Abstract
Sciatic nerve entrapment can occur as post-operative complication of perineal hernia repair when sacrotuberous ligament is incorporated during hernia deficit closure. This results in sciatic sensory loss and paralysis of the hind leg. This study investigated the spatial relationship of sciatic nerve and sacrotuberous ligament and their surface topographic projection of 68 cadavers (29 Beagles and 39 Taiwanese mongrels) with various heights (25–56 cm). By gross dissection, the sacrotuberous ligament and sciatic nerve were exposed and their distance in between was measured along four parts (A, B, C, D) of sacrotuberous ligament. The present study revealed that the C was the section of sacrotuberous ligament where the sciatic nerve and the sacrotuberous ligament are closest to each other. Furthermore, a positive correlation was observed between C and height of the dogs. From the present study, we found that the C in smaller dogs has the shortest distance between the sciatic nerve and the sacrotuberous ligament, and thus the most vulnerable to sciatic nerve entrapment, and needs to be avoided or approached cautiously during perineal hernia repair.
Highlights
Perineal hernia is a common disease condition in dogs resulting from a weakness or a separation, and eventually a failure of the pelvic diaphragm muscles, which results in herniation of the pelvic or abdominal contents into the subcutaneous perineum [1,2,3]
We described the spatial relationship of sciatic nerve along the sacrotuberous ligament, which in our opinion gives the surgeon invaluable information to avoid sciatic entrapment and the associated complications during surgical repair of a perineal hernia
In case of perineal hernia repair, the sacrotuberous ligament is the only structure with the strength similar to that of the ventral fascia, the inguinal ligament, and the tendinous aponeurosis [12]
Summary
Perineal hernia is a common disease condition in dogs resulting from a weakness or a separation, and eventually a failure of the pelvic diaphragm muscles, which results in herniation of the pelvic or abdominal contents into the subcutaneous perineum [1,2,3]. Medical or conservative therapy is unlikely to solve the problem permanently and requires herniated content repositioning and reconstruction of the weak pelvic diaphragm [4]. Sacrotuberous ligament is often incorporated as necessary to close ventral and lateral part of the hernial deficit [3, 4]. Sciatic nerve paralysis and sciatic nerve neuropraxia are often reported as a post-operative complication when sacrotuberous ligament is incorporated in the suture bite [1, 12,13,14,15]
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