Barbosa Ana Beatriz Marques, Santos Priscele Viana Dos, Targino Vanessa Apolonio, Silva Nathalie de Almeida, Silva Yanka Costa de Melo, Gomes Felippe Barbosa, Assis Thiago de Oliveira
Centro Universitário UNIFACISA, Curso de Fisioterapia, Campina Grande PB, Brasil.
Centro Universitário UNIFACISA, Curso de Medicina, Campina Grande PB, Brasil.
Arq Neuropsiquiatr. 2019 Sep 23;77(9):646-653. doi: 10.1590/0004-282X20190093. eCollection 2019.
The sciatic nerve forms from the roots of the lumbosacral plexus and emerges from the pelvis passing inferiorly to the piriformis muscle, towards the lower limb where it divides into common tibial and fibular nerves. Anatomical variations related to the area where the nerve divides, as well as its path, seem to be factors related to piriformis syndrome. OBJECTIVE To analyze the anatomical variations of the sciatic nerve and its clinical implications. METHODS This was a systematic review of articles indexed in the PubMed, LILACS, SciELO, SpringerLink, ScienceDirect and Latindex databases from August to September 2018. Original articles covering variations of the sciatic nerve were included. The level of the sciatic nerve division and its path in relation to the piriformis muscle was considered for this study. The collection was performed by two independent reviewers. RESULTS At the end of the search, 12 articles were selected, characterized according to the sample, method of evaluation of the anatomical structure and the main results. The most prevalent anatomical variation was that the common fibular nerve passed through the piriformis muscle fibers (33.3%). Three studies (25%) also observed anatomical variations not classified in the literature and, in three (25%) the presence of a double piriformis muscle was found. CONCLUSION The results of this review showed the most prevalent variations of the sciatic nerve and point to a possible association of this condition with piriformis syndrome. Therefore, these variations should be considered during the semiology of disorders involving parts of the lower limbs.
坐骨神经由腰骶丛的神经根组成，从骨盆穿出，在梨状肌下方下行，朝向下肢，在下肢处分为胫神经和腓总神经。与神经分支区域及其走行相关的解剖变异似乎是与梨状肌综合征相关的因素。目的分析坐骨神经的解剖变异及其临床意义。方法对2018年8月至9月在PubMed、LILACS、SciELO、SpringerLink、ScienceDirect和Latindex数据库中索引的文章进行系统评价。纳入涉及坐骨神经变异的原始文章。本研究考虑了坐骨神经分支的水平及其与梨状肌的关系。资料收集由两名独立的评审员进行。结果在检索结束时，选择了12篇文章，根据样本、解剖结构评估方法和主要结果进行了特征描述。最常见的解剖变异是腓总神经穿过梨状肌纤维(33.3%)。三项研究(25%)还观察到文献中未分类的解剖变异，三项研究(25%)发现存在双梨状肌。结论本综述结果显示了坐骨神经最常见的变异，并指出这种情况与梨状肌综合征可能存在关联。因此，在涉及下肢部分的疾病的症状学分析过程中应考虑这些变异。
