Pinho André R, Leite Maria J, Lixa João, Silva Miguel R, Vieira Paula, Nery-Monterroso João, Bezerra Mariana C, Alves Hélio, Madeira Maria Dulce, Pereira Pedro A
Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal.
Orthopaedics and Traumathology Department, Centro Hospitalar Universitário São João, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal.
Diagnostics (Basel). 2023 Jul 8;13(14):2314. doi: 10.3390/diagnostics13142314.
Because most of the recognized causes of superior gluteal nerve (SGN) injury are iatrogenic, detailed knowledge of the anatomy of the SGN is crucial to prevent its injury associated with surgical procedures. This study aims to describe the precise location of SGN or its branches at the greater sciatic foramen, measure the distances of these neural structures to palpable bony landmarks, and evaluate the possible correlation between these parameters and pelvis size. Twenty human cadaveric hemipelvises were studied. After dissection to expose the SGN or its branches at the greater sciatic foramen, the distances from these neural structures to the greater trochanter (GT), to the anterior superior iliac spine (ASIS), to the posterior superior iliac spine (PSIS), to the ischial tuberosity (IT), and to the greater sciatic notch apex were measured. We found that at the greater sciatic foramen, the SGN emerges as a common trunk in 75% of hemipelvises, and already divided in its superior and inferior branches in 25% of hemipelvises. When the SGN exits the pelvis as a common trunk, it does so, in most cases, in contact with the bone at the apex of the greater sciatic notch or superior to the level of the apex. The median distance from the SGN at the greater sciatic notch to the PSIS, ASIS, GT and IT is 7.6 cm, 10.9 cm, 7.5 cm and 10.8 cm, respectively. We found a positive correlation between some of the analyzed parameters and the size of the pelvis. The anatomical data of this study may serve as pivotal guides during orthopedic pelvic surgery, contributing to minimize SNG iatrogenic lesions with significant implications in the patient's quality of life.
由于大多数已确认的臀上神经（SGN）损伤原因是医源性的，因此详细了解SGN的解剖结构对于预防与手术相关的损伤至关重要。本研究旨在描述SGN或其分支在坐骨大孔处的精确位置，测量这些神经结构与可触及骨性标志的距离，并评估这些参数与骨盆大小之间的可能相关性。对20例人类尸体半骨盆进行了研究。在解剖暴露坐骨大孔处的SGN或其分支后，测量这些神经结构到股骨大转子（GT）、髂前上棘（ASIS）、髂后上棘（PSIS）、坐骨结节（IT）以及坐骨大切迹顶点的距离。我们发现，在坐骨大孔处，75%的半骨盆中SGN以共同主干出现，25%的半骨盆中已分为上、下分支。当SGN以共同主干离开骨盆时，在大多数情况下，它与坐骨大切迹顶点处的骨接触或在顶点水平以上。坐骨大切迹处的SGN到PSIS、ASIS、GT和IT的中位距离分别为7.6 cm、10.9 cm、7.5 cm和10.8 cm。我们发现一些分析参数与骨盆大小之间存在正相关。本研究的解剖学数据可作为骨科骨盆手术中的关键指南，有助于将SNG医源性损伤降至最低，这对患者的生活质量有重大影响。
