Affiliations

1 Laboratoire d'Anatomie de la Faculté de Médecine de Nantes, 1, rue Gaston Veil, 44035, Nantes Cedex 01, France. Stephane.ploteau


You are watching: Posterior cutaneous nerve of thigh

chu-nantes.fr. 2 Laboratoire d'Anatomie de la Faculté de Médecine de Nantes, 1, rue Gaston Veil, 44035, Nantes Cedex 01, France.
Entrapment the the posterior femoral cutaneous nerve and also its worse cluneal branches: anatomical communication of surgical treatment for inferior cluneal neuralgia

Affiliations

1 Laboratoire d'Anatomie de la Faculté de Médecine de Nantes, 1, rue Gaston Veil, 44035, Nantes Cedex 01, France. Stephane.ploteau
chu-nantes.fr. 2 Laboratoire d'Anatomie de la Faculté de Médecine de Nantes, 1, rue Gaston Veil, 44035, Nantes Cedex 01, France.


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Purpose: The evident failure the pudendal nerve surgical procedure in some patients has led united state to imply the possibility of entrapment that other nearby nerve structures, resulting in the principle of inferior cluneal neuralgia. Via its plenty of collateral branches, the posterior femoral cutaneous nerve innervates a really extensive territory including the posterior surface ar of the thigh, the infragluteal fold, the skin over the ischial tuberosity, but additionally the lateral anal region, scrotum or labium majus via the perineal branch.

Methods: We described the pathophysiological features of cluneal neuralgia, the surgical an approach and our preliminary results.

Results: we performed a transmuscular technique leading to the fat of the deep gluteal region. Expedition was continued cranially underneath the piriformis, looking for potential entrapments affecting the posterior femoral cutaneous nerve and the sciatic nerve. Nerve decompression ~ above the lateral surface of the ischial tuberosity was then performed. A consistent anatomical finding must be highlighted: the presence of a lateral fibrous development from the ischium passing behind the nerves and also vessels, especially the posterior femoral cutaneous nerve and also its perineal branches. In our patients, release of this expansion allowed decompression of the nerve trapped through this expansion.

Conclusion: Cluneal neuralgia constitutes a distinct entity the perineal pain, which should be identified and also distinguished from pudendal neuralgia. Surgery need to be perform via a transgluteal approach. A lateral ischial obstacle must be investigated, in the form of a consistent fibrous expansion, which, like a retinaculum, can cause nerve entrapment.


Keywords: Cluneal; Neuralgia; Operative technique; Posterior femoral cutaneous nerve; Surgical; Transgluteal approach.