Anatomy and landmarks for the superior and middle cluneal nerves: application to posterior iliac crest harvest and entrapment syndromes.

06:00 EDT 3rd September 2010 | BioPortfolio

Summary of "Anatomy and landmarks for the superior and middle cluneal nerves: application to posterior iliac crest harvest and entrapment syndromes."

Object To date, only scant descriptions of the cluneal nerves are available. As these nerves, and especially the superior group, may be encountered and injured during posterior iliac crest harvest for spinal arthrodesis procedures, the present study was performed to better elucidate their anatomy and to provide anatomical landmarks for their localization. Methods The superior and middle cluneal nerves were dissected from their origin to termination in 20 cadaveric sides. The distance between the posterior superior iliac spine (PSIS) and superior cluneal nerves at the iliac crest and the distance between this bony prominence and the origin of the middle cluneals were measured. The specific course of each nerve was documented, and the diameter and length of all cluneal nerves were measured. Results Superior and middle cluneal nerves were found on all sides. An intermediate superior cluneal nerve and lateral superior cluneal nerve were not identified on 4 and 5 sides, respectively. The superior cluneal nerves always passed through the psoas major and paraspinal muscles and traveled posterior to the quadratus lumborum. The mean diameters of the superior and middle cluneal nerves were 1.1 and 0.8 mm, respectively. From the PSIS, the superior cluneal branches passed at means of 5, 6.5, and 7.3 cm laterally on the iliac crest. At their origin, the middle cluneal nerves had mean distances of 2 cm superior to the PSIS, 0 cm from the PSIS, and 1.5 cm inferior to the PSIS. In their course, the middle cluneal nerves traversed the paraspinal muscles attaching onto the dorsal sacrum. Conclusions Knowledge of the cutaneous nerves that cross the posterior aspect of the iliac crest may assist in avoiding their injury during bone harvest. Additionally, an understanding of the anatomical pathway that these nerves take may be useful in decompressive procedures for entrapment syndromes involving the cluneal nerves.


Section of Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama;

Journal Details

This article was published in the following journal.

Name: Journal of neurosurgery. Spine
ISSN: 1547-5646
Pages: 356-9


DeepDyve research library

PubMed Articles [11453 Associated PubMed Articles listed on BioPortfolio]

The endoscopic anatomy of the middle ear approach to the fundus of the internal acoustic canal.

OBJECTIVE The application of the endoscope in the lateral skull base increases the importance of the middle ear cavity as the corridor to the skull base. The aim of this study was to define the middle...

Microsurgical resection of ambient cistern arteriovenous malformation.

The middle tentorial incisural space, located lateral to the midbrain and medial to the temporal lobe, contains the ambient cistern through which courses the third, fourth, and fifth cranial nerves, p...

Anatomical consideration for the technique of nerve-sparing during radical hysterectomy for cervical cancer.

Radical hysterectomy (RH) is an effective treatment for early-stage cervical cancer IA2 to IIA1 but RH is often associated with several significant complications such as urinary, anorectal and sexual ...

Topographic anatomy of the great auricular point: landmarks for its localization and classification.

The great auricular point (GAP) marks the exit of the great auricular nerve at the posterior border of the sternocleidomastoid muscle (SCM). It is a key landmark for the identification of the spinal a...

The thoracic surface anatomy of adult black South Africans: A reappraisal from CT scans.

Surface landmarks or planes taught in anatomy curricula derive from standard anatomical textbooks. Although many surface landmarks are valid, clear age, sex and population differences exist. We reappr...

Clinical Trials [2982 Associated Clinical Trials listed on BioPortfolio]

Comparing Postoperative Functional Recovery and Analgesic Efficacy of a Single Shot Sciatic Nerve Block Versus Posterior Capsule/Fat Pad Infiltration of Local Anesthetic for Total Knee Arthroplasty

Many methods of pain relief have been implemented in an attempt to provide safe and effective analgesia for patients following total knee arthroplasty. Numerous studies have demonstrated t...

Anatomy Study in Control Nerve From Normal Human

1. To explore the pathology of nerve, vasculature in the normal control nerve 2. Compare the pathology of control nerve and nerve from amputated limb of diabetes

DHACM in Robotic Assisted Laparoscopic Prostatectomy (RALP)

The investigators will examine the beneficial impacts of applying of dHACM on the preserved neurovascular bundles (cavernosal nerves) and the prostate bed during robotic assisted laparosco...

Ultrasound-assisted Spinal Anaesthesia in Patients With Difficult Anatomical Landmarks

Spinal anesthesia is the technique of choice in patients undergoing total joint arthroplasty at Toronto Western Hospital (UHN). The most significant predictor of the ease of performance of...

Embolectomy in Acute SYlvian Thrombosis in Refractory or Ineligible Patients to ALteplase

This trial aims at comparing two strategies currently used to address acute ischemic stroke of the middle cerebral artery : medical treatment without endovascular treatment on the one hand...

Medical and Biotech [MESH] Definitions

The compartment containing the anterior extremities and half the inferior surface of the temporal lobes (TEMPORAL LOBE) of the cerebral hemispheres. Lying posterior and inferior to the anterior cranial fossa (CRANIAL FOSSA, ANTERIOR), it is formed by part of the TEMPORAL BONE and SPHENOID BONE. It is separated from the posterior cranial fossa (CRANIAL FOSSA, POSTERIOR) by crests formed by the superior borders of the petrous parts of the temporal bones.

The middle portion of the pharynx that lies posterior to the mouth, inferior to the SOFT PALATE, and superior to the base of the tongue and EPIGLOTTIS. It has a digestive function as food passes from the mouth into the oropharynx before entering ESOPHAGUS.

The part of the hypothalamus posterior to the middle region consisting of several nuclei including the medial mamillary nucleus, lateral mamillary nucleus, and posterior hypothalamic nucleus (posterior hypothalamic area). The posterior hypothalamic area is concerned with control of sympathetic responses and is sensitive to conditions of decreasing temperature and controls the mechanisms for the conservation and increased production of heat.

The infratentorial compartment that contains the CEREBELLUM and BRAIN STEM. It is formed by the posterior third of the superior surface of the body of the sphenoid (SPHENOID BONE), by the occipital, the petrous, and mastoid portions of the TEMPORAL BONE, and the posterior inferior angle of the PARIETAL BONE.

A polygonal anastomosis at the base of the brain formed by the internal carotid (CAROTID ARTERY, INTERNAL), proximal parts of the anterior, middle, and posterior cerebral arteries (ANTERIOR CEREBRAL ARTERY; MIDDLE CEREBRAL ARTERY; POSTERIOR CEREBRAL ARTERY), the anterior communicating artery and the posterior communicating arteries.

Quick Search

DeepDyve research library

Relevant Topics

Neurology - Central Nervous System (CNS)
Alzheimer's Disease Anesthesia Anxiety Disorders Autism Bipolar Disorders Dementia Epilepsy Multiple Sclerosis (MS) Neurology Pain Parkinson's Disease Sleep Disorders Neurology is the branch of me...

Osteoporosis is a disease in which the bones become extremely porous, are subject to fracture, and heal slowly, occurring especially in women following menopause and often leading to curvature of the spine from vertebral collapse. Follow and track&n...

Pediatrics is the general medicine of childhood. Because of the developmental processes (psychological and physical) of childhood, the involvement of parents, and the social management of conditions at home and at school, pediatrics is a specialty. With ...