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The origin variability of the iliolumbar artery and iatrogenic sciatica

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Abstract

The iliolumbar artery (ILA) is a standard branch from the posterior trunk of the internal iliac artery. It is the only pelvic artery ascending from pelvic cavity. Current study comprises 171 cadavers dissection to assess the origin variability of ILA. The present study identified the incidence of the ILA origin variability in Caucasian population which also clarified the iliolumbar variability in males and females. The current study shows that the ILA arises from the common iliac artery in 2 %, from the external iliac artery in 0.3 % and from the internal iliac artery in 13.8 % either from its dorsal or dorsomedial aspects in 1 and 12.8 %, respectively. The common, external and internal iliac arteries are defined as a high (early) origin and occurred in 16.1 %. The posterior trunk of the internal iliac artery is the most common origin of the ILA found to be in 77.9 %. Occasionally, it also arose from the superior gluteal artery (0.7 %) and the sciatic artery (0.3 %). Furthermore, the ILA arises from the anterior trunk indirectly as from the inferior gluteal artery in 0.3 %. The ILA arising from the superior or inferior gluteal artery or from the sciatic artery is defined as a low (delayed) origin and occurred in 1.3 %. In contrast, the ILA was 4.7 %. Consequently, variability of the ILA leads to vascular variability of the lumbosacral trunk of the sciatic nerve. Clinicians have to be aware of these variations to avoid unnecessary ligation to prevent sciatic neuropathy.

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References

  1. Carter H (ed) (1867) Anatomy descriptive and surgical. Philadelphia, London, pp 429–446

    Google Scholar 

  2. Sharpey W, Thomson A, Cleland J (eds) (1867) Quain’s elements of anatomy, 7th edn. Longmans, Green and Co, London, pp 418–442

    Google Scholar 

  3. Wilson E (ed) (1868) A system of human anatomy, general and special, 7th edn. Philadelphia, London, pp 323–333

    Google Scholar 

  4. Feneis H, Dauber W (2007) Pocket atlas of human anatomy, 4th edn. Wemding Stuttgart, Germany, pp 264–272

    Google Scholar 

  5. Quain R (1844) The anatomy of the arteries of the human body. Taylor and Walton, London

    Google Scholar 

  6. Day MH (1964) The blood supply of the lumbar and sacral plexuses in the human foetus. J Anat Lond 98(1):105–116

    CAS  Google Scholar 

  7. Quinn SF, Frau DM, Saff GN, Kavanagh J, Roberts W, Cavanagh D, Clark RA (1988) Neurologic complications of pelvic intraarterial chemoembolization performed with collagen material and cisplatin. Radiology 1:55–57

    Article  Google Scholar 

  8. Bergman RA, Thompson SA, Afifi AK, Saadeh FA (1988) Compendium of human anatomic variation: catalog, atlas and world literature. Urban and Schwarzenberg, Baltimore 86

    Google Scholar 

  9. Beck M, Leunig M, Ellis T, Sledge J, Ganz R (2003) The acetabular blood supply: implications for periacetabular osteotomies. Surg Radiol Anat 25(5–6):361–367

    Article  CAS  PubMed  Google Scholar 

  10. Parsons FG, Keith A (1897) Sixth annual report of the committee of collective investigation of the Anatomical Society of Great Britain and Ireland (1895–96). J Anat Physiol 31:31–44

    Google Scholar 

  11. Ebraheim N, Lu J, Biyani A, Yang H (1997) Anatomic considerations of the principal nutrient foramen and artery on internal surface of the ilium. Surg Radiol Anat 19(4):237–239

    Article  CAS  PubMed  Google Scholar 

  12. Chen R, Liu Y, Liu C, Hu Y, Xu D, Zhong S, Li ZH (1999) Anatomic basis of iliac crest flap pedicled on the iliolumbar artery. Surg Radiol Anat 21(2):103–107

    Article  CAS  PubMed  Google Scholar 

  13. Yiming A, Baqué P, Rahili A, Mayer J, Braccini AL, Fontaine A, Leplatois A, Clavé A, Bourgeon A, de Peretti F (2002) Anatomical study of the blood supply of the coxal bone: radiological and clinical application. Surg Radiol Anat 24(2):81–86

    Article  CAS  PubMed  Google Scholar 

  14. Heye S, Nevelsteen A, Maleux G (2005) Internal iliac artery coil embolization in the prevention of potential type 2 endoleak after endovascular repair of abdominal aortoiliac and iliac artery aneurysms: effect of total occlusion versus residual flow. J Vasc Interv Radiol 16:235–239

    Article  PubMed  Google Scholar 

  15. Bleich A, Rahn D, Wieslander C, Wai C, Roshanravan S, Corton M (2007) Posterior division of the internal iliac artery: anatomic variations and clinical applications. Am J Obstet Gynecol 197(6): 658.e1–5

  16. Naguib N, Nour-Eldin N, Hammerstingl R, Lehnert T, Floeter J, Zangos S, Vogl TJ (2008) Three-dimensional reconstructed contrast-enhanced MR angiography for internal iliac artery branch visualization before uterine artery embolization. J Vasc Interv Radiol 19(11):1569–1575

    Article  PubMed  Google Scholar 

  17. Kiray A, Akçalı O, Tayefi H, Koşay C, Ergür I (2010) Anatomical variations of iliolumbar artery and its relation with surgical landmarks. Acta Orthop Traumatol Turc 44(6):464–468. doi:10.3944/AOTT.2010.2347

    Article  PubMed  Google Scholar 

  18. Rusu MC, Cergan R, Dermengiu D, Curcă GC, Folescu R, Motoc AGM, Jianu AM (2010) The iliolumbar artery—anatomic considerations and details on the common iliac artery trifurcation. Clin Anat 23(1):93–100

    CAS  PubMed  Google Scholar 

  19. Teli CG, Katate NN, Kothandaraman U (2013) Morphometry of the iliolumbar artery and the iliolumbar veins and their correlations with the lumbosacral trunk and the obturator nerve. JCDR 7(3):422–426. doi:10.7860/JCDR/2013/4763.2789

    PubMed Central  PubMed  Google Scholar 

  20. Winters HA, van Harten SM, van Royen BJ (2002) The iliolumbar artery as the nutrient pedicle for an iliac crest graft: a new technique in reconstruction of the lumbar spine. Plast Reconstr Surg 109(1):249–252

    Article  PubMed  Google Scholar 

  21. Elliot KA, Smit JH (2006) Anomalies in the branching pattern of the internal iliac artery. J Anat 209:578

    Google Scholar 

  22. Yoon W, Kim JK, Jeong YY, Seo JJ, Park JG, Kang HK (2004) Pelvic arterial hemorrhage in patients with pelvic fractures: detection with contrast-enhanced CT1. Radiographics 24:1591–1605

    Article  PubMed  Google Scholar 

  23. Lipshutz B (1918) A composite study of the hypogastric artery and its branches. Ann Surg 67:584–608

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Bilhim T, Casal D, Furtado A, Pais D, Erse J, O’Neill G, Pisco JM (2011) Branching patterns of the male internal iliac artery: imaging findings. Surg Radiol Anat 33:151–159

    Article  PubMed  Google Scholar 

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Acknowledgments

We would like to thank the entire staffs in the Centre for Anatomy and Human Identification, University of Dundee, and Anatomisches Institut, Karl-Franzens-Universitat Graz, for providing the essential facilities for the preparation of the study as well as King Saud bin Abdulaziz University for Health Sciences for their support.

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Correspondence to Waseem Al Talalwah.

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Al Talalwah, W., Al Dorazi, S.A. & Soames, R. The origin variability of the iliolumbar artery and iatrogenic sciatica. Eur J Orthop Surg Traumatol 25 (Suppl 1), 199–204 (2015). https://doi.org/10.1007/s00590-014-1548-3

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  • DOI: https://doi.org/10.1007/s00590-014-1548-3

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