Neonatal Lumbar Plexus Injury

Hope, Ellen E.; Thong, Nguyen

doi:10.1001/archneur.1985.04060010104028

Cited by 25 publications

(4 citation statements)

References 5 publications

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“…In such cases, the injuries of the nerve roots or the nerves are joined with more frequent peripheral lesion compared with those due to the same injuries in the postfi xed type. In the postfi xed type, the S 3 root can have many fi laments, normally carried in the S 2 root, and the S 4 contribution can be greater (22,23).…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of nervus pudendus

Matejcik¹,

Štěňo²,

Haviarová³

2013

BLL

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An objective of our work was to clarify variations in pudendal nerve formation, as well as their possible impact on the clinical picture. Bilateral pudendal nerve course and formation was studied on 20 adult cadavers. Anterior approach was used in 15 of them, both posterior and anterior approaches were used in fi ve of them. The prefi xed type plexus formation was observed in eight cases (40 %). In these cases S 1 , S 2 roots contributed to the formation of the pudendal nerve. In the postfi xed type particularly the S 3 root was dominant in two cases (66.7 %), and less the S 4 root in one case (23.3 %) from three cases. Mostly the S 2 root participated in its formation in 17 cases (85 %). The pudendal nerve branches run below the sacrospinous ligament on the level of the sacrospinous and sacrotuberous ligaments. The changes of the nerve and the branching therof were most evident from the anterior access below the sacrospinous ligament and in front of the sacrotuberous ligament. The inferior rectal nerve penetrating the sacrospinous ligament was seen in one case, it has risen from the pudendal nerve before entering the pudendal canal in four cases. The dorsal nerve of the penis has risen from the S 1 root in two cases (10 %). We observed its branching before entering the pudendal canal in 15 cases (75 %). It has divided in the pudendal canal in other cases. This description may be useful particularly for the pudendal nerve block and the nerve saving surgeries directed on the relevant region (Fig. 8 The pudendal nerve is one of the sacral plexus branches; originating from the anterior branches of S 2 to S 4 sacral nerves. It is the sensory and motor nerve of the perineum, innervating the external anal sphincter, urethral sphincter, perineal muscles and the skin (1-5).The main trunk of the pudendal nerve is formed proximally to the ischial spine, and medially and caudally to the sciatic nerve. It runs between the piriformis and coccygeus, medially to the pudendal vessels. Branches for the levator ani and coccygeus leave the pudendal nerve at the inferior margin of the piriformis. It then continues into the gluteal area through the greater sciatic foramen, and enters the pudendal canal through the lesser sciatic foramen.It runs behind the sacrospinous ligament and in front of the sacrotuberous ligament, then continues ventrocaudally into the perineal area, where it enters the pudendal canal (Alcock) formed by divided fascia of obturatorius internus. During its course it gives off inferior anal nerves and inferior rectal nerves respectively, which rise from the pudendal nerve just before entering the pudendal canal, or leave the pudendal canal and enter the proximal part of ischiorectal fossa; then they run through the fat and innervate the external anal sphincter and the skin around the anus (4, 5). Approximately in the centre of the pudendal canal it bifurcates into two branches -the perineal nerves and the dorsal nerve of the penis/clitoris. The perineal nerves serve for sensitive skin innervation of the...

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of nervus pudendus

Matejcik¹,

Štěňo²,

Haviarová³

2013

BLL

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“…Injuries may also be observed in radial, peroneal, and obturatory nerves due to birth traumas. In the literature, it has also been reported that lumbar plexus injuries may be observed due to tractions or manoeuvres administered during birth especially with breech and footling presentations (Hope et al, ). However, it is quite difficult to diagnose this age group with lumbar plexus lesion.…”

Section: Discussionmentioning

confidence: 99%

Morphological structure and variations of lumbar plexus in human fetuses

et al. 2012

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CABEZAS, J. J.; SOTO, A. & BINVIGNAT, O. Nervio femoral accesorio: Una variación del plexo lumbar. Int. J. Morphol., 31(4):1479-1481, 2013. RESUMEN: Variaciones en el origen de los ramos del plexo lumbar son observadas comúnmente durante las disecciones. Entre ellas se pueden mencionar: ausencia del nervio iliohipogástrico, presencia de un nervio obturador accesorio, bifurcación del nervio femoral, entre otras, destacándose la presencia de un nervio accesorio del nervio femoral. Durante una disección de rutina, en un cadáver fijado en formaldehido 10%, de un individuo adulto, Chileno, de sexo masculino, se observó la presencia unilateral de este nervio femoral accesorio originado del ramo anterior del nervio femoral, el cual estaba formado por dos ramos, describiendo sus características de origen, trayecto y distribución. Las variaciones anatómicas del plexo lumbar deben ser consideradas en el momento de efectuar cirugías en la región, evitando daños al nervio mencionado u otros, durante la disección quirúrgica. PALABRAS CLAVE: Anatomía; Nervios periféricos; Plexo lumbar; Nervio femoral; Nervio femoral accesorio. INTRODUCCIÓN Variaciones en el origen de los ramos del plexo lum-bar son observadas comúnmente durante las disecciones. Entre ellas se pueden mencionar: ausencia del nervio iliohipogástrico, división del nervio genitofemoral dentro del vientre muscular del psoas mayor, origen del nervio cu-táneo femoral del muslo desde las raíces L1 y L2 o sólo de L2, presencia de un nervio obturador accesorio y la bifur-cación del nervio femoral (Webber, 1961; Anloague & Huijbregts, 2009). De estas variaciones, destaca la presencia de un ner-vio paralelo al nervio femoral que fue denominado como "nervio accesorio del nervio femoral". Este ramo del plexo lumbar ha sido descrito con un trayecto cubierto por el mús-culo psoas mayor, cruzando oblicuamente en dirección lateral para unirse al nervio femoral a una corta distancia sobre el ligamento inguinal (Jamieson, 1903). El presente artículo muestra la presencia unilateral de este nervio y del nervio femoral compuesto por dos ra-mos, uno anterior y otro posterior, con la correspondiente descripción de su origen, trayecto y sector de inervación. MATERIAL Y MÉTODO La presencia del nervio mencionado se encontró du-rante una disección de rutina en un cadáver de un individuo adulto fijado en formaldehido al 10%, de sexo masculino y de nacionalidad Chilena. Este individuo es parte del Labo-ratorio de Anatomía Humana, Facultad de Medicina, Uni-versidad Católica del Maule, Talca, Chile. La observación y posterior disección del mismo se realizó siguiendo su trayecto paralelo al nervio femoral. Para visualizar su origen, se separaron las fibras del vientre del músculo psoas mayor. Del nervio en cuestión se obtuvieron fotografías y se registraron variables biométricas que fue-ron efectuadas con una regla y un caliper de precisión. DESCRIPCIÓN En el lado derecho del cadáver de un individuo adul-to se observó un nervio femoral accesorio (Fig. 1), que se encontraba paralelo y lateral a...

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“…Any lesion to the lumbar plexus is mostly iatrogenic. They could also be a result of trauma during birth (HOPE, BODENSTEINER and THONG, 1985), fibrous or muscular band entrapments (KASHUK, 1977), intrinsic or extrinsic tumors or due to a damage caused by any sharp object penetration or a gunshot. Apart from the above said, any procedure (such as in genitofemoral neuralgia (RHO, LAMER and FULMER, 2001)) done to relieve pain in relation to the branches of lumbar plexus or involvement of the lumbar plexus would also require detailed knowledge of the normal anatomy of the lumbar plexus and the possible variations related to its formation (BENZEL, BAROLAT-ROMANA and LARSON, 1988;BENZEL, 1992).…”

Section: Introductionmentioning

confidence: 99%

An extensive study and review of literature about multiple variations of the lumbar plexus

Nayak¹,

Surendran²,

Reghunathan³

et al. 2017

J Morphol Sci

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Introduction: Lumbar plexus involves the L1 -L5 spinal segments for the formation of the nerves which supply parts of the abdominal wall, pelvis and the upper part of the thigh (both sensory and motor). Our aim in this study was to compile all the rare variations found in a single cadaver, which is of the rarest possible kind. Methods: During the dissection of the abdomen and pelvis in approximately 70 year old cadaver, there were multiple variations observed in the anatomy of the lumbar plexus. The entire region was cleaned for visibility of the variations and all those were clearly documented for compiling purpose. Results: The following variations in the formation of the lumbar and sacral nerves were observed. 1. The genitofemoral nerve bifurcated at a higher level; genital branch of genitofemoral nerve gave branches to the anterior abdominal wall muscles, 2. A communicating branch was given from the lateral cutaneous nerve of thigh to the medial cutaneous nerve of thigh, 3. A muscular branch was given from femoral nerve to psoas major, 4. There was absence of contribution of L4 spinal nerve in the formation of the lumbosacral trunk, and 5. Lumbosacral trunk gave communicating branches to the femoral and obturator nerves. Most of the variations found were rare and finding all the above said variations in a single cadaver is even rare. Conclusion: Knowledge of the normal anatomy and any possible variations would help the clinicians and surgeons dealing with this region and avoid possible complications beforehand.

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Neonatal Lumbar Plexus Injury

Cited by 25 publications

References 5 publications

Surgical treatment of nervus pudendus

Surgical treatment of nervus pudendus

Morphological structure and variations of lumbar plexus in human fetuses

An extensive study and review of literature about multiple variations of the lumbar plexus

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