Yıl 2018, Cilt 57, Sayı 2, Sayfalar 88 - 93 2018-06-28

Variant anatomy of sciatic nerve and their clinical implications
Siyatik sinirin varyasyon anatomisi ve klinik yansımaları

Z. Aslı Aktan İkiz [1] , Okan Bilge [2] , Hülya Üçerler [3] , Servet Çelik [4] , Erengül Boduç [5]

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Aim: The aim of present study was to demonstrate the variations of piriformis muscle, sciatic nerve and its branches and discuss their clinical importance.

Materials and Methods: Fifty-two gluteal and lower limb regions of 26 formalin fixed male cadavers were evaluated in Ege University Faculty of Medicine, Department of Anatomy. The anatomical relationship between the sciatic nerve and the piriformis muscle, and division level of sciatic nerve in thigh was recorded. 

Results: The sciatic nerve exited the pelvis as a single branch through the infrapiriform foramen with no variation in 84.62% of the lower limbs. The division variations of sciatic nerve were determined in 23.08%. In 8 of 12 high divisions were observed in gluteal regions (15.38%). The common peroneal nerve and the tibial nerve entered deep gluteal region via the greater sciatic foramen below piriformis muscle separately in four lower limbs (7.69%). Two separate nerve divisions passed above and through (or below) the piriformis muscle and then combined together to form common peroneal nerve while tibial nerve passing below the piriformis muscle in 4 lower limbs (7.69%). In 2 of 12, high division occurred in the 1/3 upper portion of the thigh unilaterally (3.85%). The division of sciatic nerve in the popliteal fossa was seen in two lower limbs (3.85%).

Conclusion: The clinical importance of the sciatic nerve around the piriformis muscle or in the thigh was discussed for piriformis syndrome, palsy after total hip arthroplasty, intramuscular injections in gluteal region and failed popliteal nerve block.

Amaç: Çalışmanın amacı musculus piriformis, siyatik sinir ve dallarının varyasyonlarını göstermek ve klinik önemini tartışmaktır.

Gereç ve Yöntem: Ege Üniversitesi Tıp Fakültesi, Anatomi Anabilim Dalı’nda formalin ile fikse edilmiş 26 erkek kadavraya ait 52 adet gluteal bölge ve alt ekstremite değerlendirildi. Siyatik sinir ve musculus piriformis arasındaki anatomik ilişki ile uylukta siyatik sinirin dallanma seviyesi kaydedildi.

Bulgular: Alt ekstremitelerin %84.62’sinde siyatik sinir pelvisten tek dal halinde, varyasyonsuz olarak çıktı. Siyatik sinirin dallanma varyasyonu %23.08 olarak tespit edildi. On iki adet olarak bulunan yüksekten ayrılmanın 8’i gluteal bölgede idi (%15.38). Dört alt ekstremitede (%7.69) nervus peroneus communis ve nervus tibialis derin gluteal bölgeye foramen ischiadicum majus yolu ile musculus piriformis’in altından ayrı ayrı girdi. Dört alt ekstremitede ise (%7.69) iki ayrı dal musculus piriformis’in üzerinden, içinden (ya da altından) geçti ve nervus tibialis musculus piriformis’in altından geçerken bu iki dal da nervus peroneus communis’i oluşturmak üzere daha sonra birleşti. On iki örneğin ikisinde, yüksekte ayrılma unilateral olarak uyluğun 1/3 üst bölümünde izlendi. Siyatik sinirin fossa poplitea’da dallarına ayrılması da iki alt ekstremitede görüldü (%3.85).

Sonuç: Siyatik sinirin musculus piriformis çevresindeki veya uyluktaki varyasyonları; piriformis sendromu, total kalça protezi sonrası ortaya çıkan paralizi, gluteal bölgeye uygulanan intramusküler enjeksiyonlar ve başarısız popliteal sinir bloğu yönü ile tartışıldı.

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Dergi Bölümü Araştırma Makaleleri
Yazarlar

Orcid: 0000-0001-8949-1691
Yazar: Z. Aslı Aktan İkiz (Sorumlu Yazar)
Kurum: Ege University Faculty of Medicine, Department of Anatomy, İzmir
Ülke: Turkey


Orcid: 0000-0002-8993-2271
Yazar: Okan Bilge
Kurum: Ege University Faculty of Medicine, Department of Anatomy, İzmir
Ülke: Turkey


Orcid: 0000-0002-8261-9442
Yazar: Hülya Üçerler
Kurum: Ege University Faculty of Medicine, Department of Anatomy, İzmir
Ülke: Turkey


Orcid: 0000-0002-1102-4417
Yazar: Servet Çelik
Kurum: Ege University Faculty of Medicine, Department of Anatomy, İzmir
Ülke: Turkey


Orcid: 0000-0001-8872-1993
Yazar: Erengül Boduç
Kurum: Ege University Faculty of Medicine, Department of Anatomy, İzmir
Ülke: Turkey


Bibtex @araştırma makalesi { etd414980, journal = {Ege Tıp Dergisi}, issn = {1016-9113}, eissn = {2147-6500}, address = {Ege Üniversitesi}, year = {2018}, volume = {57}, pages = {88 - 93}, doi = {10.19161/etd.414980}, title = {Variant anatomy of sciatic nerve and their clinical implications}, key = {cite}, author = {Aktan İkiz, Z. Aslı and Çelik, Servet and Bilge, Okan and Üçerler, Hülya and Boduç, Erengül} }
APA Aktan İkiz, Z , Bilge, O , Üçerler, H , Çelik, S , Boduç, E . (2018). Variant anatomy of sciatic nerve and their clinical implications. Ege Tıp Dergisi, 57 (2), 88-93. DOI: 10.19161/etd.414980
MLA Aktan İkiz, Z , Bilge, O , Üçerler, H , Çelik, S , Boduç, E . "Variant anatomy of sciatic nerve and their clinical implications". Ege Tıp Dergisi 57 (2018): 88-93 <http://dergipark.gov.tr/etd/issue/36516/414980>
Chicago Aktan İkiz, Z , Bilge, O , Üçerler, H , Çelik, S , Boduç, E . "Variant anatomy of sciatic nerve and their clinical implications". Ege Tıp Dergisi 57 (2018): 88-93
RIS TY - JOUR T1 - Variant anatomy of sciatic nerve and their clinical implications AU - Z. Aslı Aktan İkiz , Okan Bilge , Hülya Üçerler , Servet Çelik , Erengül Boduç Y1 - 2018 PY - 2018 N1 - doi: 10.19161/etd.414980 DO - 10.19161/etd.414980 T2 - Ege Tıp Dergisi JF - Journal JO - JOR SP - 88 EP - 93 VL - 57 IS - 2 SN - 1016-9113-2147-6500 M3 - doi: 10.19161/etd.414980 UR - http://dx.doi.org/10.19161/etd.414980 Y2 - 2017 ER -
EndNote %0 Ege Tıp Dergisi Variant anatomy of sciatic nerve and their clinical implications %A Z. Aslı Aktan İkiz , Okan Bilge , Hülya Üçerler , Servet Çelik , Erengül Boduç %T Variant anatomy of sciatic nerve and their clinical implications %D 2018 %J Ege Tıp Dergisi %P 1016-9113-2147-6500 %V 57 %N 2 %R doi: 10.19161/etd.414980 %U 10.19161/etd.414980
ISNAD Aktan İkiz, Z. Aslı , Bilge, Okan , Üçerler, Hülya , Çelik, Servet , Boduç, Erengül . "Siyatik sinirin varyasyon anatomisi ve klinik yansımaları". Ege Tıp Dergisi 57 / 2 (Haziran 2018): 88-93. http://dx.doi.org/10.19161/etd.414980