Diop M, Parratte B, Tatu L, Vuillier F, Faure A, Monnier G
Department of Anatomy, Faculty of Medicine, Besançon, France.
Surg Radiol Anat. 2002 Aug-Sep;24(3-4):155-9. doi: 10.1007/s00276-002-0048-z. Epub 2002 Sep 11.
Observation of a 60 year-old-man with superior gluteal nerve (SGN) entrapment neuropathy in the suprapiriformis foramen encouraged us to explore, through anatomical dissection, the possible morphological etiologies of this condition. Ten SGNs in five embalmed cadavers were dissected via gluteal and pelvic access. The origin, course and distribution of the nervous trunk and its relations were studied. In most cases, the nerve fibers of the SGN arose from ventral branches of L4, L5 and S1 to constitute the nervous trunk in the pelvis, then reached the gluteal area and divided into two branches, cranial and caudal. By running through the suprapiriformis foramen with the cranial gluteal vascular pedicle, the nervous trunk was always up between the superior edge of the piriformis muscle and the greater sciatic notch; rarely some of the nerve fibers went through the muscle. Bone, muscular and vascular morphological factors liable to cause SGN entrapment syndrome, and the circumstances of discovery, were analyzed. The role of hypertrophy of the piriformis muscle, resulting in a narrow suprapiriformis foramen, was confirmed through surgery.
对一名60岁患有梨状肌上孔臀上神经（SGN）卡压性神经病变的男性患者的观察，促使我们通过解剖来探究这种情况可能的形态学病因。通过臀部和盆腔入路，对5具防腐尸体中的10条SGN进行了解剖。研究了神经干的起源、走行和分布及其关系。在大多数情况下，SGN的神经纤维起源于L4、L5和S1的腹侧分支，在盆腔内构成神经干，然后到达臀部区域并分为两支，即颅侧支和尾侧支。神经干总是与臀上血管蒂一起穿过梨状肌上孔，位于梨状肌上缘和坐骨大切迹之间；很少有一些神经纤维穿过该肌肉。分析了易导致SGN卡压综合征的骨骼、肌肉和血管形态学因素以及发现情况。通过手术证实了梨状肌肥大导致梨状肌上孔狭窄的作用。
