THE ANATOMICAL OVERVIEW OF A TUNNEL SYNDROME OF A PUDENDAL NEUROVASCULAR FASCICLE

Abstract

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Aim. During our study we decided to allocate a projection and topographic-anatomic features of a pudendal neurovascular fascicle from foramen infrapiriforme, to define its projection in the gluteal region in order to improve diagnostics and treatment. Material and Methods. Аnatomical research performed on 15 corpses. Each of them included 30 internal pudendal spinal nerve fascicle (SNF). Results and Discussion. As a result of the study was defined that pudendal vessels and a nerve are defined in a small gap at the entrance of Alcock channel, formed by sacrotuberous ligament sacrospinal ligament, and ischial tuberosity. The gap is defined as the threshold of the Alcock channel in the gluteal region. We have defined the walls limiting it: the forward wall is a sacrospinalligament, the back wall is a sacrotuberous ligament, the lower wall - a ischial tuberosity. The threshold was divided into 2 segments. The first segment - from an exit of foramen infrapiriforme to the upper edge of a sacrotuberous ligament. The second- from the upper edge ofa sacrotuberous ligament. To determine a projection of apudendal SNF there was calculated an average distance from the median body line to foramen infrapiriforme. In the entrance between a sacrotuberous ligament and a sacrospinal ligament the nerve is fixed. Conclusions. In all cases the epineurium of trunks of sciatic, posterior femoral and pudental nerves was bound in the field of a sacral plexus that can possibly have the reflected character and clinical implications such as syndrome of a piriform muscle and tunnel syndrome of a sexual nerve.