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2011 | 70 | 3 |

Tytuł artykułu

Variant anatomy of sciatic nerve in black Kenyan Population

Warianty tytułu

Języki publikacji

EN

Abstrakty

EN
Knowledge of variant anatomy of the sciatic nerve is important in avoiding inadvertent injury during operations in the gluteal region and interpreting nondiscogenic sciatica. This variant anatomy may cause piriformis syndrome and failure of sciatic nerve block. The variations differ between populations but data from Africans is scarce. This study, therefore, investigated variations of sciatic nerve in a black Kenyan population. One hundred and sixty-four sciatic nerves from 82 cadavers of black Kenyans were exposed by dissection at the Department of Human Anatomy, University of Nairobi, Kenya. The level of bifurcation, relationship to piriformis, and topographic relations between the branches were studied. The results were analysed by SPSS version 16.0 and are presented by macrographs. In 33 (20.1%) cases division occurred in the pelvis, while in 131 (79.9%) it occurred outside the pelvis. A single trunk sciatic nerve exited below the piriformis muscle in 131 (79.9%) cases. In cases of pelvic division, the tibial nerve was always infrapiriformic, while the common peroneal nerve passed below piriformis in 16 (9.8%) cases, pierced the piriformis in 13 (7.9%), and passed above it in 4 (2.4%). For those in which division was extrapelvic, 110 (67.1%) were in the popliteal fossa, 17 (10.4%) in the middle third of the thigh, and 4 (2.4%) in the gluteal region. Where the division was pelvic, in 19 (11.6%) cases they continued separately, in 8 (4.9%) the two nerves reunited, and in 6 (3.7%) they were connected by a communicating nerve. The sciatic nerve in the Kenyan population varies from the classical description in over 30% of cases, with many high divisions, low incidence of piriformic course of common peroneal nerve, reunion, and unusual connection between common peroneal and tibial nerves. These variations may complicate surgery and interpretation of sciatic neuropathy. Preoperative nerve imaging and extra operative diligence in the gluteal region and the back of the thigh are recommended. (Folia Morphol 2011; 70, 3: 175–179)

Słowa kluczowe

Wydawca

-

Czasopismo

Rocznik

Tom

70

Numer

3

Opis fizyczny

p.175-179,fig.,ref.

Twórcy

autor
  • Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
  • Department of Human Anatomy, Department, University of Nairobi, Nairobi, Kenya
autor
  • Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
  • Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
autor
  • Department of Human Anatomy, University of Nairobi, Nairobi, Kenya

Bibliografia

  • 1. Bardeen CR, Elting AW (1901) A statistical study of the variations in the formation and position of lumbosacral flexus in man. Anat Anz, 19: 209–239.
  • 2. Beaton IE, Anson JB (1937) The relation of the sciatic nerve and its subdivisions to the piriformis muscle. Anat Rec, 70: 1–5.
  • 3. Chiba S (1992) Multiple positional relationships of nerves arising from the sacral plexus to piriformis muscle in humans. Kaibogaku Zasshi; 67: 691–724.
  • 4. Chukwuanukwu TOG, Ukoha UU, Chukwujekwu IE, Asomugha AL, Oanusi A, Anyabolu AE, Ashaolu JO (2007) Bilateral thigh division of sciatic nerve: incidence and clinical implication in Nigeria. Trop J Med Res, 11: 12–13.
  • 5. Conlay B, Baker DC (1979) Hypoglossal-Facial Nerve Anastomosis for Reinnervation of the paralysed face. Plast Recons Surg, 63: 63–72.
  • 6. Dogan NU, Uysal II, Seker M (2009) The communications between the ulnar and median nerves in upper limb. Neuroanatomy, 8: 15–19.
  • 7. Gabrielli C, Olave E, Mandiola E (1997) Inferior gluteal nerve course associated to the high division of sciatic nerve. Rev Clin Anat, 15: 79–83.
  • 8. Guvencer 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. Turkish Neurosurg, 19: 139–144.
  • 9. Kakuriza J, Kiryowa H, Turyabahika J, Ochieng J, Ibingira CBR (2010) Levels of bifurcation of the sciatic nerve among Ugandans at School of Biomedical Sciences, Makerere and Mulago Hospital, Uganda. East Central Afr J Surg, 15: 69–72.
  • 10. Le Minor JM (1990) A rare variation of the median and musculotaneous nerves in man. Arch Anat Histol Embryol, 73: 33–42.
  • 11. Lee CS, Tsai TL (1974) The relation of the sciatic nerve to piriformis muscle. J Formos Med Assoc, 73: 75–80.
  • 12. Mandiola El, Hernandez PH, Hofer UP, Crovetto E, Ortega E (1986) Variaciones anatomicas del origin del nervio isquiatico (en fetos humanos termino) An Anat Norm, 4: 40–43.
  • 13. 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, 61: 277–282.
  • 14. Oluyemi KA, Adesanya OA, Saalu CL, Okwuonu UC, Ofusori DA, Odun EI (2007) Communication between median and musculocutaneous nerve and accessory head of biceps brachii: a case report. Internet J Surg, 12: 1.
  • 15. Pokorny D, Jahoda D, Veigl D, Pinskerova V, Sosna A (2006) Topographic variations of the relationship of the sciatic nerve and the piriformis muscle and its prevalence to palsy after total hip arthroplasty. Surg Rad Anat, 28: 88–91.
  • 16. Prakash BAK, Devi MN, Sridevi NS, Rao PK, Singh G (2010) Sciatic nerve division: a cadaver study in the Indian population and review of literature. Singapore Med J, 51: 721–723.
  • 17. Ugrenovic S, Jovanovic I, Krstic V (2005) The level of sciatic nerve division and its relations to the piriformis muscle. Vojnosanit Pregl, 62: 45–49.
  • 18. Vicente EJD, Viotto MJS, Barboso CAA, Vicente PC (2007) Study on anatomical variations between sciatic nerve and piriformis muscle. Rev Bras Fisioter, 11: 227–232.
  • 19. Woodson GE (2007) Spontaneous laryngeal reinnervation after recurrent laryngeal or vagus nerve injury. Ann Otorhinol-Laryngol, 116: 57–65.

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Typ dokumentu

Bibliografia

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Identyfikator YADDA

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