Manolakos Konstantinos, Zygogiannis Konstantinos, Mousa Chagigia, Demesticha Theano, Protogerou Vasileios, Troupis Theodore
6th Orthopedic Department, KAT Hospital, Athens, GRC.
Department of Trauma and Orthopedics, Laiko General Hospital of Athens, Athens, GRC.
Cureus. 2022 May 11;14(5):e24910. doi: 10.7759/cureus.24910. eCollection 2022 May.
Several anatomical variations of the iliohypogastric nerve branches have been observed in earlier studies. Knowledge of these variations is useful for the improvement of peripheral nerve blocks and avoidance of iatrogenic nerve injuries during surgeries. The purpose of this study was to perform a systematic review of the literature about the anatomical topography and variations of the iliohypogastric nerve. An extensive search on PubMed, Scopus, and Web of Science electronic databases was conducted by the first author in November 2021, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Anatomical or cadaveric studies about the origin, the course, and the distribution of the iliohypogastric nerve were included in this review. Thirty cadaveric studies were included for qualitative analysis. Several anatomical variations of the iliohypogastric nerve were depicted including its general properties, its origin, its branching patterns, its course, its relation to anatomical landmarks, and its termination. Among them, the absence of the iliohypogastric nerve ranged from 0 to 34%, its origin from L1 ranged from 62.5 to 96.5%, and its isolated emergence from psoas major ranged from 47 to 94.5%. Numerous anatomical variations of the iliohypogastric nerve exist but are not commonly cited in classic anatomical textbooks. The branches of the iliohypogastric nerve may be damaged during spinal anesthesia and surgical procedures in the lower abdominal region. Therefore, a better understanding of the regional anatomy and its variations is of vital importance for the prevention of iliohypogastric nerve injuries.
早期研究中已观察到髂腹下神经分支的几种解剖变异。了解这些变异有助于改进周围神经阻滞，并避免手术期间的医源性神经损伤。本研究的目的是对有关髂腹下神经解剖形态和变异的文献进行系统综述。第一作者于2021年11月根据系统评价和Meta分析的首选报告项目（PRISMA）指南，对PubMed、Scopus和科学网电子数据库进行了广泛检索。本综述纳入了关于髂腹下神经起源、走行和分布的解剖学或尸体研究。纳入30项尸体研究进行定性分析。描述了髂腹下神经的几种解剖变异，包括其一般特性、起源、分支模式、走行、与解剖标志的关系及其终末。其中，髂腹下神经缺如的发生率为0%至34%，其起源于L1的发生率为62.5%至96.5%，其单独发自腰大肌的发生率为47%至94.5%。髂腹下神经存在许多解剖变异，但在经典解剖学教科书中并不常被提及。在脊髓麻醉和下腹部手术过程中，髂腹下神经的分支可能会受到损伤。因此，更好地了解局部解剖及其变异对于预防髂腹下神经损伤至关重要。
