: 10.11648/j.ijcda.20150103.14

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  • @article{10.11648/j.ijcda.20150103.14,
      author = {El Sayed Aly Mohamed Metwally and Nancy Mohamed Aly El-Sekily and Naguib Abd El Karim Ramadan},
      title = {Arterial Supply of Sciatic Nerve and Its Impact on Clinical Practice},
      journal = {International Journal of Clinical and Developmental Anatomy},
      volume = {1},
      number = {3},
      pages = {79-84},
      doi = {10.11648/j.ijcda.20150103.14},
      url = {https://doi.org/10.11648/j.ijcda.20150103.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcda.20150103.14},
      abstract = {Sciatic nerve is the nerve of the posterior compartment of thigh; it is formed in the pelvis from the ventral rami of L4 to S3 spinal nerves. It leaves the pelvis via the greater sciatic foramen below piriformis and divides into common peroneal nerve and tibial nerve at the level of the upper angle of the popliteal fossa. The vasculature of peripheral nerves is adapted specifically to their structure and function. Arterial vessels that reach main nerve trunks originate from the adjacent main arteries or their muscular or cutaneous branches. Although variability in arterial supply of sciatic nerve was discussed by some authors it is still deficient. To minimize sciatic nerve ischemia and its concomitant problems, an understanding of the origin and course of the arteries supplying it in the gluteal region and the posterior compartment of thigh is important. The present study aimed to detect the different arteries supplying the sciatic nerve in the gluteal and posterior thigh regions and to study the importance of this in clinical practice. Three cases subjected to vascular surgery and twenty lower limbs of ten formalin preserved male cadavers were used. Higher division of sciatic nerve was observed in all specimens. In 6 specimens (30%), arterial supply of sciatic nerve originated from the inferior gluteal artery, 6 specimens (30%)from first, second and third perforating arteries, 5 specimens (25%)from the lateral circumflex femoral artery and 3 specimens (15%)from internal pudendal artery. Anastomosis between internal iliac artery through its internal pudendal branch and external iliac artery through perforating arteries was observed. It was concluded that there is a good anastomosis between internal iliac and profunda femoris artery on the same side but cross pelvic anastomosis is absent or deficient and in case of profunda femoris occlusion we should preserve internal pudendal artery and the reverse.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Arterial Supply of Sciatic Nerve and Its Impact on Clinical Practice
    AU  - El Sayed Aly Mohamed Metwally
    AU  - Nancy Mohamed Aly El-Sekily
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    AB  - Sciatic nerve is the nerve of the posterior compartment of thigh; it is formed in the pelvis from the ventral rami of L4 to S3 spinal nerves. It leaves the pelvis via the greater sciatic foramen below piriformis and divides into common peroneal nerve and tibial nerve at the level of the upper angle of the popliteal fossa. The vasculature of peripheral nerves is adapted specifically to their structure and function. Arterial vessels that reach main nerve trunks originate from the adjacent main arteries or their muscular or cutaneous branches. Although variability in arterial supply of sciatic nerve was discussed by some authors it is still deficient. To minimize sciatic nerve ischemia and its concomitant problems, an understanding of the origin and course of the arteries supplying it in the gluteal region and the posterior compartment of thigh is important. The present study aimed to detect the different arteries supplying the sciatic nerve in the gluteal and posterior thigh regions and to study the importance of this in clinical practice. Three cases subjected to vascular surgery and twenty lower limbs of ten formalin preserved male cadavers were used. Higher division of sciatic nerve was observed in all specimens. In 6 specimens (30%), arterial supply of sciatic nerve originated from the inferior gluteal artery, 6 specimens (30%)from first, second and third perforating arteries, 5 specimens (25%)from the lateral circumflex femoral artery and 3 specimens (15%)from internal pudendal artery. Anastomosis between internal iliac artery through its internal pudendal branch and external iliac artery through perforating arteries was observed. It was concluded that there is a good anastomosis between internal iliac and profunda femoris artery on the same side but cross pelvic anastomosis is absent or deficient and in case of profunda femoris occlusion we should preserve internal pudendal artery and the reverse.
    VL  - 1
    IS  - 3
    ER  - 

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Author Information
  • Department of Anatomy and Embryology, Faculty of Medicine, Alexandria University, Alexandria, Egypt

  • Department of Anatomy and Embryology, Faculty of Medicine, Alexandria University, Alexandria, Egypt

  • General Surgery Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

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