Macroscopic observations of muscular bundles of accessory iliopsoas muscle as the cause of femoral nerve compression

J Orthop. 2018 Dec 21;16(1):64-68. doi: 10.1016/j.jor.2018.12.009. eCollection 2019 Jan-Feb.

Abstract

Compression of the femoral nerve (FN) to the iliac fossa has been reported as a consequence of several pathologies as well as due to the aberrant muscles. The purpose of this research was to investigate the patterns of the accessory muscles of iliopsoas muscles and the relationship of the FN in fifty semi pelvis. Accessory muscular slips from iliacus and psoas, piercing or covering the FN, were found in 19 specimens (7.9%). Based on the macroscopic structure, the muscle was categorized into two types. Pattern 1 as the more frequent variation, was sheet muscular type covering the FN (17 specimens, 89.5%). Pattern 2, the less frequent variation was found on a muscular slip covering the FN (2 specimens, 10.5%). Iliac and psoas muscles and their variants on both types were defined. Appraising the relation between the muscle and the nerves, each disposition of the patterns may be a potential risk for nerve entrapment. The knowledge about the possible variations of the iliopsoas muscle complex and the FN may also give surgeons confidence during pelvic surgery. Recognition of these variations in normal anatomy may be useful to the clinicians when treating patients with refractory leg pain.

Keywords: Compression; Entrapment syndrome; Femoral nerve; Iliacus muscle; Leg pain; Muscular variations; Neuropathic pain; Peripheral nerve stimulation; Psoas major muscle.