Study on variant anatomy of sciatic nerve

Abstract

Introduction: Sciatic Nerve is the nerve of the posterior compartment of thigh formed in the pelvis from the ventral rami of the L4 to S3 spinal nerves. It leaves the pelvis via the greater sciatic foramen below piriformis and divides into Common Peroneal Nerve (CPN) and Tibial Nerve (TN) at the level of the upper angle of the popliteal fossa. Higher division of the sciatic nerve is the most common variation where the TN and CPN may leave the pelvis through different routes. Such variation may lead to compression of the nerve and lead to Non-discogenic sciatica. Materials and Methods: Fifty lower limbs were used for the study from Department of Anatomy, J.J.M.M.C Davangere. Observation and Results: In our study on 25 cadavers (50 lower limbs), we have observed 4 (8%) lower limbs high division of sciatic nerve was noted. High division of sciatic nerve in the back of thigh was noted in one specimen (2%), while high division within the pelvis was noted in 3 specimens (6%), while in 46 (92%) it occurred outside the pelvis. Conclusion: Knowledge regarding such variation & differences in the course of sciatic nerve is important for the surgeons to plan for various surgical interventions pertaining to the gluteal region. The variant anatomy of sciatic nerve may cause piriformis syndrome and failure of sciatic nerve block. Hence present study is undertaken to know the level of division, exit, course, relationship to piriformis and variations in the branching pattern of sciatic nerve.