VARIATION IN BIFURCATION OF SCIATIC NERVE

Dr. K. Aparna Veda Priya, Dr. Rubina, Dr. Srijani Banerje, Dr. Zainab Fatima, Dr. Sheik Reshma Sultana

Abstract


INTRODUCTION: Sciatic Nerve (SN) 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 its terminal branches, 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 tibial nerve and Common peroneal nerve may leave the pelvis through different routes. Such variation may lead to compression of the nerve and lead to Non-discogenic sciatica. Hence study of its variation is important. 

AIMS AND OBJECTIVES: To study the variation in division of sciatic nerve and its clinical and surgical implications.

METHODOLOGY: This study was conducted in Department of Anatomy of Osmania medical college, Koti , Hyderabad .During routine undergraduate dissection of human cadavers, total(44 lower limbs)20 males and 2 females cadavers were dissected during the study .The cadavers with visible trauma or prior surgeries were excluded from routine  study. Dissection of lower limb was followed, During the dissection of gluteal region, nerve was identified and carefully dissected. At first ,origin was confirmed and then ,it was traced down. The variation was identified , noted and photographed .The results were analysed and compared with previous study.

RESULTS: Higher level of bifurcation of sciatic nerve (in pelvic cavity) was identified in one cadaver on left side. Among 44 lowerlimb, the percentage of higher level of bifurcation is 2%

CONCLUSION: Sciatic nerve is the main nerve of the Lowerlimb. Considering its variation in bifurcation at different levels is essential for Surgeons, Orthopaedicians, Plastic surgeons, Anatomist and researchers. This high division results in sciatica, nerve injury during deep intramuscular injections in gluteal region, piriformis syndrome, failed sciatic nerve block in anesthesia and it helps the orthopedicians during posterior hip operations


Keywords


SCIATIC NERVE, PIRIFORMIS MUSCLE, TIBIAL NERVE, COMMON PERONEAL NERVE.

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