Anat Cell Biol.  2020 Sep;53(3):369-371. 10.5115/acb.20.096.

Reunification of a split sciatic nerve

• Huang B
• Decater T
• Iwanaga J
• Dumont AS
• Tubbs RS

• KMID: 2507650
• DOI: http://doi.org/10.5115/acb.20.096

Abstract

Sciatic nerve (SN) variaitons can result in interesting clinical presentations. We identified a SN variant that does not fit into preexisting classification schemes. In an adult male cadaver, the SN was found to divide proximally and partly exit through the piriformis muscle. Distal to the piriformis, the two parts of the SN were reunited. Although apparently extremely rare, such a finding should be added to the archives of anatomical variations.

Keyword

Anatomy; Anatomic variation; Cadaver; Sciatic nerve

Figure

• 

  Fig. 1 Gluteal and posterior thigh regions on the right side. The GM is reflected laterally. The superior part (CFN) of the sciatic nerve is seen piercing the PM (yellow arrow) and the inferior root (TN) runs below the inferior border of the PM (red arrow). Note the Cb between the two. Cb, communicating branch; CFN, common fibular nerve; GM, gluteus maximus; PM, piriformis muscle; TN, tibial nerve.

Reference

References

1. Adibatti M, Sangeetha V. 2014; Study on variant anatomy of sciatic nerve. J Clin Diagn Res. 8:AC07–9. DOI: 10.7860/JCDR/2014/9116.4725. PMID: 25302181.

2. Beaton LE, Anson BJ. 1937; The relation of the sciatic nerve and of its subdivisions to the piriformis muscle. Anat Rec. 70:1–5. DOI: 10.1002/ar.1090700102.

3. Smoll NR. 2010; Variations of the piriformis and sciatic nerve with clinical consequence: a review. Clin Anat. 23:8–17. DOI: 10.1002/ca.20893. PMID: 19998490.

4. Varenika V, Lutz AM, Beaulieu CF, Bucknor MD. 2017; Detection and prevalence of variant sciatic nerve anatomy in relation to the piriformis muscle on MRI. Skeletal Radiol. 46:751–7. DOI: 10.1007/s00256-017-2597-6. PMID: 28280851.

5. Güvençer M, Iyem C, Akyer P, Tetik S, Naderi S. 2009; Variations in the high division of the sciatic nerve and relationship between the sciatic nerve and the piriformis. Turk Neurosurg. 19:139–44. DOI: 10.5603/FM.a2015.0130. PMID: 19431123.

6. Antoniadis G, Kretschmer T, Pedro MT, König RW, Heinen CP, Richter HP. 2014; Iatrogenic nerve injuries: prevalence, diagnosis and treatment. Dtsch Arztebl Int. 111:273–9. DOI: 10.3238/arztebl.2014.0273. PMID: 24791754.

7. Dupont G, Unno F, Iwanaga J, Oskouian RJ, Tubbs RS. 2018; A variant of the sciatic nerve and its clinical implications. Cureus. 10:e2874. DOI: 10.7759/cureus.2874. PMID: 30155377. PMCID: PMC6110408.

8. Berihu BA, Debeb YG. 2015; Anatomical variation in bifurcation and trifurcations of sciatic nerve and its clinical implications: in selected university in Ethiopia. BMC Res Notes. 8:633. DOI: 10.1186/s13104-015-1626-6. PMID: 26526618. PMCID: PMC4630888.

9. Gunnal S, Wabale R. 2013; An unusual formation of sciatic nerve. Indian J Med Sci. 67:193–6. DOI: 10.4103/0019-5359.125883. PMID: 24469565.

10. Okraszewska E, Migdalski L, Jedrzejewski KS, Bolanowski W. 2002; Sciatic nerve variations in some studies on the Polish population and its statistical significance. Folia Morphol (Warsz). 61:277–82. PMID: 12725497.

11. Khan H, Ling S, Ali S, Jonnalagadda P, Ramsey F, Weiner M, Awan O. 2019; Sciatic nerve variants in patients diagnosed with sciatica: is there a correlation? J Comput Assist Tomogr. 43:953–7. DOI: 10.1097/RCT.0000000000000919. PMID: 31738201.

12. Robinson DR. 1947; Pyriformis syndrome in relation to sciatic pain. Am J Surg. 73:355–8. DOI: 10.1016/0002-9610(47)90345-0. PMID: 20289074.

13. Saleh HA, El-fark MM, Abdel-Hamid GA. 2009; Anatomical variation of sciatic nerve division in the popliteal fossa and its implication in popliteal nerve blockade. Folia Morphol (Warsz). 68:256–9. PMID: 19950076.

14. Ro TH, Edmonds L. 2018; Diagnosis and management of piriformis syndrome: a rare anatomic variant analyzed by magnetic resonance imaging. J Clin Imaging Sci. 8:6. DOI: 10.4103/jcis.JCIS_58_17. PMID: 29541492. PMCID: PMC5843966.