Anatomical variations of the lumbar plexus in fetus

Abstract

The lumbar plexus is formed within the psoas major muscle and is one of the main nervous pathways supplying the lower limb. Although we came across literature concerning the variations in lumbar plexus in adults, there is dearth of the same in foetuses. Aim of the study was to study the variations in lumbar plexus in foetus. The study was done bilaterally in 25 formalin-fixed fetuses (10 females, 15 males), age ranging from 20 to 37 weeks of gestation. The formation of lumbar plexus and their branching pattern were observed. The findings were noted and tabulated. Multiple variations were observed in the formation and branching pattern of lumbar plexus. Anatomical variations found in the present case may be injured during certain surgical procedures in infants and children, particularly in the lower abdominal region, e.g. appendectomy, inguinal hernia repair, iliac crest bone graft harvesting etc. As a consequence to such operations, several clinical conditions may be encountered such as meralgia paresthetica, groin pain and testicular pain in which the lateral femoral cutaneous, ilioinguinal and the genitofemoral nerves are mostly involved. Thus, awareness about the regional anatomy and its variations is essential for preventing intra-operative complications.