The Anatomy of the Perineal Branch of the Sciatic Nerve

Abstract

Introduction: A "perineal" branch of the sciatic nerve has been visualized during surgery, but there is currently no description of this nerve branch in the literature. Our study investigates the presence and frequency of occurrence of perineal innervation by the sciatic nerve and characterizes its anatomy in the posterior thigh.

Materials and Methods: Fifteen cadavers were obtained for dissection. Descriptive results were recorded.Statistical analysis was performed and analyzed statistically.

Results: Twenty-one sciatic nerves were adequately anatomically preserved. Six sciatic nerves contained a perineal branch of the sciatic nerve. Five sciatic nerves had a branch contributing to the perineal branch of the posterior femoral cutaneous (PFC) nerve. In specimens with adequate anatomical preservation, the perineal branch of the sciatic nerve passed posterior to the ischial tuberosity in three specimens and posterior to the conjoint tendon of the long head of biceps femoris and semitendinosus muscles (conjoint tendon) in one. Of thoseIn specimens in which the perineal branch of the PFC nerve received a contribution from the sciatic nerve, the branch passed posterior to the sacrotuberous ligament in one case specimenand posterior to the conjoint tendon in three. Unilateral nerve anatomy was found to poorly predictbe a poor predictor of contralateral anatomy (Cohen's kappa = 0.06).

Conclusions: Our study demonstrates for the first time the presence and frequency of occurrence of the perineal branch of the sciatic nerve and a sciatic contribution to the perineal branch of the PFC nerve. Clinicians should be cognizant of this nerve and its varying anatomy to better informso their clinical practice is better informed. This article is protected by copyright. All rights reserved.

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