Unusual Multiple Branch Variations of the Lumbosacral Plexus: A Cadaveric Case Report
Document Type
Poster
Start Date
28-4-2026 12:00 PM
End Date
28-4-2026 2:00 PM
Description
Background The lumbosacral plexus gives rise to major peripheral nerves of the lower limb. While variations in U1e plexus including the sciatic nerve formatlon and course are well documented and clinically relevant to surgery, regional anesthesia, and deep gluteal pain syndromes, complex branching patterns beyond established· classifications remain uncommon and-underreported.
Methods During a routine cadaveric dissection conducted for a physical therapy educational laboratory, the gluteal and pelvic regions of a male specimen were systematically explored. Neurovascular structures were traced from their pelvic origins to distal trajectories. Anatomical variants were documented photographically, and their relationships with surrounding musculature and landmarks were recorded.
Results On the left side, the sciatic nerve demonstrated early bifurcation within the pelvis, with the common fibular. division traversing the piriformis muscle. A large accessory branch (V1) emerged alongside the superior gluteal nerve and subdivided into secondary branches that pierced the piriformis. These branches contributed to innervation of the gluteus maximus and the posterior femoral cutaneous nerve, while one branch joined the sciatic nerve distally. Fascial integration of the variant branches was observed prior to their re~separation into typical terminal nerves. The contralateral side exhibited conventional anatomy.
Conclusion This case illustrates a rare and complex variation of the lumbosacral plexus involving early sciatic bifurcation, trans~piriforrnis passage, and multiple accessory motor-sensory branches. Recognition of such variants is critical for diagnostic accuracy, surgical planning, and rehabilitation, particularly in patients with atypical or persistent gluteal and lower limb pain.
Recommended Citation
Luong, Vicky; Corsino, Robert-Basilio-Candido; and Keiff, Jacob, "Unusual Multiple Branch Variations of the Lumbosacral Plexus: A Cadaveric Case Report" (2026). School of Allied Health Professions Research Day. 42.
https://digitalscholar.lsuhsc.edu/ahrd/2026/posters/42
Unusual Multiple Branch Variations of the Lumbosacral Plexus: A Cadaveric Case Report
Background The lumbosacral plexus gives rise to major peripheral nerves of the lower limb. While variations in U1e plexus including the sciatic nerve formatlon and course are well documented and clinically relevant to surgery, regional anesthesia, and deep gluteal pain syndromes, complex branching patterns beyond established· classifications remain uncommon and-underreported.
Methods During a routine cadaveric dissection conducted for a physical therapy educational laboratory, the gluteal and pelvic regions of a male specimen were systematically explored. Neurovascular structures were traced from their pelvic origins to distal trajectories. Anatomical variants were documented photographically, and their relationships with surrounding musculature and landmarks were recorded.
Results On the left side, the sciatic nerve demonstrated early bifurcation within the pelvis, with the common fibular. division traversing the piriformis muscle. A large accessory branch (V1) emerged alongside the superior gluteal nerve and subdivided into secondary branches that pierced the piriformis. These branches contributed to innervation of the gluteus maximus and the posterior femoral cutaneous nerve, while one branch joined the sciatic nerve distally. Fascial integration of the variant branches was observed prior to their re~separation into typical terminal nerves. The contralateral side exhibited conventional anatomy.
Conclusion This case illustrates a rare and complex variation of the lumbosacral plexus involving early sciatic bifurcation, trans~piriforrnis passage, and multiple accessory motor-sensory branches. Recognition of such variants is critical for diagnostic accuracy, surgical planning, and rehabilitation, particularly in patients with atypical or persistent gluteal and lower limb pain.