Variations in the Course of the Inferior Gluteal Nerve and Artery: A Case Report and Literature Review

Jun Yan,Masaki Takechi,Jiro Hitomi

doi:10.4236/ss.2013.410084

Abstract

Variations in the course of the inferior gluteal nerve and artery were observed in Japanese cases (4/94 sides). In these variation cases, the inferior gluteal nerve exited the pelvis from the upper edge of the piriformis (suprapiriformis foramen) in 4/4 sides (4.26%). In 2/4 sides (2.13%), the normal inferior gluteal artery was not observed, except that a fine artery exited the pelvis from the inferior piriformis foramen to form an “arch” with the superior gluteal artery under the gluteal maximus in 1/4 side. Moreover, in 1/4 side, a twig of the internal pudendal artery exited pelvis from inferior piriformis foramen and distributed to the surrounding tissues. The present observations of the inferior gluteal nerve and artery course are very important and useful for surgeons and nurses.

Highlights

Anatomy textbooks show that the inferior gluteal nerve (IGN) and artery (IGA) perforate below the piriformis, exit the pelvis, and distribute primarily to the gluteus maximus [1,2,3]
The inferior gluteal nerve exited the pelvis from the upper edge of the piriformis in 4/4 sides (4.26%)
In 2/4 sides (2.13%), the normal inferior gluteal artery was not observed, except that a fine artery exited the pelvis from the inferior piriformis foramen to form an “arch” with the superior gluteal artery under the gluteal maximus in 1/4 side

Summary

Introduction

Anatomy textbooks show that the inferior gluteal nerve (IGN) and artery (IGA) perforate below the piriformis (infrapiriformis foramen [IPF]), exit the pelvis, and distribute primarily to the gluteus maximus [1,2,3]. In the most recent detailed investigation of the relation between the IGN and piriformis muscle, Chiba advocated (in Japanese) that this relation should be classified into XIII types, the IGA was not mentioned [5]. Such a complex classification of this relation is useless in the clinical setting. The purpose of this report was 1) to focus on the IGN that exits the pelvis from the SPF only and to compare the percentages of the nerve(s) that pass through the SPF in the literature, and 2) to discuss the IGA supplying the gluteus maximus by passing through the course variation

Observations

The Inferior Gluteal Nerve

The Inferior Gluteal Artery

Discussion

Findings

Conclusions